Tchernev Georgi, Zanardelli Matteo, Voicu Cristiana, Bakardzhiev Ilko, Lotti Torello, Lotti Jacopo, França Katlein, Batashki Atanas, Wollina Uwe
Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Polyclinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.
Pharmacology, Toxicology and Innovative Treatments, Rome, Italy.
Open Access Maced J Med Sci. 2017 Jul 19;5(4):539-540. doi: 10.3889/oamjms.2017.081. eCollection 2017 Jul 25.
A 16 years old female patient, affected by atopic dermatitis and rhinoconjunctivitis allergica since childhood, requested a dermatologic consultation for lesions which had appeared after 3 months of local treatment with clobethasole propionate. The histological analysis confirmed the diagnosis of dyshidrotic eczema and the microbiological smears demonstrated a significant infection with . The risk of developing corticosteroids' side-effects depends on the potency of the product, extended period of use and the volume of product applied. Clobetasol propionate is a group I- highly potent corticosteroid, which should be used for a maximum period of 2 weeks. Several authors have found that this agent has cumulative depot effect, persisting in the epidermis for 4 days after only one application. Taking together these observations, sustained by the clinical case presented above, we can conclude that the infectious risks associated with topical corticosteroid treatment must not be neglected, particularly since treated patients are fragile, and frequently have multiple well-known risk factors.
一名16岁女性患者，自幼患有特应性皮炎和变应性鼻结膜炎，在使用丙酸氯倍他索局部治疗3个月后出现皮损，遂请求皮肤科会诊。组织学分析确诊为汗疱疹型湿疹，微生物涂片显示存在显著感染。发生皮质类固醇副作用的风险取决于产品的效力、使用时间长短以及涂抹产品的量。丙酸氯倍他索是一种I类高效皮质类固醇，最长使用期限应为2周。几位作者发现，该药物具有累积储库效应，仅一次涂抹后在表皮中可持续存在4天。综合上述观察结果以及上述临床病例，我们可以得出结论，与局部皮质类固醇治疗相关的感染风险不容忽视，尤其是因为接受治疗的患者较为脆弱，且经常有多种已知风险因素。
