The results are presented of a double-blind trial comparing the efficacy of betamethasone phosphate per cent, clobetasone butyrate per cent, and placebo in the treatment of acute unilateral non-granulomatous uveitis. The two steroids gave comparable results in improvement of the patients' symptoms, although betamethasone phosphate was significantly more effective than clobetasone butyrate in improving the ocular signs of uveitis. In comparing the placebo group of patients with those given topical steroids, the former group, though improving, appeared to lag behind by approximately 1 week. Four patients receiving placebo, however, had to be withdrawn because of worsening of the condition. Mild cases of anterior uveitis would probably resolve without using topical steroids.
Each user experiences their own unique feelings when using steroids and coming off the drug. When someone chooses to stop using they can experience a variety of withdrawal symptoms linked to addiction. Symptoms can include mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, the desire to take more steroids, and depression. Evidence for steroid addiction is certainly not as strong as it is for other drugs like cocaine or heroin. Though it is clear that people develop a tolerance and dependence on them and willingly experience negative consequences when using steroids - both of which are signs for drug dependence.
Compliance raises very specific questions in dermatology related to the frequent use of local treatments: creams or ointments, including topical corticosteroids. The adherence in dermatology is a complex issue. It is difficult to quantify objectively because of the patient subjectivity, the constant adaptation to changes in the course of the disease, and due to the lack of adapted device. Moreover poor compliance may be related to topical corticosteroid phobia, defined as a fear vis-à-vis the topical corticosteroids, rational or not. The topical corticosteroid phobia is very common in the management of chronic inflammatory skin diseases especially in atopic dermatitis.