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Received Aug 19, 2017; Accepted Oct 19, 2017
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1. Introduction
Eczema is a skin inflammatory disease and can be caused by multiple intrinsic and extrinsic factors. Chronic generalized eczema, a common type of eczema, is characterized by lesions occurring at multiple sites, complex etiology, persistent recurrence, and severe pruritus. The disease substantially reduces the quality of life of patients and imposes serious economic burden on patients [1]. Topical glucocorticoid (GC), which is commonly used to treat eczema in clinical practice, can usually relieve eczema-associated symptoms such as inflammation and pruritus rapidly [2]. Topical GC use at a proper dosage is quite safe and barely causes adverse reactions [3]. However, patients with chronic generalized eczema often use topical GC for a long time and at a relatively high dose. Wester and colleagues have found that long-term use of topical GC may cause GC to enter circulation system through skin absorption, resulting in reversible hypothalamic-pituitary-adrenal axis suppression and the consequent systemic adverse reactions [4]. Coureau and colleagues have demonstrated that the weekly dose of topical propionic acid chloride betamethasone cream should be less than 50 g in order to prevent GC-associated severe adverse reactions [5].
Halometasone cream is a commonly used high-potency topical GC. It inhibits inflammation, epidermal hyperplasia, and allergic reactions, constrict blood vessels, and relieve pruritus. The mechanism of action of halometasone is that the drug can bind to steroid receptors to modulate the protein synthesis that is involved in the development of chronic generalized eczema and thus to regulate the function of inflammatory cells and lysosomes and ultimately to reduce inflammatory responses [6–8]. According to the instruction of halometasone cream, only 1.41% of halometasone cream used for consecutive 7 days on a lesion area of 400 cm2 can be absorbed via the skin. However, the dosage of halometasone cream use in the real world is often higher than the recommended dosage provided by the manufacturer. The...