Update on topical glucocorticoid use in children.
OBJECTIVE
This monograph reviews recent studies, examining topical glucocorticoid use in children. Emphasis is placed on mechanism of action, relative potency, cutaneous absorption, adverse affects, steroid phobia, and treatment compliance.


RESULTS
Recent literature has shown that over 80% of patients prescribed topical glucocorticoids are fearful of side effects and fail to use them appropriately. This lack of compliance leads to decreased therapeutic benefits. Despite this 'steroid phobia', multiple studies indicate that proper use of glucocorticoids in children is well tolerated and effective. Recent studies have failed to show clinically significant hypothalamic-pituitary-adrenal suppression and cutaneous atrophy in children. High-potency steroids have been shown to cause growth restriction when used during pregnancy. Steroid allergy occurs with a prevalence of 2.7% and should be considered in children who fail to respond as expected to topical glucocorticoids.


CONCLUSIONS
Topical glucocorticoids continue to be well tolerated, effective and cost-effective in the treatment of inflammatory cutaneous conditions in children.
Dartmouth Medical School, Hanover, New Hampshire, USA. jdinulos@gmail.com
Keith W
KW
Morley
James G
JG
Dinulos
D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D017408:Guidelines as Topic; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D010349:Patient Compliance; D011965:Receptors, Glucocorticoid / Q000187:drug effects* / Q000276:immunology
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011965:Receptors, Glucocorticoid; D006854:Hydrocortisone