Serum Triamcinolone Levels During Intensive, Inpatient Wet-Dressing Therapy

Clin Exp Dermatol. 2020 Jul;45(5):549-554. doi: 10.1111/ced.14161. Epub 2020 May 14.

Abstract

Background: Wet dressings combined with topical corticosteroids are beneficial for patients with generalized and refractory dermatosis; however, to our knowledge, serum levels after topical corticosteroid absorption during intensive therapy have not been reported previously.

Aim: To examine serum levels of triamcinolone acetonide (TAC) after topical corticosteroid application during intensive wet-dressing therapy.

Methods: We performed a retrospective study of adult patients admitted for inpatient wet-dressing therapy from 7 November 2015 to 24 June 2016. Data were collected on sex, age, body surface area, TAC serum levels, number of wet-dressing changes after 24 and 48 h, and type of wet dressing.

Results: In total, 29 patients (14 men, 15 women) were assessed. Median [interquartile range (IQR)] age was 57 years (51.5-67.0 years) and involved body surface area was 1.98 m2 (1.88-2.15) m2 . Before the 24-hour blood draw, patients had received 1-3 dressing changes. Median (IQR) TAC level at 24 h was 0.33 µg/dL (0.20-0.58 µg/dL), with no significant difference noted between the number of dressing changes and TAC serum level. At 48 h, results of a serum TAC test were available for 22 patients with 2-6 dressing changes. Mean (IQR) serum level was 0.30 µg/dL (0.30-0.87 µg/dL). For each additional dressing change, there was an estimated 0.21 µg/dL increase in TAC serum level (95% CI 0.11-0.31; P < 0.001). TAC serum level was not significantly associated with sex, age, body surface area or dressing type.

Conclusions: Intensive, inpatient wet-dressing therapy is associated with detectable TAC serum levels. However, we suspect that topical TAC has a primarily local therapeutic effect on the skin.

MeSH terms

  • Administration, Topical
  • Aged
  • Bandages*
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / blood*
  • Glucocorticoids / pharmacokinetics
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skin Diseases / drug therapy*
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / blood*
  • Triamcinolone Acetonide / pharmacokinetics

Substances

  • Glucocorticoids
  • Triamcinolone Acetonide