In response to Dr. Epstein's comments, the authors agree with his interpretation of their conclusions; ie, "significant absorption of topical corticosteroids can occur" and that the possibility of systemic toxicity occurs "only under limited and special circumstances." Recognition of these facts should results in more judicious use of topical glucosteroids.
The increased absorption of topical glucocorticoids, when an occlusive dressing is used, is fully appreciated by the authors although the degree of increase has not been well-evaluated. Since this mode of application is often used when extensive areas are treated with topical glucocorticoids and is accompanied by enhanced possibility of systemic toxicity, this method was employed in the authors' study.
The results reported by Feldman and Maibach may not be comparable to the data published by us because of differences in technique. Possible discrepancies may be due to the age group of the subjects. The authors' study was done with