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Betamethasone, Hydrocortisone Equally Effective in Control of Childhood Eczema

Short-course betamethasone valerate, a potent steroid, and a longer course of a weaker preparation using hydrocortisone both control eczema in children equally well.

Researchers at the Universities of Nottingham and Ulster and Aston University, United Kingdom, carried out a randomised, double-blind, 18-week parallel group study to determine the efficacy of the two preparations in treating mild or moderate atopic eczema. They compared a three-day burst of betamethasone valerate 0.1% to 1.0% hydrocortisone for seven days, in treating disease exacerbations and maintaining remissions in 174 children recruited from 13 general practices.

The researchers evaluated two primary outcomes, the total number of scratch-free days and the number of disease relapses. Secondary outcomes included the median duration of the first disease relapse, the number of nights when sleep was not disturbed; disease severity, two quality-of-life measures and the number of treatment failures in each arm.

There were no differences between the two groups in any outcome measure. The median numbers of scratch free days were 118.0 with hydrocortisone and 117.5 with betamethasone. There was a median of one relapse in each group.

Both groups showed clinically significant improvements in disease severity and quality-of-life compared to baseline. The researchers found no significant changes in skin thickness.
British Journal of Dermatology 2002; 146(3):541-541. "Randomized controlled trial of short bursts of a potent topical corticosteroid versus more prolonged use of a mild preparation for children with atopic eczema"

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