EFFICACY AND SAFETY OF TOPICAL STEROIDS IN PEDIATRIC ATOPIC-DERMATITIS

Background Atopic dermatitis (AD) affects 10-15% of children in the US A and up to 20% of children in the UK. Topical corticosteroids are the mainstay of therapy to control acute flares of AD in both children an d adults. Aim In paediatric patients, it is especially important to en sure that local application of a corticosteroid used is limited to the least amount needed to produce a therapeutic response, as children ar e particularly prone to systemic adverse effects of these agents. The development of newer corticosteroid molecules is aimed at achieving ma ximum activity and minimal unwanted side effects. Review Mometasone fu roate (Elocon(R)), a medium potency topical corticosteroid, is the onl y topical steroid approved for use in children in the USA, Mometasone furoate undergoes biotransformation in the liver into three different metabolites with very little intrinsic activity. Local side effects ar e minimal, with an atrophogenic potential comparable with that of 1% h ydrocortisone ointment, and the risk of adrenal suppression is low. In clinical trials including over 300 infants and children, once-daily 0 .1% mometasone furoate was found to be statistically significantly mor e effective than twice-daily 1% or 2.5% hydrocortisone, twice-daily 0. 05% alclometasone dipropionate and twice-daily 0.05% fluticasone propi onate. Conclusion The once-daily regimen of mometasone furoate is also useful in promoting compliance and reducing the potential for adverse effects. (C) 1997 Published by Elsevier Science B.V.