Total Body Inunction as Topical Corticosteroid Therapy

In a study of 19 patients, Fleischmajer1has shown that inunction with 2.5% hydrocortisone acetate given twice a day over prolonged periods produced no major systemic effects. Dermatologists are familiar also with the experiments on the systemic effect of percutaneous absorption of locally applied corticosteroids. These studies have been done by Danto and Maddin2; Smith3; Fitzpatrick, Griswold, and Hicks4; Gemzell, Haard and Nilzen5; Livingood, Hildebrand, Key, and Smith6; Witten, Shapiro and Silber7; Tschan and Adoni,8and others. For a long time we have been interested in topical corticosteroid therapy used over large and even uninvolved areas as a form of more effective therapy. The difficulties have been the expense of such therapy and the need for controlled clinical studies and for controlled assay studies of the systemic effects. We have used this technique in the study of topical hydrocortisone, prednisone, and dexamethasone.