Role of the ACTH test and estimation of a safe dose for high potency steroids in vitiligo: A prospective randomized study
| Autor: | Minerva Gómez-Flores, José Gerardo González-González, Fernando J. Lavalle-González, Jorge Ocampo-Candiani, Jesús Zacarías Villarreal Pérez, Leonardo Mancillas-Adame, Alberto de la Fuente-García, Oliverio Welsh-Lozano |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Body surface area
vitiligo medicine.medical_specialty business.industry Vitiligo cortisol lcsh:RL1-803 medicine.disease Placebo Gastroenterology Surgery topical steroids Internal medicine Statistical significance medicine Adrenal insufficiency lcsh:Dermatology Potency Prospective randomized study Original Article Clobetasol propionate business medicine.drug |
| Zdroj: | Indian Dermatology Online Journal, Vol 5, Iss 2, Pp 117-121 (2014) Indian Dermatology Online Journal |
| ISSN: | 2229-5178 |
| Popis: | Background: Topical corticosteroids are used as first line of therapy for vitiligo, although side effects such as adrenal insufficiency are possible. Objectives: To establish the role of ACTH test before, during, and after treatment with high potency topical steroids; to determine if adrenal insufficiency occurs secondary to the use of high potency topical steroids in patients with vitiligo and intact cutaneous barrier; and also to determine response to treatment and side effects. Materials and Methods: Forty-four adults with non-segmental vitiligo affecting 20% or less of the body surface area were included and randomized to receive topical clobetasol propionate 0.05% cream (group 1) or placebo (group 2) for 12 weeks, with a maximum dose of 50 g per week. The placebo group was crossed over after week 6 and started on clobetasol until completion of the study. Serum cortisol levels with the 1 μg ACTH test were determined at baseline and on weeks 6 and 12. Results: No adrenal insufficiency was detected nor statistical significance was achieved when comparing cortisol levels between and within the groups at baseline and weeks 6 and 12. Group 1 had a better response to therapy but with more side effects. Conclusions: Doses of 50 g or less per week of clobetasol during a period of 12 weeks are safe on adult vitiligo patients, although local side effects are possible. Repigmentation rates were incomplete with single steroid therapy, making combined therapy a better option. |
| Databáze: | OpenAIRE |
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