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Topical corticosteroids for skin disorders in infants and children
1Paediatric Dermatology, Hospitals for Sick Children, London, United Kingdom.
Insights
Topical corticosteroids are vital for treating childhood eczema and inflammatory skin conditions. Careful monitoring and avoiding potent steroids are crucial due to potential side effects in children.
Area of Science:
- Pediatric Dermatology
- Dermatological Therapeutics
Background:
- Topical corticosteroids are a cornerstone in managing pediatric inflammatory dermatoses, including atopic eczema.
- Conditions like infantile seborrhoeic eczema, pompholyx, and contact dermatitis often require corticosteroid treatment.
Purpose of the Study:
- To review the appropriate use of topical corticosteroids in pediatric dermatology.
- To highlight specific conditions where these treatments are indicated or not recommended.
- To emphasize safety considerations and monitoring for pediatric patients.
Main Methods:
- Review of current clinical practices and literature regarding topical corticosteroid use in children.
- Discussion of the wet wrap technique as an inpatient crisis intervention for acute erythrodermic eczema.
- Identification of specific dermatoses where topical corticosteroids may not be necessary or beneficial.
Main Results:
- The wet wrap technique is effective for acute erythrodermic eczema in inpatients over 3-5 days.
- Topical corticosteroids are not typically required for conditions like pityriasis alba, perioral eczema, or juvenile plantar dermatosis.
- Children are at higher risk for side effects from topical corticosteroids.
Conclusions:
- Judicious use of topical corticosteroids is essential in pediatric dermatology.
- Close patient monitoring and avoidance of potent agents are critical to minimize adverse effects in children.
- Treatment decisions should be individualized based on the specific dermatosis and patient risk factors.
Abstract:
Topical corticosteroids are an essential part of the treatment regimen of children with atopic eczema and a number of other inflammatory dermatoses, such as infantile seborrhoeic eczema, pompholyx and contact dermatitis. A special form of treatment, the 'wet wrap technique, has been found to be effective in treating children with acute erythrodermic eczema in an inpatient setting. Therapy usually lasts for 3 to 5 days and is useful as crisis intervention therapy. On the other hand, in some conditions, for example pityriasis alba, perioral eczema or juvenile plantar dermatosis, therapy with these agents is generally not required or may not be useful. It is important to remember that care must be taken when a topical corticosteroid is prescribed in children, since this age group is particularly at risk of developing side effects. Thus, the patient should be monitored closely, and potent agents should be avoided.