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Keywords:

  • Paediatric atopic dermatitis;
  • Topical corticosteroids;
  • Mometasone furoate

Abstract

Background Atopic dermatitis (AD) affects 10–15% of children in the USA and up to 20% of children in the UK. Topical corticosteroids are the mainstay of therapy to control acute flares of AD in both children and adults.

Aim In paediatric patients, it is especially important to ensure that local application of a corticosteroid used is limited to the least amount needed to produce a therapeutic response, as children are particularly prone to systemic adverse effects of these agents. The development of newer corticosteroid molecules is aimed at achieving maximum activity and minimal unwanted side effects.

Review Mometasone furoate (Elocon®), a medium potency topical corticosteroid, is the only topical steroid approved for use in children in the USA. Mometasone furoate undergoes biotransformation in the liver into three different metabolites with very little intrinsic activity. Local side effects are minimal, with an atrophogenic potential comparable with that of 1% hydrocortisone ointment, and the risk of adrenal suppression is low. In clinical trials including over 300 infants and children, once-daily 0.1% mometasone furoate was found to be statistically significantly more effective than twice-daily 1% or 2.5% hydrocortisone, twice-daily 0.05% alclometasone dipropionate and twice-daily 0.05% fluticasone propionate.

Conclusion The once-daily regimen of mometasone furoate is also useful in promoting compliance and reducing the potential for adverse effects.