Indian Dermatology Online Journal

ORIGINAL ARTICLE
Year
: 2014  |  Volume : 5  |  Issue : 2  |  Page : 117--121

Role of the ACTH test and estimation of a safe dose for high potency steroids in vitiligo: A prospective randomized study


Alberto de la Fuente-García1, Minerva Gómez-Flores1, Leonardo Mancillas-Adame2, Jorge Ocampo-Candiani1, Oliverio Welsh-Lozano1, Jesús Zacarías Villarreal Pérez2, José Gerardo González-González2, Fernando Lavalle-González2 
1 Department of Dermatology, Dr. José E. González University Hospital, Monterrey, Nuevo León, Mexico
2 Department of Endocrinology, Dr. José E. González University Hospital, Monterrey, Nuevo León, Mexico

Correspondence Address:
Alberto de la Fuente-García
Department of Dermatology, Dr. José E. González University Hospital, Av. Francisco I. Madero Pte y Av. Gonzalitos s/n. Colonia Mitras Centro, C.P. 64460, Monterrey, Nuevo León
Mexico

Background: Topical corticosteroids are used as first line of therapy for vitiligo, although side effects such as adrenal insufficiency are possible. Objectives: To establish the role of ACTH test before, during, and after treatment with high potency topical steroids; to determine if adrenal insufficiency occurs secondary to the use of high potency topical steroids in patients with vitiligo and intact cutaneous barrier; and also to determine response to treatment and side effects. Materials and Methods: Forty-four adults with non-segmental vitiligo affecting 20% or less of the body surface area were included and randomized to receive topical clobetasol propionate 0.05% cream (group 1) or placebo (group 2) for 12 weeks, with a maximum dose of 50 g per week. The placebo group was crossed over after week 6 and started on clobetasol until completion of the study. Serum cortisol levels with the 1 μg ACTH test were determined at baseline and on weeks 6 and 12. Results: No adrenal insufficiency was detected nor statistical significance was achieved when comparing cortisol levels between and within the groups at baseline and weeks 6 and 12. Group 1 had a better response to therapy but with more side effects. Conclusions: Doses of 50 g or less per week of clobetasol during a period of 12 weeks are safe on adult vitiligo patients, although local side effects are possible. Repigmentation rates were incomplete with single steroid therapy, making combined therapy a better option.


How to cite this article:
de la Fuente-García A, Gómez-Flores M, Mancillas-Adame L, Ocampo-Candiani J, Welsh-Lozano O, Pérez JV, González-González JG, Lavalle-González F. Role of the ACTH test and estimation of a safe dose for high potency steroids in vitiligo: A prospective randomized study.Indian Dermatol Online J 2014;5:117-121


How to cite this URL:
de la Fuente-García A, Gómez-Flores M, Mancillas-Adame L, Ocampo-Candiani J, Welsh-Lozano O, Pérez JV, González-González JG, Lavalle-González F. Role of the ACTH test and estimation of a safe dose for high potency steroids in vitiligo: A prospective randomized study. Indian Dermatol Online J [serial online] 2014 [cited 2021 Oct 27 ];5:117-121
Available from: https://www.idoj.in/article.asp?issn=2229-5178;year=2014;volume=5;issue=2;spage=117;epage=121;aulast=de;type=0