Veien N K, Olholm Larsen P, Thestrup-Pedersen K, Schou G
The Dermatology Clinic, Vesterbro 99, DK-9000 Aalborg, Denmark.
Br J Dermatol. 1999 May;140(5):882-6. doi: 10.1046/j.1365-2133.1999.02819.x.
Chronic hand eczema can be incapacitating, and there is little knowledge of the efficacy and safety of long-term treatment with topical corticosteroids. We compared the efficacy and safety of two different schedules for the treatment of chronic hand eczema with a potent topical corticosteroid, mometasone furoate. In a prospective, open, randomized trial, 120 patients with chronic hand eczema were treated daily with mometasone furoate fatty cream until the dermatitis cleared or for a maximum of 9 weeks. Those who cleared were randomized to treatment for up to 36 weeks with mometasone furoate on Sunday, Tuesday and Thursday (group A), mometasone furoate on Saturday and Sunday (group B) or no further corticosteroid treatment (group C). In the event of relapse, patients were permitted daily treatment with mometasone furoate for 3 weeks on two separate occasions. For 50 of 106 randomized patients, daily treatment for 3 weeks controlled their dermatitis; 29 needed 6 weeks and 27 needed 9 weeks of treatment. During the maintenance phase, 29 of 35 (83%) in group A, 25 of 37 (68%) in group B and nine of 34 (26%) in group C had no recurrences (P = 0.001, chi2-test). Side-effects were minimal. It is concluded that long-term, intermittent treatment of chronic hand eczema with mometasone furoate fatty cream is effective and safe.
慢性手部湿疹可能使人丧失劳动能力，而对于外用糖皮质激素长期治疗的疗效和安全性了解甚少。我们比较了两种不同方案使用强效外用糖皮质激素糠酸莫米松治疗慢性手部湿疹的疗效和安全性。在一项前瞻性、开放性、随机试验中，120例慢性手部湿疹患者每日使用糠酸莫米松乳膏治疗，直至皮炎消退或最长治疗9周。皮疹消退的患者被随机分为三组，分别在周日、周二和周四使用糠酸莫米松（A组），周六和周日使用糠酸莫米松（B组），或不再接受糖皮质激素治疗（C组），治疗长达36周。若病情复发，允许患者在两个不同时段每日使用糠酸莫米松治疗3周。106例随机分组患者中，50例经3周每日治疗控制了皮炎；29例需要6周治疗，27例需要9周治疗。在维持治疗阶段，A组35例中有29例（83%）、B组37例中有25例（68%）、C组34例中有9例（26%）未复发（χ2检验，P = 0.001）。副作用极小。结论是，长期、间歇性使用糠酸莫米松乳膏治疗慢性手部湿疹有效且安全。
