Del Rosso James, Friedlander Sheila Fallon
Department of Dermatology, University of Nevada School of Medicine, Las Vegas, Nevada, USA.
J Am Acad Dermatol. 2005 Jul;53(1 Suppl 1):S50-8. doi: 10.1016/j.jaad.2005.04.030.
Topical corticosteroids remain the most commonly used topical treatments for inflammatory dermatoses, including psoriasis and atopic dermatitis. Topical corticosteroids are available in a variety of vehicles-creams, ointments, lotions, gels, and, more recently, foam. The vehicle used can substantially affect the individual agent's clinical action, potency, and acceptability to the patient. Moreover, some vehicles are better suited for specific body areas. Selection of the appropriate product should be determined by area of usage, physician experience, cost, and patient preference, particularly regarding vehicle. Although topical corticosteroids are associated with several side effects, including skin atrophy, telangiectases, purpura, and striae formation, appropriate usage can minimize these occurrences. Judicious use includes short-term, appropriate application as initial monotherapy or in combination strategies with other therapeutic agents that ideally possess complementing mechanisms of action. Examples include pulsing with high-potency topical corticosteroids and combination regimens with other topical agents such as topical calcineurin inhibitors, calcipotriene, or tazarotene. Appropriate education of patients and caregivers alike will facilitate the optimal use of these medications.
外用糖皮质激素仍然是治疗包括银屑病和特应性皮炎在内的炎症性皮肤病最常用的外用药物。外用糖皮质激素有多种剂型，如乳膏、软膏、洗剂、凝胶，最近还有泡沫剂。所使用的剂型会极大地影响单个药物的临床作用、效力以及患者的接受度。此外，一些剂型更适合特定的身体部位。合适产品的选择应根据使用部位、医生经验、成本以及患者偏好来决定，尤其是关于剂型的偏好。尽管外用糖皮质激素会引发多种副作用，包括皮肤萎缩、毛细血管扩张、紫癜和条纹形成，但合理使用可将这些情况的发生降至最低。明智的使用包括短期、适当地作为初始单一疗法使用，或与其他理想情况下具有互补作用机制的治疗药物联合使用。例子包括使用高效外用糖皮质激素进行脉冲治疗，以及与其他外用药物如外用钙调神经磷酸酶抑制剂、卡泊三醇或他扎罗汀联合使用。对患者和护理人员进行适当的教育将有助于这些药物的最佳使用。
