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西日本皮膚科
Vol. 40 (1978) No. 1 P 5-24

記事言語:

http://doi.org/10.2336/nishinihonhifu.40.5

綜説

Studies were made mainly on side-effects in connection with corticosteroid therapy in the field of dermatology to obtain results as follows.
General therapy
1) The diurnal change in endogenous cortisol shows a small peak in the evening in addition to a big peak in the early morning. 2) The decline in the adrenocortcal reserve activity is deemed as one of the causes for the development of alopecia maligna and alopecia areata multiplex. 3) Some cases show a definite fall in the aderenocortical reserve activity following administration of relatively small doses even in a group of relative indications for general therapy with corticosteroid (eczema-dermatitis group, palmoplantar pustulosis, psoriasis) in the field of dermatology. 4) At present, internal corticosteroid preparations with the possibility of side-effects being separated from effects are not available.
External therapy
1) Percutaneous absorption enough to cause adrenocrotical suppression occurs in the case where a corticosteroid external preparation in doses of 10 to 60g/day has been used by occlusive dressing technique and simple application in patients with eczema-dermatitis group and psoriasis.
2) In case of adrenocortical suppression having been caused, the degree of suppression will become higher, if the doses of external application is increased. In case of there being a high-degree suppression, however, the degree of suppression remains unchanged even if the doses of external application at that point of time are increased.
3) The degree of adrenocortical suppression and clinical effects are generally correlated with each other, but there also is the possibility of separating one from the other.
4) The adrenocortical suppression is generally transient. In case of strong suppression having occurred during external application, however. a delay in recovery after discontinuation of application is observed.
5) When the adrenocortical suppression is caused by external application of corticosteroid preparations, the peripherally circulating eosinocyte count is also decreased.
6) Some cases show not only the adrenocortical suppression, a decrease in the peripherally circulating eosinocyte count and a rise in blood sugar levels but also side effects like those observable on general administration such as a rise in the serum total cholesterol, accumulation of Na and functional irregular bleeding of the genital organs.
7) When comparison is made of the external application and internal administration, internal administration of betamethasone 1 tab 1 day corresponds to application of 0.05% clobetasol 17-propionate ointment 10g/day, while 0.05% clobetasol 17-propionate ointment 40g/day is equal to betamethasone 2 tab 1 day or less.
8) In the case where a corticosteroid preparation has been administered externally to infantile atopic dermatitis on a short and long-term basis, there is little systemic effects centering around aderenocortcal suppression with an ordinary technique for external application employed.

Copyright © 1978 日本皮膚科学会西部支部

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