TY - JOUR
T1 - Serum triamcinolone levels during intensive, inpatient wet-dressing therapy
AU - Mirza, S. A.
AU - Wentworth, A. B.
AU - Harvey, J. A.
AU - Bridges, A. G.
AU - Camilleri, M. J.
AU - el-Azhary, R. A.
AU - McEvoy, M. T.
AU - Sartori Valinotti, J. C.
AU - Wetter, D. A.
AU - Davis, M. D.P.
N1 - Publisher Copyright:
© 2019 British Association of Dermatologists
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background: Wet dressings combined with topical corticosteroids are beneficial for patients with generalized and refractory dermatosis; however, to our knowledge, serum levels after topical corticosteroid absorption during intensive therapy have not been reported previously. Aim: To examine serum levels of triamcinolone acetonide (TAC) after topical corticosteroid application during intensive wet-dressing therapy. Methods: We performed a retrospective study of adult patients admitted for inpatient wet-dressing therapy from 7 November 2015 to 24 June 2016. Data were collected on sex, age, body surface area, TAC serum levels, number of wet-dressing changes after 24 and 48 h, and type of wet dressing. Results: In total, 29 patients (14 men, 15 women) were assessed. Median [interquartile range (IQR)] age was 57 years (51.5–67.0 years) and involved body surface area was 1.98 m2 (1.88–2.15) m2. Before the 24-hour blood draw, patients had received 1–3 dressing changes. Median (IQR) TAC level at 24 h was 0.33 µg/dL (0.20–0.58 µg/dL), with no significant difference noted between the number of dressing changes and TAC serum level. At 48 h, results of a serum TAC test were available for 22 patients with 2–6 dressing changes. Mean (IQR) serum level was 0.30 µg/dL (0.30–0.87 µg/dL). For each additional dressing change, there was an estimated 0.21 µg/dL increase in TAC serum level (95% CI 0.11–0.31; P < 0.001). TAC serum level was not significantly associated with sex, age, body surface area or dressing type. Conclusions: Intensive, inpatient wet-dressing therapy is associated with detectable TAC serum levels. However, we suspect that topical TAC has a primarily local therapeutic effect on the skin.
AB - Background: Wet dressings combined with topical corticosteroids are beneficial for patients with generalized and refractory dermatosis; however, to our knowledge, serum levels after topical corticosteroid absorption during intensive therapy have not been reported previously. Aim: To examine serum levels of triamcinolone acetonide (TAC) after topical corticosteroid application during intensive wet-dressing therapy. Methods: We performed a retrospective study of adult patients admitted for inpatient wet-dressing therapy from 7 November 2015 to 24 June 2016. Data were collected on sex, age, body surface area, TAC serum levels, number of wet-dressing changes after 24 and 48 h, and type of wet dressing. Results: In total, 29 patients (14 men, 15 women) were assessed. Median [interquartile range (IQR)] age was 57 years (51.5–67.0 years) and involved body surface area was 1.98 m2 (1.88–2.15) m2. Before the 24-hour blood draw, patients had received 1–3 dressing changes. Median (IQR) TAC level at 24 h was 0.33 µg/dL (0.20–0.58 µg/dL), with no significant difference noted between the number of dressing changes and TAC serum level. At 48 h, results of a serum TAC test were available for 22 patients with 2–6 dressing changes. Mean (IQR) serum level was 0.30 µg/dL (0.30–0.87 µg/dL). For each additional dressing change, there was an estimated 0.21 µg/dL increase in TAC serum level (95% CI 0.11–0.31; P < 0.001). TAC serum level was not significantly associated with sex, age, body surface area or dressing type. Conclusions: Intensive, inpatient wet-dressing therapy is associated with detectable TAC serum levels. However, we suspect that topical TAC has a primarily local therapeutic effect on the skin.
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U2 - 10.1111/ced.14161
DO - 10.1111/ced.14161
M3 - Article
C2 - 32410250
AN - SCOPUS:85084602545
SN - 0307-6938
VL - 45
SP - 549
EP - 554
JO - Clinical and Experimental Dermatology
JF - Clinical and Experimental Dermatology
IS - 5
ER -