Fluticasone Cream Safe in Children With Atopic Dermatitis

March 22, 2002

NEW YORK (MedscapeWire) Mar 25 — A study in the March issue of the Journal of the American Academy of Dermatology soothes concerns about potentially dangerous adverse effects from local steroids used to treat pediatric skin conditions. In this phase IV open-label study, topical fluticasone cream was safe for up to 4 weeks in treating atopic dermatitis in children as young as 3 months of age.

"Topical corticosteroids are useful for the treatment of pediatric dermatoses," write S. F. Friedlander and colleagues from the Fluticasone Pediatrics Safety Study Group. "However, concerns regarding possible systemic and topical toxicities have limited the use of moderate-potency corticosteroids in children."

In this study, 51 children ranging in age from 3 months to 6 years received treatment with fluticasone propionate cream, 0.05% twice daily for 3 to 4 weeks. All had moderate to severe atopic dermatitis and were treated over 35% or more of their body surface area; mean body surface area treated was 64%.

Mean cortisol levels were similar at baseline (13.76 +/- 6.94 µg/dL prestimulation and 30.53 +/- 7.23 µg/dL poststimulation) and at end of treatment (12.32 +/- 6.92 µg/dL prestimulation and 28.84 +/- 7.16 µg/dL poststimulation). Only 2 of 43 children had end-treatment poststimulation values less than 18.0 µg/dL.

"No significant adverse cutaneous effects were noted," the authors write. "Fluticasone propionate cream 0.05% appears to be safe for the treatment of severe eczema for up to four weeks in children three months of age and older."

This study was supported by Glaxo Wellcome Inc.

J Am Acad Dermatol. 2002;46(3):387-393

Reviewed by Gary D. Vogin, MD

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