Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement
Identifieur interne : 000E64 ( Main/Exploration ); précédent : 000E63; suivant : 000E65Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement
Auteurs : Emma Mooney [Australie] ; Marius Rademaker [Nouvelle-Zélande] ; Rebecca Dailey [Australie] ; Ben S. Daniel [Australie] ; Catherine Drummond ; Gayle Fischer [Australie] ; Rachael Foster [Australie] ; Claire Grills [Australie] ; Anne Halbert [Australie] ; Sarah Hill [Nouvelle-Zélande] ; Emma King [Australie] ; Elizabeth Leins [Australie] ; Vanessa Morgan [Australie] ; Roderic J. Phillips [Australie] ; John Relic [Australie] ; Michelle Rodrigues [Australie] ; Laura Scardamaglia [Australie] ; Saxon Smith [Australie] ; John Su [Australie] ; Orli Wargon [Australie] ; David Orchard [Australie]Source :
- Australasian Journal of Dermatology [ 0004-8380 ] ; 2015-11.
Abstract
Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self‐esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short‐term hypothalamic‐pituitary‐adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.
Url:
DOI: 10.1111/ajd.12313
Affiliations:
- Australie, Nouvelle-Zélande
- Nouvelle-Galles du Sud, Victoria (État)
- Melbourne
- Université de Melbourne
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Phillips</name><affiliation></affiliation><affiliation></affiliation><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Murdoch Children's Research Institute, Victoria</wicri:orgArea></affiliation></author><author><name sortKey="Relic, John" sort="Relic, John" uniqKey="Relic J" first="John" last="Relic">John Relic</name><affiliation wicri:level="2"><country>Australie</country><placeName><region type="state">Nouvelle-Galles du Sud</region></placeName><wicri:cityArea>Department of Dermatology, Royal Newcastle Centre, Newcastle</wicri:cityArea></affiliation></author><author><name sortKey="Rodrigues, Michelle" sort="Rodrigues, Michelle" uniqKey="Rodrigues M" first="Michelle" last="Rodrigues">Michelle Rodrigues</name><affiliation></affiliation><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Department of Dermatology, St Vincent's Hospital, Victoria</wicri:orgArea></affiliation></author><author><name sortKey="Scardamaglia, Laura" sort="Scardamaglia, Laura" uniqKey="Scardamaglia L" first="Laura" last="Scardamaglia">Laura Scardamaglia</name><affiliation></affiliation><affiliation wicri:level="4"><orgName type="university">Université de Melbourne</orgName><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation><affiliation></affiliation><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Department of Dermatology, Western Hospital, Victoria</wicri:orgArea></affiliation></author><author><name sortKey="Smith, Saxon" sort="Smith, Saxon" uniqKey="Smith S" first="Saxon" last="Smith">Saxon Smith</name><affiliation wicri:level="2"><country>Australie</country><placeName><region type="state">Nouvelle-Galles du Sud</region></placeName><wicri:cityArea>Department of Dermatology, Royal North Shore Hospital, Sydney</wicri:cityArea></affiliation><affiliation wicri:level="2"><country>Australie</country><placeName><region type="state">Nouvelle-Galles du Sud</region></placeName><wicri:cityArea>Sydney Medical School, University of Sydney, Sydney</wicri:cityArea></affiliation></author><author><name sortKey="Su, John" sort="Su, John" uniqKey="Su J" first="John" last="Su">John Su</name><affiliation></affiliation><affiliation wicri:level="4"><orgName type="university">Université de Melbourne</orgName><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation><affiliation></affiliation><affiliation></affiliation><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Murdoch Children's Research Institute, Victoria</wicri:orgArea></affiliation></author><author><name sortKey="Wargon, Orli" sort="Wargon, Orli" uniqKey="Wargon O" first="Orli" last="Wargon">Orli Wargon</name><affiliation wicri:level="2"><country>Australie</country><placeName><region type="state">Nouvelle-Galles du Sud</region></placeName><wicri:cityArea>Department Paediatric Dermatology, Sydney Children's Hospital, Sydney</wicri:cityArea></affiliation></author><author><name sortKey="Orchard, David" sort="Orchard, David" uniqKey="Orchard D" first="David" last="Orchard">David Orchard</name><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Department of Paediatric Dermatology, Royal Children's Hospital, Victoria</wicri:orgArea></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Australie</country></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Australasian Journal of Dermatology</title><title level="j" type="alt">AUSTRALASIAN JOURNAL OF DERMATOLOGY</title><idno type="ISSN">0004-8380</idno><idno type="eISSN">1440-0960</idno><imprint><biblScope unit="vol">56</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="241">241</biblScope><biblScope unit="page" to="251">251</biblScope><biblScope unit="page-count">11</biblScope><date type="published" when="2015-11">2015-11</date></imprint><idno type="ISSN">0004-8380</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0004-8380</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self‐esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short‐term hypothalamic‐pituitary‐adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Nouvelle-Zélande</li></country><region><li>Nouvelle-Galles du Sud</li><li>Victoria (État)</li></region><settlement><li>Melbourne</li></settlement><orgName><li>Université de Melbourne</li></orgName></list><tree><noCountry><name sortKey="Drummond, Catherine" sort="Drummond, Catherine" uniqKey="Drummond C" first="Catherine" last="Drummond">Catherine Drummond</name></noCountry><country name="Australie"><region name="Victoria (État)"><name sortKey="Mooney, Emma" sort="Mooney, Emma" uniqKey="Mooney E" first="Emma" last="Mooney">Emma Mooney</name></region><name sortKey="Dailey, Rebecca" sort="Dailey, Rebecca" uniqKey="Dailey R" first="Rebecca" last="Dailey">Rebecca Dailey</name><name sortKey="Daniel, Ben S" sort="Daniel, Ben S" uniqKey="Daniel B" first="Ben S" last="Daniel">Ben S. Daniel</name><name sortKey="Fischer, Gayle" sort="Fischer, Gayle" uniqKey="Fischer G" first="Gayle" last="Fischer">Gayle Fischer</name><name sortKey="Fischer, Gayle" sort="Fischer, Gayle" uniqKey="Fischer G" first="Gayle" last="Fischer">Gayle Fischer</name><name sortKey="Foster, Rachael" sort="Foster, Rachael" uniqKey="Foster R" first="Rachael" last="Foster">Rachael Foster</name><name sortKey="Grills, Claire" sort="Grills, Claire" uniqKey="Grills C" first="Claire" last="Grills">Claire Grills</name><name sortKey="Halbert, Anne" sort="Halbert, Anne" uniqKey="Halbert A" first="Anne" last="Halbert">Anne Halbert</name><name sortKey="King, Emma" sort="King, Emma" uniqKey="King E" first="Emma" last="King">Emma King</name><name sortKey="Leins, Elizabeth" sort="Leins, Elizabeth" uniqKey="Leins E" first="Elizabeth" last="Leins">Elizabeth Leins</name><name sortKey="Morgan, Vanessa" sort="Morgan, Vanessa" uniqKey="Morgan V" first="Vanessa" last="Morgan">Vanessa Morgan</name><name sortKey="Orchard, David" sort="Orchard, David" uniqKey="Orchard D" first="David" last="Orchard">David Orchard</name><name sortKey="Orchard, David" sort="Orchard, David" uniqKey="Orchard D" first="David" last="Orchard">David Orchard</name><name sortKey="Phillips, Roderic J" sort="Phillips, Roderic J" uniqKey="Phillips R" first="Roderic J" last="Phillips">Roderic J. Phillips</name><name sortKey="Relic, John" sort="Relic, John" uniqKey="Relic J" first="John" last="Relic">John Relic</name><name sortKey="Rodrigues, Michelle" sort="Rodrigues, Michelle" uniqKey="Rodrigues M" first="Michelle" last="Rodrigues">Michelle Rodrigues</name><name sortKey="Scardamaglia, Laura" sort="Scardamaglia, Laura" uniqKey="Scardamaglia L" first="Laura" last="Scardamaglia">Laura Scardamaglia</name><name sortKey="Scardamaglia, Laura" sort="Scardamaglia, Laura" uniqKey="Scardamaglia L" first="Laura" last="Scardamaglia">Laura Scardamaglia</name><name sortKey="Smith, Saxon" sort="Smith, Saxon" uniqKey="Smith S" first="Saxon" last="Smith">Saxon Smith</name><name sortKey="Smith, Saxon" sort="Smith, Saxon" uniqKey="Smith S" first="Saxon" last="Smith">Saxon Smith</name><name sortKey="Su, John" sort="Su, John" uniqKey="Su J" first="John" last="Su">John Su</name><name sortKey="Su, John" sort="Su, John" uniqKey="Su J" first="John" last="Su">John Su</name><name sortKey="Wargon, Orli" sort="Wargon, Orli" uniqKey="Wargon O" first="Orli" last="Wargon">Orli Wargon</name></country><country name="Nouvelle-Zélande"><noRegion><name sortKey="Rademaker, Marius" sort="Rademaker, Marius" uniqKey="Rademaker M" first="Marius" last="Rademaker">Marius Rademaker</name></noRegion><name sortKey="Hill, Sarah" sort="Hill, Sarah" uniqKey="Hill S" first="Sarah" last="Hill">Sarah Hill</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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