Rasmussen J E
Arch Dermatol. 1978 Aug;114(8):1165-7.
The real and potential problems associated with the percutaneous absorption of topically applied corticosteroids have been used as an argument against the prolonged administration of these drugs. Many pediatricians and dermatologists consider children to be more likely to absorb substantial quantities of topically applied corticosteroids than adults. This study examines the percutaneous absorption of 0.1% triamcinolone acetonide ointment applied four times a day for a period of six weeks to patients with severe atopic eczema. The results of 8 AM and 4 PM plasma cortisol and 24-hour urinary cortisol determinations do not indicate any notable adrenal suppression. No patient had an 8 AM cortisol value that would be considered in the abnormal range. These results indicate that the use of a medium-strength topical corticosteroid for this length of time probably poses no noteworthy hazard from percutaneous absorption.
局部应用皮质类固醇经皮吸收所带来的实际和潜在问题,已被用作反对长期使用这些药物的论据。许多儿科医生和皮肤科医生认为,儿童比成人更有可能大量吸收局部应用的皮质类固醇。本研究调查了重度特应性皮炎患者每天4次外用0.1%曲安奈德软膏,持续6周后的经皮吸收情况。上午8点和下午4点的血浆皮质醇测定结果以及24小时尿皮质醇测定结果均未显示出任何明显的肾上腺抑制。没有患者上午8点的皮质醇值处于异常范围。这些结果表明,在这段时间内使用中效局部皮质类固醇,经皮吸收可能不会带来显著危害。