Giannotti B
Clinica Dermatologica II, University of Florence, Italy.
Drugs. 1988;36 Suppl 5:9-14. doi: 10.2165/00003495-198800365-00004.
The effectiveness of a topical corticosteroid is related to various factors which should be considered when planning treatment. The most relevant factor is the potency of the drug. Another important factor is the absorption through the skin, which is influenced by marked regional variations in percutaneous penetration, hydration and the degree of inflammation present, types of dressings, the solubility of the drug and the age of the patient. Multiple daily applications do not lead to better or faster resolution of the disease. Intermittent therapy with treatment-free intervals, when the vehicle alone is applied, can be as effective as continuous treatment. The choice of a topical corticosteroid depends not only on the severity or activity of the disease, but also on the age of the subject, the body site affected and the extent of the surface area to be treated. In addition, the choice of vehicle depends on the type of lesion and on the body region afflicted. Combinations of a corticosteroid with other agents can be useful, but they are recommended in only a few specific indications. Treatment guidelines for topical corticosteroids must therefore take into account a number of factors which will influence the clinician's ultimate decision in providing care for the patient with steroid-responsive dermatoses.
局部用皮质类固醇的疗效与多种因素有关，在制定治疗方案时应予以考虑。最相关的因素是药物的效力。另一个重要因素是经皮肤吸收，这受到经皮渗透、水合作用、炎症程度、敷料类型、药物溶解度和患者年龄等显著区域差异的影响。每日多次用药并不会使疾病得到更好或更快的缓解。当仅使用基质时，采用有停药间隔的间歇疗法与持续治疗同样有效。局部用皮质类固醇的选择不仅取决于疾病的严重程度或活动度，还取决于受试者的年龄、受累身体部位以及待治疗的表面积大小。此外，基质的选择取决于皮损类型和受累身体区域。皮质类固醇与其他药物联合使用可能有用，但仅在少数特定适应证中推荐。因此，局部用皮质类固醇的治疗指南必须考虑许多因素，这些因素将影响临床医生为患有类固醇反应性皮肤病的患者提供护理时的最终决策。
