Role of the ACTH test and estimation of a safe dose for high potency steroids in vitiligo: A prospective randomized study.
Indian Dermatol Online J
; 5(2): 117-21, 2014 Apr.
Article
en En
| MEDLINE
| ID: mdl-24860741
ABSTRACT
BACKGROUND:
Topical corticosteroids are used as first line of therapy for vitiligo, although side effects such as adrenal insufficiency are possible.OBJECTIVES:
To establish the role of ACTH test before, during, and after treatment with high potency topical steroids; to determine if adrenal insufficiency occurs secondary to the use of high potency topical steroids in patients with vitiligo and intact cutaneous barrier; and also to determine response to treatment and side effects. MATERIALS ANDMETHODS:
Forty-four adults with non-segmental vitiligo affecting 20% or less of the body surface area were included and randomized to receive topical clobetasol propionate 0.05% cream (group 1) or placebo (group 2) for 12 weeks, with a maximum dose of 50 g per week. The placebo group was crossed over after week 6 and started on clobetasol until completion of the study. Serum cortisol levels with the 1 µg ACTH test were determined at baseline and on weeks 6 and 12.RESULTS:
No adrenal insufficiency was detected nor statistical significance was achieved when comparing cortisol levels between and within the groups at baseline and weeks 6 and 12. Group 1 had a better response to therapy but with more side effects.CONCLUSIONS:
Doses of 50 g or less per week of clobetasol during a period of 12 weeks are safe on adult vitiligo patients, although local side effects are possible. Repigmentation rates were incomplete with single steroid therapy, making combined therapy a better option.
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Banco de datos:
MEDLINE
Tipo de estudio:
Clinical_trials
Idioma:
En
Año:
2014
Tipo del documento:
Article