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• W2134260104 abstract "To the Editor: We read with interest the research on the change of bone mineral density in adults with moderate to severe atopic dermatitis (AD) using topical corticosteroids.1van Velsen S.G. Haeck I.M. Knol M.J. Lam M.G. Bruijnzeel-Koomen C.A. Two-year assessment of effect of topical corticosteroids on bone mineral density in adults with moderate to severe atopic dermatitis.J Am Acad Dermatol. 2012; 66: 691-693Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar There are some similar studies,2Aalto-Korte K. Turpeinen M. Bone mineral density in patients with atopic dermatitis.Br J Dermatol. 1997; 136: 172-175Crossref PubMed Scopus (27) Google Scholar, 3Haeck I.M. Hamdy N.A. Timmer-de Mik L. Lentjes E.G. Verhaar H.J. Knol M.J. et al.Low bone mineral density in adult patients with moderate to severe atopic dermatitis.Br J Dermatol. 2009; 161: 1248-1254Crossref PubMed Scopus (30) Google Scholar, 4van Velsen S.G. Knol M.J. van Eijk R.L. de Vroede M.A. de Wit T.C. Lam M.G. et al.Bone mineral density in children with moderate to severe atopic dermatitis.J Am Acad Dermatol. 2010; 63: 824-831Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar and this research plays an important role in clinical practice. However, there are some questions to be explored.There are some scales to evaluate the severity of AD, such as scoring of AD (SCORAD) and Three-Item Severity score, and these scales are useful tools to evaluate different studies on AD. If the authors can show the scale used in the article, it will be easier to compare the research and to support the clinical decisions.The authors calculated the cumulative dose of topical and oral corticosteroids, but they seemed to neglect the effect of oral corticosteroids in data analysis and interpretation. In addition, there is an unexplained question in data analysis. The mean dose of topical corticosteroids during 2-year follow-up was 86.8 ± 80.5 g, and the bone mineral density and biochemical parameters of bone metabolism of 2 groups were compared. However, the 2 groups were divided according to the dose of topical corticosteroids, 75 g per month.The authors used the mean and SD in 2 tables, however, the values of SD were greater than values of mean. These values cannot reflect the actual statistical characteristics of the dose of topical corticosteroids and the values of bone mineral density, and it is better to use median as an alternative. By the way, the total number of subjects in 2 groups is 71 in Table II, but the number of total subjects in this study is 75. To the Editor: We read with interest the research on the change of bone mineral density in adults with moderate to severe atopic dermatitis (AD) using topical corticosteroids.1van Velsen S.G. Haeck I.M. Knol M.J. Lam M.G. Bruijnzeel-Koomen C.A. Two-year assessment of effect of topical corticosteroids on bone mineral density in adults with moderate to severe atopic dermatitis.J Am Acad Dermatol. 2012; 66: 691-693Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar There are some similar studies,2Aalto-Korte K. Turpeinen M. Bone mineral density in patients with atopic dermatitis.Br J Dermatol. 1997; 136: 172-175Crossref PubMed Scopus (27) Google Scholar, 3Haeck I.M. Hamdy N.A. Timmer-de Mik L. Lentjes E.G. Verhaar H.J. Knol M.J. et al.Low bone mineral density in adult patients with moderate to severe atopic dermatitis.Br J Dermatol. 2009; 161: 1248-1254Crossref PubMed Scopus (30) Google Scholar, 4van Velsen S.G. Knol M.J. van Eijk R.L. de Vroede M.A. de Wit T.C. Lam M.G. et al.Bone mineral density in children with moderate to severe atopic dermatitis.J Am Acad Dermatol. 2010; 63: 824-831Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar and this research plays an important role in clinical practice. However, there are some questions to be explored. There are some scales to evaluate the severity of AD, such as scoring of AD (SCORAD) and Three-Item Severity score, and these scales are useful tools to evaluate different studies on AD. If the authors can show the scale used in the article, it will be easier to compare the research and to support the clinical decisions. The authors calculated the cumulative dose of topical and oral corticosteroids, but they seemed to neglect the effect of oral corticosteroids in data analysis and interpretation. In addition, there is an unexplained question in data analysis. The mean dose of topical corticosteroids during 2-year follow-up was 86.8 ± 80.5 g, and the bone mineral density and biochemical parameters of bone metabolism of 2 groups were compared. However, the 2 groups were divided according to the dose of topical corticosteroids, 75 g per month. The authors used the mean and SD in 2 tables, however, the values of SD were greater than values of mean. These values cannot reflect the actual statistical characteristics of the dose of topical corticosteroids and the values of bone mineral density, and it is better to use median as an alternative. By the way, the total number of subjects in 2 groups is 71 in Table II, but the number of total subjects in this study is 75. Two-year assessment of effect of topical corticosteroids on bone mineral density in adults with moderate to severe atopic dermatitisJournal of the American Academy of DermatologyVol. 66Issue 4PreviewTo the Editor: Application of topical corticosteroids may be a risk factor for low bone mineral density (BMD) in patients with atopic dermatitis (AD).1 We assessed the effect of topical corticosteroids on BMD during a 2-year follow-up study in 75 adult patients with moderate to severe AD (mean age, 40.2 years; 52% men). Using dual-energy x-ray absorptiometry, BMD was measured at the lumbar spine and hips. T-scores of each patient were calculated. Cumulative dose of topical and oral corticosteroids during follow-up was calculated from pharmacy records. Full-Text PDF ReplyJournal of the American Academy of DermatologyVol. 68Issue 1PreviewTo the Editor: We thank Dr Zhanglei Mu and Dr Jianzhong Zhang for their interest in our research letter, “Two-year assessment of effect of topical corticosteroids on bone mineral density in adults with moderate to severe atopic dermatitis.” Full-Text PDF" @default.
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