A case of iatrogenic growth retardation induced by a corticosteroid-containing anti-allergic drug

Corticosteroids: options in the era of steroid-sparing therapy

Topical corticosteroids remain the most commonly used topical treatments for inflammatory dermatoses, including psoriasis and atopic dermatitis. Topical corticosteroids are available in a variety of vehicles-creams, ointments, lotions, gels, and, more recently, foam. The vehicle used can substantially affect the individual agent's clinical action, potency, and acceptability to the patient. Moreover, some vehicles are better suited for specific body areas. Selection of the appropriate product should be determined by area of usage, physician experience, cost, and patient preference, particularly regarding vehicle. Although topical corticosteroids are associated with several side effects, including skin atrophy, telangiectases, purpura, and striae formation, appropriate usage can minimize these occurrences. Judicious use includes short-term, appropriate application as initial monotherapy or in combination strategies with other therapeutic agents that ideally possess complementing mechanisms of action. Examples include pulsing with high-potency topical corticosteroids and combination regimens with other topical agents such as topical calcineurin inhibitors, calcipotriene, or tazarotene. Appropriate education of patients and caregivers alike will facilitate the optimal use of these medications.

Toxicity of drugs used for treatment of rhinitis: a reminder to the otorhinolaryngologist

We retrospectively studied files on toxicity of drugs used for treatment of rhinitis (nasal antihistamines, oral antihistamines, nasal vasoconstrictors, oral decongestants, nasal corticosteroids, nasal anticholinergic agent, nasal mast cell stabilizer, and respiratory antigen preparations for oral use) that occurred in São Paulo, Brazil, from 1 July 1996 to 30 June 1998. There were 823 cases of toxicity by these agents, with a predominance of oral decongestants (in combination with antihistamines) (53.4%). There was a significant incidence of toxicity within children aged 1 to 4 years (P < 0.05) and a preponderance among males aged 5-9 years and females aged 10-39 years. Accidental intake of medicines accounted for the majority of toxicity cases (57.2%).