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Update on topical glucocorticoid use in children
Keith W Morley1, James G Dinulos
1Dartmouth Medical School, Hanover, New Hampshire, USA. jdinulos@gmail.com
Current Opinion in Pediatrics
|January 10, 2012
Summary
Topical glucocorticoids are safe and effective for children, despite parental fear of side effects. Proper use ensures therapeutic benefits for inflammatory skin conditions.
Area of Science:
- Pediatric Dermatology
- Pharmacology
- Cutaneous Medicine
Background:
- Reviews recent studies on topical glucocorticoid use in pediatric patients.
- Focuses on mechanism of action, potency, absorption, and adverse effects.
- Addresses 'steroid phobia' and its impact on treatment compliance.
Observation:
- Over 80% of patients exhibit fear of side effects, leading to improper use and reduced efficacy.
- Recent studies show no clinically significant hypothalamic-pituitary-adrenal suppression or cutaneous atrophy in children.
- High-potency steroids may cause growth restriction during pregnancy; steroid allergy prevalence is 2.7%.
Findings:
- Topical glucocorticoids are well-tolerated and effective in children.
- Despite 'steroid phobia,' appropriate use is safe and beneficial.
- Clinically significant adverse effects like HPA axis suppression are rare in pediatric populations.
Implications:
- Emphasizes the need for patient education to overcome 'steroid phobia' and improve compliance.
- Highlights the continued role of topical glucocorticoids as a cost-effective treatment for pediatric inflammatory skin conditions.
- Suggests considering steroid allergy in non-responsive cases.
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