Topical corticosteroids and Staphylococcus aureus in atopic dermatitis

Nilsson, Eskil; Henning, Claes; Magnusson, Jelena

doi:10.1016/0190-9622(92)70151-5

Cited by 171 publications

(92 citation statements)

References 17 publications

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“…This indicates that the reduction of S. aureus is probably a secondary phenomenon, possibly being due to less favorable skin conditions for colonization. It could also explain why in studies, in which potent topical glucocorticosteroids were applied for a period of 7 days or longer, a significant reduction of S. aureus was demonstrated that was not substantially increased by combining the steroid with an antibiotic [19, 20]. However, data about the kinetics of antibacterial and clinical efficacy are lacking in these studies.…”

Section: Discussionmentioning

confidence: 99%

Effect of Gentian Violet, Corticosteroid and Tar Preparations in <i>Staphylococcus</i>-aureus-Colonized Atopic Eczema

et al. 1999

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Background: In atopic eczema (AE), skin colonization with Staphylococcus aureus plays a possible role in the pathophysiology of the disease. Methods: Thirty-eight patients with AE were screened for their cutaneous colonization with S. aureus. The antibacterial and clinical efficacy of topical therapy with the antiseptic dye gentian violet, a potent glucocorticosteroid or a tar solution (liquor carbonis detergens) was evaluated in vivo in 21 patients with a density of >10⁴ CFU/cm² and in vitro. Skin sites were treated twice daily for 4 days with the active drug or a corresponding control. Quantification of S. aureus was done daily during therapy as well as 3 days thereafter. The severity of the lesions was rated by a regional SCORAD. Results: In gentian-violet-treated skin, bacterial density decreased significantly in lesional (p < 0.001) and unaffected skin (p < 0.001). Bacterial densities did not decrease during therapy with glucocorticosteroid or liquor carbonis detergens but dropped afterwards. All therapeutics reduced the severity score, reduction being greatest for the glucocorticosteroid and lowest for liquor carbonis detergens. In vitro, a high antibactericidal efficacy was demonstrated only for gentian violet. Conclusions: Antibacterial therapy with gentian violet not only reduces S. aureus dramatically, but also reduces the severity of the eczema. Reduction of S. aureus after therapy with glucocorticosteroids and LCD seems to be secondary to improvement of the skin condition.

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Section: Discussionmentioning

confidence: 99%

Effect of Gentian Violet, Corticosteroid and Tar Preparations in <i>Staphylococcus</i>-aureus-Colonized Atopic Eczema

et al. 1999

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“…Five of the missing trials [248][249][250][251][252] most likely do not appear in the GREAT database owing to differences between the inclusion criteria of the review and the GREAT database, or their interpretation. The inclusion criteria for the GREAT database are broad and were designed to encompass all the RCTs of eczema treatment in relation to clinical benefits and harms.…”

Section: Discussionmentioning

confidence: 99%

“…Three trials [248][249][250] did not fit the GREAT database inclusion criteria primarily owing to not giving an adequate description of randomisation having occurred.…”

Section: Assessment Of the Trials Missing From The Great Databasementioning

confidence: 99%

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10177. The contractual start date was in September 2008. The final report began editorial review in April 2014 and was accepted for publication in April 2016. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, ...

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“…It has been demonstrated that in patients with AEDS there is a deficiency in the expression of beta-defensins and cathelicidins that may account for the susceptibility to skin infection, especially from Staphilococcus aureus (22). S. Aureus has a major role in AEDS, as indicated by the following features: 1) a very high density of colony-forming units S. aureus per cm 2 of inflamed atopic skin lesions (23); 2) the higher affinity for S. aureus of the atopic skin compared with nonatopic or psoriatic skin (24); 3) the reduction of S. aureus counts on atopic skin sites following effective topical treatment (25)…”

mentioning

confidence: 99%