Letters to the Editor
Rational use of topical corticosteroids
- Angus Kingon, Pablo Férnandez-Peñas
- Aust Prescr 2014;37:5-6
- 1 February 2014
- DOI: 10.18773/austprescr.2014.016
Editor, – In the article on topical corticosteroids (Aust Prescr 2013;36:158-61) there is no reference to the oral mucosa. Some steroid preparations have long been used as effective treatment for conditions in the mouth, notably for lichen planus.1 One option is 0.05% betamethasone ointment. This has proved particularly relevant in over 20 years of practice, as I am contacted periodically by pharmacists questioning if such a prescription is appropriate for use on the oral mucosa.
Pablo Fernández-Peñas, one of the authors of the article, comments:
Some mucosas have stratified epithelium similar to the skin, but with thinner or non-existent stratum corneum. This changes the absorption of molecules. In a cream or ointment there are more components than the corticosteroid, and I do not have enough information to assess that it is safe to use skin products in the oral mucosa.
The clinical outcome will depend on making a correct diagnosis and applying the right molecule in the most appropriate vehicle for the correct duration. In this regard, there may be vehicles that are not adequate for the oral mucosa. Most dermatologists tend to compound their topical corticosteroids in ‘orabase’ for use on mucosas, to be on the safe side.
Oral surgeon, Pymble, NSW