Use of Topical Corticosteroids in the Treatment of Noninfectious Inflammatory Dermatoses of the Scalp: A Survey of Practicing Dermatologists and Dermatology Residents Using Delphi Methodology

Abstract

Background

Noninfectious inflammatory dermatoses of the scalp are common, and their symptomsin particular, those affecting appearance, can have a psychological effect that may be disproportionate to their clinical severity. Effective, cosmetically acceptable treatments are important to manage these conditions. Topical corticosteroids form the cornerstone of acute treatment for many of these conditions. We surveyed practicing dermatologists and dermatology residents to determine the current clinical practice in prescribing topical corticosteroids for these disorders in their various preparation formats.

Methods

A Delphi method was used, consisting of 2 questionnaire rounds. The first round contained 34 questions and was completed by 612 dermatologists and dermatology residents via email. The first round of responses was analyzed, and points that had > 70% agreement were used to form a second questionnaire of 21 statements. This second round was completed by 346 participants, and their responses were used to generate a final report. Participants were practicing in both public and private practices.

Results

Clobetasol propionate 0.05% topical solution was considered to be the most appropriate treatment for noninfectious inflammatory scalp dermatoses in general, with 75.1% agreement in the second round of questionnaire. The main advantages of clobetasol propionate over other topical corticosteroids were reported as potency, effectiveness, and broad action spectrum (94.8% agreement). The preferred pharmaceutical format was the solution of clobetasol propionate.

Conclusion

Clobetasol propionate was the preferred topical treatment for the management of scalp dermatoses, usually as first-line treatment; solution was the preferred preparation.

Keywords:

• seborrheic dermatitis
• psoriasis
• shampoo
• topical
• solution
• clobetasol
• scalp
• therapy

Data Sharing Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Compliance with Ethics Guidelines

This survey used aggregate data for analysis and did not involve any intervention on human subjects and was therefore not considered biomedical research that would require mandatory IRB review, in accordance with local (Spain) regulations. The survey was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki. Survey conduct was consistent with good clinical practices and applicable laws and regulations. All participants provided consent to participate.

Acknowledgments

To Jane Marshall (medical writer freelance, Glasgow, UK).

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

JPC is a consultant for ISDIN. LP, JD and JS are ISDIN employers. VGP has received honoraria from ISDIN. JFMB reports personal fees from ISDIN. The authors report no other conflicts of interest in this work.

Additional information

Funding

Publication costs funded by ISDIN S.A.