ABSTRACT
BACKGROUND: To determine whether the application of 1% hydrocortisone cream during radiation therapy can prevent the occurrence of moist desquamation. METHODS: Fifty adult female breast carcinoma patients were randomized after modified radical mastectomy and chemotherapy to receive prophylactic placebo cream (n = 27) or 1% hydrocortisone cream (n = 23) during radiation therapy. The patients, caregiver and assessor were all blinded to the treatment received. Occurrence of moist desquamation, severity of acute radiation dermatitis (ARD) and hyperpigmentation were evaluated weekly until the end of radiotherapy. RESULTS & CONCLUSION: Five patients in each group developed moist desquamation; however, its extent and severity were milder in the steroid group. Mean ARD scores were also lower in the steroid group (0.713 vs. 0.874, p = 0.024). A lower incidence of Grades 1 and 2 radiation dermatitis was also noted in the steroid group at weeks 2 and 4, respectively, indicating prophylactic use of steroids delayed the onset of radiodermatitis.
Subject(s)
Breast Neoplasms/radiotherapy , Hydrocortisone/administration & dosage , Radiodermatitis/prevention & control , Administration, Cutaneous , Adult , Aged , Anti-Inflammatory Agents/administration & dosage , Antineoplastic Agents/administration & dosage , Breast Neoplasms/therapy , Combined Modality Therapy , Double-Blind Method , Female , Humans , Incidence , Mastectomy/methods , Middle Aged , Prospective Studies , Radiodermatitis/epidemiology , Radiodermatitis/pathology , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
Acute radiation dermatitis (ARD) is a common side effect of radiation therapy and is characterized by erythema, dry desquamation or moist desquamation. This wet desquamation is a very painful condition for the patient and often leads to interruption of radiotherapy. The objective of this article is to assess the efficacy of topical corticosteroids in the prevention of ARD compared with placebo, other topical medication or no treatment. The prophylactic application of topical corticosteroid among patients undergoing radiotherapy appears to significantly reduce the incidence of ARD, specifically moist desquamation, compared with other treatments. Future trials with a more standardized measure of radiation dermatitis grading are recommended. Further research may also be conducted to determine if a mildly potent, midpotent or super potent topical steroid will be more effective in preventing ARD.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Radiodermatitis/drug therapy , Radiotherapy/adverse effects , Administration, Topical , Adrenal Cortex Hormones/administration & dosage , Humans , Randomized Controlled Trials as TopicABSTRACT
Seborrheic dermatitis is a common, chronic, relapsing inflammatory skin disorder that manifests as erythema, scaling and pruritus in sebum gland-rich areas of the skin. The objective of this article is to evaluate the clinical efficacy of pimecrolimus 1% cream in the treatment of seborrheic dermatitis compared with corticosteroids, antimycotics, placebo or no intervention. Pimecrolimus 1% cream appears to be a well-tolerated and effective treatment for seborrheic dermatitis. It has comparable efficacy, in terms of decreasing severity of erythema, scaling and pruritus, to the standard treatments: topical corticosteroids and antimycotics. However, future studies with more standardized measures of treatment outcome are recommended. More studies may also be conducted to further evaluate pimecrolimus 1% cream as a long-term maintenance therapy for seborrheic dermatitis.
