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To the Editor.—The article by Doctor Feinblatt and coworkers on "Percutaneous Absorption of Hydrocortisone in Children" (Amer J Dis Child 112:218-224, 1966) contains a number of highly questionable conclusions.
Their experiments dealt with absorption of hydrocortisone from skin covered with polyethylene film. Such occlusive covering markedly enhances absorption, a point mentioned, but apparently not fully appreciated, by the authors. In their discussion, figures obtained from studies with occluded skin sites were used in estimating absorption in their patient where occlusion was not used.
Feldman and Maibach showed (Arch Derm 91:661, 1965) that absorption of hydrocortisone from intact skin is increased approximately ten-fold by occluding skin with polyethylene film. Furthermore, Feldman and Maibach confirmed Malkinson's preliminary studies that absorption of hydrocortisone from intact skin without occlusion was less than 1%. Even with occlusion, Feldman and Maibach obtained absorption of only about 5% of applied hydrocortisone; much less than the results
EPSTEIN E. PERCUTANEOUS ABSORPTION OF HYDROCORTISONE IN CHILDREN. Am J Dis Child. 1967;113(4):507. doi:10.1001/archpedi.1967.02090190153025