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November 1966

The Corticosteroid ReservoirLack of Physiologic and Therapeutic Significance

Arch Dermatol. 1966;94(5):639-642. doi:10.1001/archderm.1966.01600290113020

Percutaneous absorption of topically applied triamcinolone acetonide ointment under polyethylene film occlusive wraps caused endogenous adrenocortical suppression in two patients with generalized atopic dermatitis, one normal patient, and one patient with generalized mild dermatitis due to the occlusive dressings. Continued occlusive therapy without steroid ointment did not prolong the adrenal suppression. Thus the corticosteroid reservoir in the stratum corneum was not sufficient to maintain enough percutaneous steroid absorption to suppress the pituitaryadrenal axis. Lack of clinical effectiveness plus frequent development of a low-grade irritant dermatitis in areas where plastic wraps without corticoids were applied make us doubt that the corticosteroid reservoir of Vickers has therapeutic value.