The reservoir effect of topical steroids in vitiliginous skin: A cross-sectional study.
Loading...
Date
2015-07
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: Prolonged and frequent use of topical steroids may lead to decrease in
effi cacy as well as many local adverse effects. Stratum corneum has a unique property of
reservoir effect. Aims: To study the reservoir effect of topical steroids in a steroid-responsive
condition which may enable a decrease in the dosing frequency of topical steroids.
Methods: A cross-sectional study design was used. Patients with at least three vitiliginous
patches of more than 2 cm2 present over the trunk or limbs were included. Exclusion criteria
were topical or systemic corticosteroid use within the previous 4 weeks, antihistamine
use within the previous 7 days, history of any allergy in the past and immunosuppression.
Clobetasol propionate cream was applied on the fi rst vitiliginous area (site A) and fl uticasone
propionate ointment was applied on the second vitiliginous area (site B). The third vitiliginous
area, site C (control site) was left without applying any medication. Histamine-induced
wheal suppression test was performed on each site, at the same time of the day, on every
consecutive day following steroid application, until the values obtained at sites A and B
approached those obtained at site C. SPSS software for Windows, version 16.0 was used for
statistical analysis. The mean and standard deviation of the various studied parameters were
calculated for various treatment groups and compared using analysis of variance (ANOVA)
test. Results: Forty patients were included in the study. The average wheal volumes and
average erythema sizes at sites A and B were signifi cantly smaller than the corresponding
values at site C for up to 5 days after applying medication (P < 0.001). Limitations: The
presence of a cutaneous reservoir of topical steroid was confi rmed based on its suppressive
effect on the wheal and fl are response to histamine. It is not certain that the concentration
that suppresses histamine-induced wheal and fl are is suffi cient for therapeutic effi cacy in
vitiligo. Conclusion: The reservoir effect of topical clobetasol propionate and fl uticasone
propionate persisted for 5 days in vitiliginous skin. Hence, it may be possible to reduce the
frequency of topical steroid application in vitiligo.
Description
Keywords
Clobetasol propionate, fluticasone propionate, reservoir effect, topical steroid, vitiliginous skin
Citation
Singh Satyendra Kumar, Nasir Farzeen. The reservoir effect of topical steroids in vitiliginous skin: A cross-sectional study. Indian Journal of Dermatology, Venereology and Leprology. 2015 Jul-Aug; 81(4): 370-375.