Corticosteroids: Options in the era of steroid-sparing therapy

Rosso, James Del; Friedlander, Sheila Fallon

doi:10.1016/j.jaad.2005.04.030

Cited by 130 publications

(105 citation statements)

References 54 publications

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“…In the natural course of steroid atrophy, the first event is represented by a reduction in epidermal thickness [5], which is potentially reversible with early treatment readjustment [36]. Extended steroid use leads to additional dermal deterioration and striae formation which, unlike epidermal atrophy, tend to be persistent or irreversible [22].…”

Section: Discussionmentioning

confidence: 99%

“…The first-line treatment for mild forms of disease consists of topical corticosteroids [3][4][5][6], with skin atrophy being the most severe potential side effect at the site of treatment [5,6]. The severity of the disease and the response to treatment are generally assessed using clinical scoring systems [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…More frequently, steroidinduced skin atrophy in psoriasis is assessed based on clinical examination [6]. In particular, use of low-potency corticosteroid for short periods of time is generally considered risk-free, with no development of skin atrophy [5]. However, clinically evident skin atrophy in response to six-week hydrocortisone application has been reported [21].…”

Section: Introductionmentioning

confidence: 99%

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Conventional ultrasonography and sonoelastography in the assessment of plaque psoriasis under topical corticosteroid treatment – work in progress

et al. 2014

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Aims: The objective of the study was to compare the efficiency of 20 MHz skin ultrasonography and 40 MHz conventional ultrasonography in the assessment of plaque psoriasis and to assess the efficiency of 40 MHz real-time sonoelastography in the early detection of steroid-induced skin atrophy in psoriatic plaques. Patients and methods: Ultrasonographic blinded evaluation was performed on 16 plaques in three consecutive patients, at baseline and after hydrocortisone acetate 1% ointment six-week application. The parameters were epidermal and dermal thicknesses for gray-scale ultrasonography and strain ratio for sonoelastography. Strain ratio was computed between the dermis and the adjacent hypodermis. Student's t-test for paired samples was performed. A confidence level of p<.05 was considered significant. Results: At follow-up, epidermal thickness was significantly reduced with 20 MHz (p = .002) and 40 MHz sonography (p = .032), while dermal thickness varied insignifcantly with 20 MHz (p = .35) and 40 MHz sonography (p = .33). Measurements at 40 MHz were significantly higher than their 20 MHz counterparts at baseline (epidermis: p < .001; dermis: p = .003) and at follow-up (epidermis: p < .001; dermis: p = .001). Strain ratio revealed no significant change of dermal elasticity (p = .96). Conclusions: Although epidermal and dermal measurements varied significantly with 20 MHz and 40 MHz ultrasonography, both techniques efficiently quantified treatment response by measuring the reduction of epidermal thickness. Sonoelastographic findings were consistent with the expected outcome of short-term use of low-potency corticosteroid. Further studies are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Conventional ultrasonography and sonoelastography in the assessment of plaque psoriasis under topical corticosteroid treatment – work in progress

et al. 2014

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“…They are very effective at mitigating inflammation; however, their side effects limit their long term use. Many of the new treatments are being sought as corticosteroids sparing alternatives (Del Rosso & Friedlander, 2005). Mechanism of Action: Corticosteroids bind intracellular receptors forming dimers that bind to the glucocorticoid response element of the promoter region of steroid responsive genes, which up regulates 10-100 genes (Bolognia et al, 2008).…”

Section: Corticosteroidsmentioning

confidence: 99%

Natural Products and Dermatological Hypersensitivity Diseases

MacDonald¹,

Kulka²

2012

Allergic Diseases - Highlights in the Clinic, Mechanisms and Treatment

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“…Topical corticosteroids, such as betamethasone valerate (BMV), are the mainstay of treatment for steroid-responsive inflammatory dermatoses, including psoriasis, due to their anti-inflammatory, immunosuppressive, anti-proliferative and vasoconstrictive properties. In general, they inhibit dermal edema, capillary dilatation, movement of inflammatory cells within the skin and cellular proliferation in the dermis and epidermis (21,22).…”

mentioning

confidence: 99%

Efficacy and Tolerability of a New Pharmaceutical Form of Betamethasone Valerate in the Prevention of Hypertrophic Scars following Anterior Trunk Plastic Surgery: A Preliminary Exploratory Study

et al. 2014

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Hypertrophic scars are fibroproliferative diseases of the skin. Many treatment options are now available, but none is completely effective. The primary objective ofthis study was to compare the efficacy of a betamethasone valerate (BMV) 2.25 mg plaster versus no treatment in the prevention of hypertrophic scars after anterior trunk plastic surgery. An exploratory, open, prospective, controlled study was carried out on 16 consecutive patients with postoperative wounds. A 12-week daily treatment was initiated after wounds cicatrisation. The effect of a daily application of the plaster was compared to no treatment by dividing the wound into 2-4 parts. The wound evaluation was performed during the treatment period at 2, 4, 8 and 12 weeks, and 6 months after the end of the treatment. A total of 60 wounds was evaluated. Pain and itching improved in both groups after 12 weeks. However, only the wounds treated with BMV plaster showed a significantly greater and more rapid improvement as compared with the non-treated wounds after 4 and 8 weeks of treatment in all the evaluated parameters (p<0.0001). The efficacy and tolerability of BMV plaster in the prevention of hypertrophic scar development is promising.

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Corticosteroids: Options in the era of steroid-sparing therapy

Cited by 130 publications

References 54 publications

Conventional ultrasonography and sonoelastography in the assessment of plaque psoriasis under topical corticosteroid treatment – work in progress

Conventional ultrasonography and sonoelastography in the assessment of plaque psoriasis under topical corticosteroid treatment – work in progress

Natural Products and Dermatological Hypersensitivity Diseases

Efficacy and Tolerability of a New Pharmaceutical Form of Betamethasone Valerate in the Prevention of Hypertrophic Scars following Anterior Trunk Plastic Surgery: A Preliminary Exploratory Study

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