This report is another study that demonstrates the success of topical steroid therapy in an effort to avoid circumcision under anesthesia in older children. This article is an important contribution, as it is a report from a North American institution, where the threshold to proceed to circumcision has historically been lower than other countries, where the parent's desire to avoid late circumcision could potentially overstate the outcome or benefits of the topical steroid therapy. This therapy could also be applied to other foreskin problems such as persistent penile adhesions with similar expected results.
Transdermal patches can be a very precise time released method of delivering a drug. Cutting a patch in half might affect the dose delivered. The release of the active component from a transdermal delivery system (patch) may be controlled by diffusion through the adhesive which covers the whole patch, by diffusion through a membrane which may only have adhesive on the patch rim or drug release may be controlled by release from a polymer matrix. Cutting a patch might cause rapid dehydration of the base of the medicine and affect the rate of diffusion.