clobetasol and clobetasone-butyrate

Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma that can affect the vulval skin. Surgical excision is the gold-standard treatment, however, recurrence rates are high and extensive excisions can produce long-lasting cosmetic and functional defects. We describe one of the largest case series to-date (n = 6) on the use of topical 5% imiquimod cream as a novel treatment option and discuss our experiences. With the addition of our six cases to the literature, there are now 29 documented cases of vulval EMPD treated with 5% imiquimod cream. Of these, 50% of primary disease cases and 73% of recurrent primary disease cases have achieved clinical resolution with 5% imiquimod therapy alone. These findings suggest that imiquimod provides a viable alternative to surgical excision for vulval EMPD. However, we acknowledge that this is a simple retrospective analysis and that treatment scheduling and follow-up needs investigation in a trial setting.

Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Aminoquinolines; Anti-Inflammatory Agents; Antineoplastic Agents; Clobetasol; Female; Humans; Imiquimod; Middle Aged; Paget Disease, Extramammary; Vulvar Neoplasms

Topics: Child; Clobetasol; Female; Glucocorticoids; Humans; Psoriasis

Topical steroid creams and ointments have been available as over-the-counter (OTC) medications for the self treatment of acute dermatitis and other steroid responsive skin disorders for more than ten years. Despite earlier fears, widespread availability and use of these creams is not associated with clinically significant adverse effects. In dermatological practice, hydrocortisone 1% remains the mainstay of treatment for facial eczema, but it is often not effective in eczema affecting other body areas. Eumovate(TM) (clobetasone butyrate 0.05%) cream has recently been made available as a pharmacy medication for the short-term management of acute eczema and allergic dermatitis by adults and children aged 10 or older, based on evidence derived from clinical trials involving over 3500 patients. This review summarises the key efficacy and safety data derived from 29 clinical trials and the post-licensing pharmacovigilance safety information, which supported the reclassification of this product for OTC use. These data show clobetasone butyrate 0.05% is more effective than 1.0% hydrocortisone in the treatment of eczema and more effective than flurandrenolone 0.0125% (p=0.01%) and a potent topical steroid hydrocortisone butyrate (p<0.05), in the treatment of psoriasis. A review of the effect of topical steroids on skin thickness concluded that, following short term application, there was no clinically significant difference between hydrocortisone 1.0% and clobetasone butyrate 0.05% in terms of potential for skin thinning. Similarly, even under extreme conditions, clobetasone butyrate 0.05% has negligible systemic absorption and has almost no effect on HPA axis function.

Topics: Acute Disease; Administration, Cutaneous; Administration, Topical; Adverse Drug Reaction Reporting Systems; Anti-Inflammatory Agents; Clobetasol; Dermatitis; Humans; Hydrocortisone; Nonprescription Drugs; Ointments; Randomized Controlled Trials as Topic; Self Medication

Topics: Anti-Inflammatory Agents, Non-Steroidal; Betamethasone; Clobetasol; Humans; Ophthalmic Solutions; Uveitis, Anterior

Topics: Androstadienes; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Betamethasone; Clobetasol; Humans; Loteprednol Etabonate; Ophthalmic Solutions; Prednisolone; Uveitis, Anterior

Herbs and minerals have been used in clinical dermatology for hundreds of years and herbal ingredients are becoming increasingly popular with the public in treatment of various dermatological conditions characterised by inflammation and pruritus. The aim of this study was to compare the efficacy of traditional topical therapeutic agents with a moderate potency topical glucocorticoid on experimental contact dermatitis and contact urticaria. The effects of ichthammol 10% pet, zinc oxide 20% pet, camphor 20% pet, levomenthol 10% pet, tea tree oil 20 or 50% and clobetason butyrate 0.05% ointment were studied in the following experimental models: elicitation of allergic contact dermatitis to nickel, irritant contact dermatitis to benzalkonium chloride, and in immediate reactions to histamine and benzoic acid (non-immunological contact utricaria) respectively. Delayed reactions were evaluated using a clinical scoring system and immediate reactions were estimated by planimetry. Histamine-induced pruritus was evaluated using VAS. Tea tree oil reduced allergic contact dermatitis by 40.5% (p = 0.003), zinc oxide by 17.4% (p = 0.04) and clobetason butyrate by 23.5% (p = 0.01). Zinc oxide reduced histamine induced flare by 18.5% (p = 0.01), ichthammol by 19.2% (p = 0.02) and clobetason butyrate by 44.1% (p = 0.02). Irritant contact dermatitis and non-immunological contact urticaria were not influenced by the pre-treatments. Pruritus induced by histamine also remained unchanged. In conclusion, tea tree oil seems to be a more effective anti-eczematic agent than zinc oxide and clobetasone butyrate, while clobetasone butyrate is superior to both ichthammol and zinc oxide in topical treatment of urticarial reactions.

Topics: Adult; Aged; Benzalkonium Compounds; Benzoic Acid; Camphor; Clobetasol; Dermatitis, Contact; Female; Histamine; Humans; Male; Menthol; Middle Aged; Nickel; Quaternary Ammonium Compounds; Tea Tree Oil; Zinc Oxide

The main objective of this explorative study was to evaluate if tacrolimus ointment could be safer than corticosteroid ointment, with special reference to the intraocular pressure in the treatment of eyelid eczema in patients with atopic keratoconjunctivitis (AKC). Secondary aims were to compare the effects of the treatments on eyelid eczema and their potential impact on ocular surface inflammation.. Tacrolimus 0.1% ointment and clobetasone butyrate 0.05% ointment were compared in a double-masked explorative crossover study. In total, 25 AKC patients were included. Each ointment was applied twice daily for 3 weeks, with 2 weeks of washout before, between, and after treatments. Efficacy was determined by eye examination and the patients' own symptom scoring. Cytology and cytokine measurements were performed on tear samples. Safety parameters were intraocular pressure, presence of bacteria and fungi, and the patients' reports of adverse events. The validity of the crossover design was explored with analysis of variance, and the effect of each medication was calculated with paired t-test and Wilcoxon paired test.. A total of 20 patients completed the study. Both treatments were effective in reducing signs and symptoms of eyelid eczema, with a near superior benefit for tacrolimus in terms of eczema (total skin score) signs (P=0.05). No serious adverse events occurred and interestingly, intraocular pressure was not evidently affected by either treatment.. Tacrolimus 0.1% ointment is a promising alternative therapy for eyelid eczema in AKC patients. Long-term studies are needed to further determine the value of tacrolimus in this patient group.

Topics: Adolescent; Adult; Aged; Antibodies, Bacterial; Biomarkers; Blepharitis; Clobetasol; Cross-Over Studies; Cytokines; Dermatitis, Atopic; Eyelids; Female; Glucocorticoids; Humans; Immunosuppressive Agents; Inflammation Mediators; Intraocular Pressure; Keratoconjunctivitis; Male; Middle Aged; Ointments; Tacrolimus; Tears; Treatment Outcome

We report a prospective randomized study comparing the effects of highly potent and moderately potent topical steroids in treating pediatric phimosis.. A total of 70 boys 1 to 12 years old with phimosis were randomly assigned to receive topical application of either betamethasone valerate 0.06% (a highly potent steroid) or clobetasone butyrate 0.05% (a moderately potent steroid). Parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroids over the stenotic opening of the prepuce twice daily for 4 weeks, then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 0 to 5. Response to treatment was arbitrarily defined as improvement in the retractibility score of more than 2 points.. Mean treatment and followup periods were 4.3 and 19.1 weeks, respectively. The response rates in boys treated with betamethasone valerate and clobetasone butyrate were 81.3% and 77.4%, respectively (p = 0.63). Mean retractibility score decreased from 3.9 +/- 1.0 to 1.7 +/- 1.1, and 4.2 +/- 1.0 to 1.9 +/- 1.0 in the betamethasone and clobetasone groups, respectively. Both steroids were effective in all age groups. Pretreatment retractibility score did not affect treatment outcomes. No adverse effect was encountered.. Highly potent and moderately potent topical steroids are of comparable effectiveness in treating phimosis. A less potent steroid may be considered first to decrease the risk of the potential adverse effects.

Topics: Administration, Cutaneous; Betamethasone Valerate; Child; Child, Preschool; Clobetasol; Follow-Up Studies; Glucocorticoids; Humans; Infant; Male; Phimosis; Prospective Studies; Single-Blind Method; Treatment Outcome

The emollient base of a topical corticosteroid, through its moisturizing properties, can be a useful treatment adjunct.. To compare the healing properties of Eumovate trade mark (clobetasone butyrate) 0.05% cream with its emollient base, hydrocortisone 1% cream and with no treatment.. A single-centre, double-blind, intra-individual, comparative study that involved 18 volunteers with nickel-induced contact dermatitis. Following a positive patch test to nickel, sub-therapeutic amounts (10 micro l = 3 mg cm(-2)) of each of the treatments were applied twice daily for seven days to each of the four test sites.. In terms of the primary endpoint, a physician's global assessment after 7 days of treatment, clobetasone butyrate (CB) 0.05% cream showed a significantly better response than hydrocortisone (HC) 1% cream (78% vs 39%, difference -0.4, 95% CI -0.7 to -0.1; p = 0.046) or no treatment (78% vs 28%, difference -0.5, 95% CI -0.9 to -0.1; p = 0.016). CB 0.05% cream also showed a better response than its emollient base (78% vs 56%), though statistical significance was not achieved. In terms of moisturizing effects, there was no difference in transepidermal water loss (TEWL) between CB 0.05% cream and its emollient base. CB 0.05% cream treated sites did, however, have significantly lower values (i.e. were more moisturized) than untreated sites (difference -8.5, 95% CI -12.0 to -4.86; p < 0.001) or HC 1% treated sites (difference -7.1, 95% CI -11.0 to -3.4; p < 0.001). In terms of skin blanching activity, as expected the steroid-based creams achieved lower colorimetric values than the emollient base cream.. These results from experimentally induced skin inflammation indicate that CB 0.05% (as Eumovate 0.05% cream) has both more effective anti-inflammatory activity and better moisturizing properties than hydrocortisone 1% cream and that these effects are in part due to its efficient emollient base.

Topics: Administration, Cutaneous; Administration, Topical; Adolescent; Adult; Analysis of Variance; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Contact; Double-Blind Method; Female; Humans; Hydrocortisone; Middle Aged; Nickel; Ointments; Patch Tests; Treatment Outcome; Water Loss, Insensible

Fluticasone propionate is a novel and potent corticosteroid. It seems to have an improved therapeutic index on the basis of studies on skin thinning and suppression of hypothalamic-pituitary-adrenal axis.. We assessed the efficacy and safety of fluticasone propionate (FP) 0.05% cream once daily as compared with clobetasone butyrate (CB) 0.05% cream twice daily in children with atopic dermatitis (AD).. Twenty-two children (3 to 8 years old) with moderately active AD received either FP once daily or CB twice daily. Severity of AD was scored weekly by means of the modified Scoring of Atopic Dermatitis system (SCORAD) and treatment was either stopped when skin lesions were almost cleared (SCORAD < 9) or after 4 weeks. Cortisol excretion was determined by means of 24-hour urine before and after treatment.. Twenty-one children completed the study. After 1 week of treatment, mean SCORAD significantly decreased in both treatment groups. After 2, 3, and 4 weeks cumulatively, 8, 12, and 16 children, respectively, were clinically healed (SCORAD < 9). No significant differences in efficacy were observed between the two treatments. Urinary cortisol excretion was not altered by either of the treatments. Two weeks after discontinuation of active treatment, mean SCORAD had increased to 22, but still was significantly lower than that at the beginning of the study.. Once-daily treatment with FP is as safe and effective as twice-daily treatment with CB in children with AD. All children experienced an exacerbation of AD within 2 weeks after treatment was withdrawn, indicating the need for long-term "intermittent" treatment.

Topics: Administration, Topical; Androstadienes; Anti-Inflammatory Agents; Child; Child, Preschool; Clobetasol; Dermatitis, Atopic; Double-Blind Method; Female; Fluticasone; Glucocorticoids; Humans; Male; Ointments; Severity of Illness Index; Statistics, Nonparametric; Time Factors

The objectives of the study were to determine whether concurrent treatment with calcipotriol (50 microg/g) and either clobetasone 17-butyrate cream (0.5 mg/g) (moderate potency) or betamethasone 17-valerate cream (1 mg/g) (potent) or placebo (vehicle of calcipotriol) was more effective and/or caused less skin irritation than calcipotriol cream (50 microg/g) used twice daily. It was a multicentre, double-blind, parallel group study. Patients applied calcipotriol cream in the morning and either vehicle (n = 174), calcipotriol (n = 174), clobetasone (n = 175) or betamethasone creams (n = 176) in the evening for up to 8 weeks. Adverse events led to withdrawal in 20 patients (2.9%). The mean percentage change in PASI (psoriasis area and severity index) was -40.6 in the calcipotriol/vehicle group, -48.3 in the calcipotriol/calcipotriol group, -53.7 in the calcipotriol/clobetasone 17-butyrate group and -57.5 in the calcipotriol/betamethasone 17-valerate group. A statistically significant difference was seen between the four treatment groups (P = 0.006) with calcipotriol/vehicle being less effective than the other treatments. A statistically significant difference in favour of calcipotriol/betamethasone 17-valerate was seen between the calcipotriol/calcipotriol group and the calcipotriol/betamethasone 17-valerate group. The majority of adverse events were skin irritations, which were reported for 31.2% of patients treated with calcipotriol/vehicle, 34.3% of patients treated with calcipotriol twice daily and 23.8% vs. 17.1% of patients treated with calcipotriol/clobetasone 17-butyrate and calcipotriol/betamethasone 17-valerate, respectively. Skin irritation was seen statistically significantly less frequently in patients treated with calcipotriol/ clobetasone 17-butyrate or calcipotriol/betamethasone 17-valerate (P = 0.001), whereas no difference was seen between the other groups. In conclusion, calcipotriol applied twice daily was as effective as calcipotriol/clobetasone 17-butyrate, but slightly less effective than calcipotriol/betamethasone 17-valerate. The incidence of skin irritation was less for patients using concurrent corticosteroids, whereas treatment with calcipotriol/vehicle did not reduce the incidence of skin irritation when compared with calcipotriol twice daily.

Topics: Adult; Anti-Inflammatory Agents; Betamethasone; Calcitriol; Clobetasol; Dermatologic Agents; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Psoriasis; Treatment Outcome

Mometasone furoate (MF) is a new strongly lipophilic steroid which has an anti-inflammatory effect as evaluated by in vivo and in vitro studies.. The objective of the present study was to investigate the degree of inhibition of experimental allergic contact dermatitis induced by the treatment with MF.. The therapeutic effect was evaluated by an echographic method associated with image analysis. MF activity was compared to that of hydrocortisone acetate 0.5% (Cortaid Cream, Lachifarma), clobetasone butyrate 0.05% (Eumovate Cream, Glaxo) and clobetasol propionate 0.05% (Clobesol Cream, Glaxo), classified respectively as weak, moderately potent and very potent steroids.. The different corticosteroid formulations employed for inhibiting experimentally induced contact dermatitis reflect the expected rank order of efficacy.. MF behaves like clobetasol butyrate ranking as a moderately potent corticosteroid.

Topics: Administration, Topical; Adolescent; Adult; Analysis of Variance; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Allergic Contact; Female; Humans; Hydrocortisone; Image Enhancement; Middle Aged; Mometasone Furoate; Patch Tests; Pregnadienediols; Reproducibility of Results; Skin; Ultrasonography

Calcipotriol and corticosteroids, two therapy modalities frequently prescribed in the treatment of psoriasis, are often used in combination. The aim of the present study was to determine whether the cell biological response pattern of concurrent use of calcipotriol and corticosteroids is different from calcipotriol monotherapy. Forty patients with chronic plaque psoriasis were divided at random in four parallel groups and treated for 8 weeks with: (1) calcipotriol cream (50 micrograms/g once daily); (2) calcipotriol cream twice daily; (3) calcipotriol and clobetasone 17-butyrate (0.5 mg/g) creams; and (4) calcipotriol and betamethasone 17-valerate (1 mg/g) creams. Before and after treatment keratotome biopsies were taken and single cell suspensions prepared for flow cytometric analysis. Flow cytometric multiparameter quantification of markers for proliferation (TO-PRO-3), differentiation (antikeratin 10) and inflammation (antivimentin) was used to evaluate all four therapy modalities. A statistically significant decrease of the percentage of basal cells in S- and G2M-phase (proliferation) was obtained with all therapy modalities, except for calcipotriol monotherapy applied once daily. A significant reduction of the number of vimentin-positive cells (non-keratinocytes) was observed following combined treatment with calcipotriol and clobetasone butyrate. In contrast, monotherapy with calcipotriol had virtually no effect on the number of vimentin-positive cells. It can be concluded that: (i) calcipotriol monotherapy, applied once daily was less antiproliferative compared with twice daily applications of calcipotriol or the combined treatment with corticosteroids and that (ii) the combination of calcipotriol and corticosteroids proved to have a marked effect on the percentage of non-keratinocytes, in contrast to the modest effect of calcipotriol.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone Valerate; Calcitriol; Cell Division; Clobetasol; Dermatologic Agents; DNA; Drug Administration Schedule; Drug Therapy, Combination; Epidermis; Flow Cytometry; Glucocorticoids; Humans; Keratins; Psoriasis; Vimentin

Atopic dermatitis is commonly colonized with Staphylococcus aureus in high densities.. Our purpose was to study the effect of topical corticosteroids on the colonization of S. aureus in atopic dermatitis.. Sixty-six patients were treated with moderately potent, or very potent corticosteroids. Quantification of S. aureus and evaluation of the severity of the eczema was performed before, after 1 week, and after 2 weeks of treatment.. Fifty-three patients carried S. aureus in the most pronounced lesion before treatment. The colonization was significantly correlated with the severity of the eczema. The density of S. aureus was reduced by topical corticosteroids. The reduction increased with the potency of the corticosteroid and was most pronounced during the first week. S. aureus was eliminated after a successful 2-week treatment with a very potent corticosteroid. Propylene glycol 25% added to a moderately potent corticosteroid did not significantly increase the reduction of S. aureus.. Topical corticosteroids of sufficient potency reduce the density of S. aureus in atopic dermatitis.

Topics: Administration, Cutaneous; Adolescent; Adrenal Cortex Hormones; Adult; Child; Child, Preschool; Clobetasol; Dermatitis, Atopic; Drug Therapy, Combination; Female; Humans; Male; Methylprednisolone; Middle Aged; Neomycin; Staphylococcal Infections; Staphylococcus aureus

Dermo-epidermal atrophy is one of the main side effects of long-term treatment with topical corticosteroids. Retinoic acid may prevent and even reverse these effects in animals. Extension of this concept to therapy in humans implies that several studies have been performed; among others, it has to be established that treatment with topical retinoic acid does not interfere with the anti-inflammatory action of topical corticosteroids. The present study on the cutaneous vasoconstriction test comprised two different double-blind approaches: (i) vasoconstriction tests with betamethasone dipropionate (Diprolene) and clobetasone butyrate (Emovate) were carried out on skin that had previously been treated for 10 days with retinoic acid 0.01, 0.025 or 0.05% (or excipient); (ii) vasoconstriction tests with a combination of triamcinolone acetonide 0.1% and retinoic acid 0.025% were compared with triamcinolone acetonide 0.1% alone. Pretreatment for 10 days with retinoic acid did not alter the vasoconstriction induced by corticosteroids: no decrease or increase in the vasoconstriction score was observed, whether the skin had been previously treated with retinoic acid or with excipient. The vasoconstriction scores obtained with a combination of retinoic acid and triamcinolone acetonide were identical with those obtained with the steroid alone. This study indicates that retinoic acid does not inhibit the vasoconstriction induced by topical corticosteroids and suggests that the anti-inflammatory effect of the latter should be maintained in association with retinoic acid.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Female; Glucocorticoids; Humans; Male; Skin; Tretinoin; Triamcinolone Acetonide; Vasoconstriction

The effect of fluoromethalone 0.1% suspension (FML), clobetasone butyrate 0.1% (Eumovate) and betamethasone phosphate 0.1% (Betnesol) in post-operative inflammation was studied in 60 eyes (50 patients) in a randomized trial. No significant differences were noted, although two patients required higher penetration steroids than FML or Eumovate. Betnesol seemed to have a greater tendency to cause raised intraocular pressure than FML. In this series, however, the authors are unable to comment on differences between Eumovate and Betnesol.

Topics: Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Fluorometholone; Humans; Intraocular Pressure; Middle Aged; Postoperative Complications; Uveitis

Twenty-nine patients with symmetrical eczematous lesions were treated with 0.05% clobetasone butyrate cream. Clinical conditions and cortisol and ACTH concentrations were evaluated at the beginning and after 1 week in 12 children and after 2 weeks of treatment in 17 patients respectively. The lesions and symptoms improved steadily and no significant change in cortisol and ACTH plasma levels was observed throughout the study in all children. This steroid offers clinically effective topical antiinflammatory activity with a wide margin of safety.

Topics: Adolescent; Adrenocorticotropic Hormone; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clinical Trials as Topic; Clobetasol; Dermatitis, Atopic; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Infant; Male; Pituitary-Adrenal System; Random Allocation; Time Factors

Forty patients with skin diseases of various origins were treated with a combination of three creams, the respective bases of which were clobetasone butyrate, sodium fusidate and ketoconazole. Satisfactory results were obtained in 97.5% of cases, with remission of symptoms and good healing of lesions. Tolerance was excellent in 97.5% of cases, with only one patient complaining of burning sensations after the applications.

Topics: Administration, Topical; Adolescent; Adult; Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Drug Therapy, Combination; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases

A randomized, double-blind, parallel-group study was conducted comparing the efficacy and safety of alclometasone dipropionate cream 0.05% and clobetasone butyrate cream 0.05% in the treatment of atopic dermatitis in 43 children. The medications were applied to study areas as a thin layer of cream twice daily for 2 weeks. Efficacy was assessed by evaluation of three disease signs (erythema, induration, and pruritus) and by mean of a physician's global evaluation following treatment. Safety was evaluated through patient-reported and clinically observed adverse experiences. Both treatments were effective. At the end of the trial, average reduction in disease signs was 85% for alclometasone dipropionate-treated patients and 86% in the clobetasone butyrate-treated group. In the global evaluation, the physician rated symptoms as cleared in 9 of 22 alclometasone dipropionate-treated patients and in 10 of 21 clobetasone butyrate-treated patients.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clinical Trials as Topic; Clobetasol; Dermatitis, Atopic; Double-Blind Method; Female; Humans; Male; Methylprednisolone

The vasoconstrictor effect of 7 proprietary corticosteroid creams was compared with their effect on patches of allergic contact dermatitis provoked by patch testing in 20 subjects. A parallel between the blanching effect on the normal skin and the anti-inflammatory effect on the eczematous skin was generally found. A modified patch test method using the Finn chamber technique is described, which (with certain restrictions) offers an opportunity of studying the anti-inflammatory effect of corticosteroids on allergic dermatitis under standard conditions.

Topics: Acute Disease; Adrenal Cortex Hormones; Adult; Betamethasone; Betamethasone Valerate; Clobetasol; Dermatitis, Contact; Female; Humans; Hydrocortisone; Male; Middle Aged; Patch Tests; Skin; Triamcinolone Acetonide; Vasoconstriction

Six groups of children suffering from widespread atopic dermatitis were treated once daily with six topical steroids of different potency. Systemic effects were measured by the morning estimation of plasma cortisol. A clear relationship was demonstrated between clinical efficacy of the steroid treatment and degree of reduced adrenal function. This study demonstrated that a rapid and marked therapeutic effect can be obtained with potent topical steroids applied once daily without occlusion, but in children is accompanied by a fall in plasma cortisol.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clobetasol; Dermatitis, Atopic; Desonide; Diflucortolone; Drug Administration Schedule; Female; Fluocortolone; Halcinonide; Humans; Hydrocortisone; Infant; Male; Ointments

10 subjects were assessed using the vasoconstrictor assay technique in a double-blind study in order to evaluate the relative potencies of several diluted and undiluted proprietary corticosteroid preparations. Dermovate ointment achieved a significantly higher score than any other preparation but there was no significant difference between the scores for Betnovate ointment (betamethasone valerate 0.1%), Propaderm Forte cream (beclomethasone dipropionate 0.5%), Propaderm ointment (beclomethasone dipropionate 0.025%), Nerisone Forte ointment (diflucortolone valerate 0.3%), and Nerisone ointment (diflucortolone valerate 0.1%). Furthermore, no significant difference in scores could be demonstrated between Adcortyl ointment (triamcinolone acetonide 0.1%), Ledercort ointment (triamcinolone acetonide 0.1%) and extemporaneous dilutions of these ointments 1 part in 4 in their recommended diluents (triamcinolone acetonide 0.025%). The relevance of these findings to clinical practice is discussed.

Topics: Administration, Topical; Adult; Clobetasol; Diflucortolone; Dose-Response Relationship, Drug; Female; Glucocorticoids; Humans; Male; Triamcinolone Acetonide; Vasoconstriction

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clinical Trials as Topic; Clobetasol; Female; Humans; Infant; Male; Ointments; Skin Diseases; Switzerland

In a parallel group design, and using a 'blind evaluator' technique, alclometasone cream 0.05% and clobetasone butyrate cream 0.5% applied twice a day for 21 days were compared in thirty-one patients presenting with psoriasis. Erythema, induration and scaling were assessed at the start of treatment. Seven, 14 and 21 days later, effects of the two treatments were assessed and recorded together with the physician's global evaluation of overall improvement. Both drugs had similar beneficial effects on the clinical signs. No adverse experience was reported and the overall results indicate that alclometasone and clobetasone have comparable efficacy and safety.

Topics: Adult; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Drug Evaluation; Humans; Methylprednisolone; Psoriasis

Clobetasone butyrate eye drops comprise a new steroid preparation which has been investigated in two comparable, double-blind, multicentre clinical trials in patients with ocular inflammation. One study compared clobetasone butyrate with betamethasone phosphate eye drops (205 patients) and the other study compared corresponding preparations containing neomycin (169 patients). There was no difference between the responses to clobetasone butyrate and betamethasone. An excellent or good response was obtained in 73 per cent of patients treated with clobetasone butyrate, 75 per cent with betamethasone, 69 per cent with clobetasone butyrate formulated with neomycin, and 76 per cent with betamethasone formulated with neomycin. Patients who were known to react with a rise of intraocular pressure (IOP) to steroids were treated with clobetasone butyrate eye drops in one eye and either prednisolone eye drops (6 patients) or hydrocortisone eye drops (4 patients) in the other eye. The doses were continued for 6 weeks, or less if the IOP rose more than 10 mm Hg in one eye. All patients experienced a greater intraocular pressure rise in the eye treated with prednisolone or hydrocortisone. The mean changes in IOP were 9 mm Hg for prednisolone compared to 2 mm Hg for clobetasone butyrate (P less than 0.05 Wilcoxon signed ranks test) and 16 mm Hg for hydrocortisone compared to 2 mm Hg for clobetasone butyrate.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Child; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Drug Combinations; Endophthalmitis; Female; Humans; Hydrocortisone; Intraocular Pressure; Male; Middle Aged; Neomycin; Ophthalmic Solutions; Prednisolone; Random Allocation

Clobetasone butyrate (0.1%), a new topical corticosteroid eye preparation for the treatment of ocular inflammation, has been compared with sodium cromoglycate (2%) eye drops in thirty-nine patients experiencing allergic conjunctivitis during the hay fever season. In this double-blind, within-patient comparative study both preparations were effective in relieving the patients' symptoms of conjunctivitis. However, clobetasone butyrate was clinically more effective than sodium cromoglycate as determined by symptom score card analysis (P less than 0.01) and the patients' overall assessment of treatment (P less than 0.05). Patients' preference for the treatment of seasonal allergic conjunctivitis was markedly in favour of clobetasone butyrate (P less than 0.001).

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Betamethasone; Child; Clinical Trials as Topic; Clobetasol; Conjunctivitis; Cromolyn Sodium; Double-Blind Method; Female; Humans; Male; Middle Aged; Rhinitis, Allergic, Seasonal

Thirty-nine patients took part in a double-blind, between-patient clinical trial to compare clobetasone butyrate, betamethasone phosphate, and placebo eye drops in the treatment of episcleritis. Although from the symptom scores the patients given placebo appeared to do as well as the other patients in the first week of treatment, they did significantly less well after this time. Clobetasone butyrate and betamethasone phosphate eye drops seemed to be equally effective in the treatment of this disease.

Topics: Anti-Inflammatory Agents; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Humans; Inflammation; Intraocular Pressure; Sclera

Clobetasone butyrate has been formulated as a new steroid preparation of use in ophthalmology and has been compared with prednisolone phosphate and betamethasone phosphate in the treatment of anterior uveitis. The results from 4 double-blind, between-patient studies have shown that all 3 treatments are effective in reducing the signs and symptoms of this intraocular disease. 87% of those patients receiving clobetasone butyrate had a good or satisfactory response, but no differences in therapeutic efficacy were observed between these 3 steroid treatments. Clobetasone butyrate had little effect on intraocular pressure when compared with dexamethasone or hydrocortisone, both of which cause a significant rise in intraocular pressure.

Topics: Adolescent; Adult; Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Dexamethasone; Double-Blind Method; Female; Humans; Hydrocortisone; Intraocular Pressure; Male; Middle Aged; Ophthalmic Solutions; Prednisolone; Random Allocation; Uveitis

10 patients with sub-total villous atrophy were given the topical corticosteroids betamethasone valerate or clobetasone butyrate for a period of 4 months whilst continuing on a normal diet. 5 patients improved symptomatically while red cell folate, urinary xylose and faecal fat excretion also improved. Brush border enzymes increased in patients treated with higher dosages of each drug. Enterocyte height increased and intra-epithelial lymphocytes were significantly decreased although overall morphological appearances remained indistinguishable from untreated coeliac disease. Suppression of the pituitary adrenal axis occurred in 8 patients and there did not appear to be useful separation of topical from systemic activity. These compounds offer no advantage over prednisolone in non-responsive coeliac disease.

Topics: Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Betamethasone; Betamethasone Valerate; Celiac Disease; Clinical Trials as Topic; Clobetasol; Female; Humans; Male; Middle Aged; Patient Compliance; Prednisolone

A double-blind, half-side comparative dermal atrophy study of fluocortin butylester 0.75% clobetasone butyrate 0.05%, hydrocortisone acetate 1% and placebo creams was carried out in 29 healthy human male volunteers. Skin thickness was measured by a modified radiographic technique before and after an 8-week application period of the test preparations. Significant skin thinning occurred in 3 of the 10 subjects treated with clobetasone butyrate and atrophy of marginal significance in 1 of the 29 subjects treated with fluocortin butylester. The results suggest that, compared with other fluorinated topical steroids, fluocortin butylester 0.75% is unlikely to produce significant dermal atrophy when used in the short and medium term.

Topics: Administration, Topical; Adolescent; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Atrophy; Clobetasol; Double-Blind Method; Fluocortolone; Humans; Hydrocortisone; Male; Middle Aged; Placebos; Skin

Topics: Adult; Betamethasone; Child; Clobetasol; Double-Blind Method; Female; Humans; Hydrocortisone; Male; Ointments

We present the results of a double-blind trial comparing the efficacy of betamethasone phosphate 0.1%, clobetasone butyrate 0.1%, and placebo in the treatment of acute unilateral nongranulomatous uveitis. The 2 steroids were equally comparable in improvement of the patients' symptoms, though betamethasone phosphate was significantly more effective than clobetasone butyrate in improving the ocular signs of uveitis. However, clobetasone butyrate had significantly less effect on raising intraocular pressure in known steroid responders and ocular hypertensives than did dexamethasone. The use of a bolometer as an objective measure in uveitis was significant only in the more severe cases of uveitis. In comparing the placebo group of patients with those on topical steroids, the former group, though improving, appeared to lag behind by approximately one week. Four cases on placebo, however, had to be withdrawn because of worsening of the condition. Mild cases of anterior uveitis would probably resolve without using topical steroids.

Topics: Administration, Topical; Adult; Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Female; Humans; Intraocular Pressure; Male; Middle Aged; Uveitis

Forty patients with symmetrical eczematous lesions on their extremities were treated in a double-blind fashion with 0.05% clobetasone butyrate and 0.1% hydrocortisone butyrate in cream bases. After 2 weeks of treatment, a preference for clobetasone butyrate was observed in 7 cases, for hydrocortisone butyrate in 9 cases and in 24 cases both sides responded equally. The lesions on both sides improved steadily throughout the study in all cases. When completing the trial after 2-weeks' treatment, the clobetasone butyrate-treated lesions had healed in 8 cases and the hydrocortisone butyrate-treated lesions in 10 cases. No local side-effects were observed.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Eczema; Female; Humans; Hydrocortisone; Male; Middle Aged; Time Factors

The results are presented of a double-blind trial comparing the efficacy of betamethasone phosphate 0.1 per cent, clobetasone butyrate 0.1 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.

Topics: Acute Disease; Adult; Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Female; Humans; Male; Middle Aged; Ophthalmic Solutions; Random Allocation; Uveitis, Anterior

In a double-blind, randomized study, 0.05% clobetasone butyrate cream was found to be as effective as 0.1% betamethasone valerate in the treatment of 48 patients with atopic or contact dermatitis, after 2 weeks as well as after 4 weeks of treatment. Side-effects with both drugs were rare and mild.

Topics: Adolescent; Adult; Aged; Betamethasone; Betamethasone Valerate; Child; Clobetasol; Dermatitis, Atopic; Dermatitis, Contact; Double-Blind Method; Female; Humans; Male; Middle Aged; Time Factors

Clobetasone butyrate ointment has been shown to be more effective in treating psoriasis and eczema than flurandrenolone ointment yet to cause less epidermal thinning in a human experimental model. This is an indication that the clinical activity of topical glucocorticoids may not necessarily be inseparable from their propensity to cause atrophy of the skin.

Topics: Betamethasone; Cell Count; Clinical Trials as Topic; Clobetasol; Eczema; Flurandrenolone; Humans; Psoriasis; Skin

Eczematous external otitis is a common chronic condition that can have a significant impact on the life of sufferers, causing constant discomfort and pruritus, and leading to sleep deprivation. Treatment is based on the use of topical steroids, moisturisers and occasionally antibiotics. Results, however, can be disappointing, especially over the long term.. This study compared the long-term response to pimecrolimus, administered to a group of 11 patients, against clobetasone butyrate, administered to an equivalent number of patients. Response to the treatment was assessed and statistically analysed at 3 and 12 months.. Whereas the degree of improvement following the use of pimecrolimus and clobetasone butyrate was similar for the two groups at month 3, a highly statistically significant difference was documented at month 12, with a much greater and sustained improvement in the pimecrolimus group.

Topics: Administration, Topical; Clobetasol; Ear Canal; Humans; Otitis Externa; Tacrolimus

Pertuzumab and trastuzumab are monoclonal antibody inhibitors targeting human epidermal growth factor receptor 2 (HER-2) and are increasingly being utilised in the management of HER2-positive breast cancer, having been demonstrated to improve progression-free survival in conjunction with docetaxel. We present a rare presentation of a lichenoid drug eruption, in an annular atrophic variant, in a 35-year-old woman after initiation of HER2-inhibitor (pertuzumab and trastuzumab) therapy for metastatic breast cancer.

Topics: Adult; Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Immunological; Breast Neoplasms; Clobetasol; Female; Glucocorticoids; Humans; Lichen Planus; Receptor, ErbB-2; Trastuzumab

Topics: Child, Preschool; Clobetasol; Glucocorticoids; Humans; Insect Bites and Stings; Male; Pulsatile Flow

Topics: Blister; Child; Clobetasol; Glucocorticoids; Humans; IgA Vasculitis; Male

Topics: Anti-Inflammatory Agents; Clobetasol; Cushing Syndrome; Diaper Rash; Female; Glucocorticoids; Humans; Infant

Topics: Administration, Topical; Betamethasone; Biopsy, Needle; Clobetasol; Disease Progression; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Epitopes; Fluorescent Antibody Technique, Direct; Follow-Up Studies; Humans; Immunoblotting; Immunohistochemistry; Infant; Japan; Male; Pemphigoid, Bullous; Risk Assessment; Severity of Illness Index; Treatment Outcome

Terbinafine, a systemic antifungal commonly prescribed for onychomycosis (fungal infection involving the nails) has been reported to cause various cutaneous adverse effects. We describe an overlap syndrome between cutaneous lupus and erythaema multiforme induced by this medication with a review of other reported cases.

Topics: Aged, 80 and over; Anti-Inflammatory Agents; Antifungal Agents; Clobetasol; Dermatologic Agents; Diagnosis, Differential; Erythema Multiforme; Female; Humans; Lupus Erythematosus, Cutaneous; Naphthalenes; Ointments; Onychomycosis; Syndrome; Terbinafine; Treatment Outcome

Topics: Anti-Inflammatory Agents; Child; Clobetasol; Coloring Agents; Dermatitis, Allergic Contact; Humans; Male; Phenylenediamines; Tattooing

In the present study, we performed comprehensive pharmaceutical evaluation among an original clobetasone butyrate (CLB) ointment product and three generic products. Although spherocrystal images were observed under a polarizing microscope for only Kindavate®, the original product, distribution of active and inactive ingredients was chemically equivalent between the original and generic medicine by the attenuated total reflection infrared spectroscopy. These results suggest that the spherocrystals observed in Kindavate® are composed of hydrocarbon. On GC/MS, it was revealed that linear alkanes having 25-27 carbon atoms are densely present in Sun White®, the base used in Kindavate®. On the other hand, linear alkanes having 22-31 carbon atoms were broadly distributed in most other white petrolatums. In the CLB ointment products, the distribution equivalent of linear alkane to Sun White® was observed only in Kindavate®. Thus, the GC/MS method is extremely useful for identification of white petrolatum used in the ointment. A similar amount of CLB among the pharmaceutical products was detected in the skin tissue by skin accumulation test, although there were the differences in rheological properties and the quality of white petrolatum. The present results will be very useful for pharmacists in selecting medicine products that match the needs of the patient. Such pharmaceutical information will help spread objective knowledge about products in the future, and will contribute to the appropriate selection of medication.

Topics: Animals; Clobetasol; Drugs, Generic; Male; Mice; Mice, Hairless; Ointments; Petrolatum; Rheology; Skin; Skin Absorption

Uptake and biological effects of synthetic glucocorticoids (GCs) were analyzed using common carp (Cyprinus carpio). Fish were exposed to clobetasol propionate (CP) or clobetasone butyrate (CB) individually or in mixture at 1 μg L(-1) for 21 days. Bioconcentration factor (BCF) of CB was calculated as 100, and BCF of CP was less than 16. No effects were found in fish erythrocyte and leukocyte numbers and serum glucose levels after exposure to the selected GCs. On the other hand, serum concentrations of free amino acids significantly increased in GC-exposed groups. Thus, exposures to synthetic GCs at relatively low concentrations seemed to cause enhancement of protein degradation and subsequent increase of serum free amino acids without a corresponding increase in serum glucose levels, an effect which might be related to partial induction of gluconeogenesis by GC.

Topics: Amino Acids; Animals; Blood Glucose; Carps; Clobetasol; Erythrocyte Count; Glucocorticoids; Leukocyte Count; Proteolysis

The fact that this patient's rash was limited to his chest provided an important diagnostic clue.

Topics: Acantholysis; Acneiform Eruptions; Administration, Oral; Administration, Topical; Biopsy; Clobetasol; Dermatitis, Seborrheic; Dermatologic Agents; Diagnosis, Differential; Drug Eruptions; Folliculitis; Histamine Antagonists; Humans; Ichthyosis; Male; Middle Aged; Skin; Terfenadine; Treatment Outcome

A patient is described with dermatitis artefacta, which is a common psychocutaneous disorder whereby a fully-aware patient self-inflicts injury to their skin. The motives for their behaviour can vary and the patient always tries to hide the responsibilities for their actions. In this case report, serial use of standardised photography provided strong evidence to support the diagnosis of dermatitis artefacta. The fluorescent properties of Trimovate® Cream under Wood's light examination corroborated the diagnosis. Trimovate® Cream was applied to the skin surrounding the injuries and the limb was occluded with four layers of bandages. Traces of Trimovate® Cream were seen under Wood's light on the outer layers of the bandage. This suggested transfer of the cream from the occluded skin surface by the patient's fingers whilst tampering with the dressings. This case report shows how serial photography and imaging using ultraviolet (UV) fluorescence can provide evidence to support the diagnosis of dermatitis artefacta.

Topics: Anti-Inflammatory Agents; Clobetasol; Dermatitis; Humans; Male; Middle Aged; Photography; Self-Injurious Behavior; Ultraviolet Rays

Chronic, non-healing wounds are often characterised by an excessive, and detrimental, inflammatory response. We review our experience of using a combined topical steroid, antibiotic and antifungal preparation in the treatment of chronic wounds displaying abnormal and excessive inflammation.. A retrospective review was undertaken of all patients being treated with a topical preparation containing a steroid (clobetasone butyrate 0.05%), antibiotic and antifungal at a tertiary wound healing centre over a ten-year period. Patients were selected as the primary treating physician felt the wounds were displaying excessive inflammation. Healing rates were calculated for before and during this treatment period for each patient. Changes in symptom burden (pain, odour and exudate levels) following topical application were also calculated.. Overall, 34 ulcers were identified from 25 individual patients (mean age: 65 years, range: 37-97 years) and 331 clinic visits were analysed, spanning a total time of 14,670 days (7,721 days 'before treatment' time, 6,949 days 'during treatment' time). Following treatment, 24 ulcers demonstrated faster rates of healing, 3 ulcers showed no significant change in healing rates and 7 were healing more slowly (p=0.0006). Treatment generally reduced the burden of pain and exudate, without affecting odour.. In normal wound healing, inflammation represents a transient but essential phase of tissue repair. In selected cases, direct application of a steroid containing agent has been shown to improve healing rates, presumably by curtailing this phase. Further evaluation is required to establish the role of preparations containing topical steroids without antimicrobials in the management of chronic wounds.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antifungal Agents; Chronic Disease; Clobetasol; Drug Combinations; Female; Glucocorticoids; Humans; Inflammation; Male; Middle Aged; Nystatin; Ointments; Oxytetracycline; Retrospective Studies; Wound Healing

Topics: Aged, 80 and over; Anti-Inflammatory Agents; Clobetasol; Diflucortolone; Erythema; Humans; Male; Prednisone; Sweet Syndrome

Behçet's disease is the most common cause of pulmonary artery aneurysms. Pulmonary artery aneurysms are rare, but they are life-threatening because of their high tendency to rupture. However, there is also a chance that the aneurysms may completely resolve with immunosuppressive therapy. A 30-year-old man was admitted with chest pain, painful oral and genital ulcers, skin rash, weakness, and intermittent hemoptysis. He had a history of Behçet's disease for 6 years. The chest radiography showed a round opacity superior part of hilus on right. The helical thoracic computed tomography (CT) angiography demonstrated pulmonary aneurysms associated with Behçet's disease. The patient was successfully treated with colchicine, corticosteroids, and cyclophosphamide. A discussion about pulmonary artery aneurysms associated with Behçet's disease is provided in this case.

Topics: Administration, Topical; Adult; Aneurysm; Behcet Syndrome; Clobetasol; Colchicine; Cyclophosphamide; Drug Therapy, Combination; Glucocorticoids; Humans; Injections, Intravenous; Male; Methylprednisolone; Prednisone; Pulmonary Artery; Pulse Therapy, Drug; Radiography, Thoracic; Tomography, Spiral Computed; Treatment Outcome; Triamcinolone

Topics: Aged; Biopsy; Clobetasol; Dermatologic Agents; Glucocorticoids; Humans; Male; Nicotinic Acids; Porokeratosis; Scalp; Treatment Failure

Topics: Administration, Cutaneous; Aged; Anti-Inflammatory Agents; Clobetasol; Female; Humans; Immunosuppressive Agents; Ointments; Pemphigus; Tacrolimus; Treatment Outcome

A 45-year-old white woman presented with several years' history of firm, shiny papules on the lateral hands with slight extension to the dorsal fingers. The lesions first appeared between the index fingers and thumbs on both hands. They gradually increased in number, coalescing into plaques and affecting the junction between the palmar and dorsal skin. The patient did not have involvement of her feet. She had been diagnosed previously with chronic eczema that had failed to respond to multiple topical medications. In addition, the patient's sister had similar lesions on both hands. The patient denied any symptoms of hyperhidrosis, excessive sun exposure, or trauma. The plaques were asymptomatic, but were cosmetically unappealing to the patient. On physical examination, small, firm, skin-colored, hyperkeratotic papules, coalescing into plaques, were located on the junction between the palmar and dorsal skin on both lateral margins of the thumb and on the radial side of the index finger (Fig. 1). There were no lesions on the feet. A biopsy taken from a papule on the patient's left hand was consistent histologically with acrokeratoelastoidosis. The biopsy showed marked degeneration of collagen in the dermis with solar elastosis and some smudging of the papillary dermal collagen (Fig. 2). She was treated with clobetasone cream to the affected areas on the hands. After 6 weeks of treatment, she reported no significant improvement.

Topics: Clobetasol; Elastic Tissue; Female; Glucocorticoids; Hand Dermatoses; Humans; Keratosis; Middle Aged; Skin Diseases, Genetic; Treatment Failure

Topical steroids became available, without prescription, in the U.K. in 1987, with hydrocortisone 1% cream first being licensed for irritant contact dermatitis and reactions to insect bites. Since then the number of indications for nonprescription hydrocortisone use has increased and clobetasone has also become available as an over-the-counter (OTC) medicine. Little has been reported about how OTC steroids are used by community pharmacy clients.. We determined how OTC topical steroids are applied by patients, their demographic profile, the products used and the conditions treated, how frequently products were applied and how regularly purchased. The extent to which off-label use takes place was explored.. A patient-completed questionnaire study was used in 100 branches of a national pharmacy in Great Britain.. Questionnaires were completed and returned by 315 clients (16%). Eczema (192 cases, 61%) and dermatitis (66 cases, 21%) were the conditions most frequently treated. Nottingham Eczema Severity Scores calculated for 228 eczema and dermatitis sufferers shows that 164 patients (72%) had mild eczema. Those with more severe eczema were more likely to use clobetasone than hydrocortisone. The use of topical steroids outside OTC marketing authorization guidelines was widespread; however, no patient reported any adverse effects or deterioration in condition following steroid use.. OTC topical steroids are used mainly to treat eczema and dermatitis. Almost 50% of users treating these conditions exceed the limits of the rather restrictive OTC marketing authorization. Clinicians should be aware of the potential for adverse effects as a result of patients self-medicating with hydrocortisone or clobetasone for an extended period.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Child; Child, Preschool; Clobetasol; Contraindications; Dermatitis; Drug Administration Schedule; Eczema; Female; Glucocorticoids; Humans; Hydrocortisone; Infant; Male; Middle Aged; Nonprescription Drugs; Patient Satisfaction; Self Administration; Skin Diseases; Surveys and Questionnaires; United Kingdom

Leptin, the obese gene product, is a 16-kDa peptide hormone secreted by adiposities. Systemic administration of exogenous glucocorticoids has been found to increase circulating leptin levels. In this study, we aimed to assess serum leptin in children with atopic dermatitis (AD)-treated with local steroids. Twenty children with AD were included during the 2001-2002 time period. The study was conducted prospectively. Atopy was defined as the presence of at least one aeroallergen-specific immunoglobulin E (IgE) antibody. Serum leptin was determined using a commercially available radioimmunoassay kit with 3.4-8.3% intra-assay and 3.0-6.2% interassay coefficients of variation, and 0.5 ng/ml sensitivity. Fourteen boys and six girls with AD, the mean age of the patients was 3.1 +/- 2.2. Forty-three percentage of the family histories for atopy were positive, 60% of the cases passive smoking histories were positive. In seven patients the aeroallergen-specific IgE were positive. All 20 patients treated clobetasone 17-butirate (0.05%). There was no significant difference in serum leptin between patients (mean +/- s.d.: 4.6 +/- 3.8), and controls (mean +/- s.d.: 6.2 +/- 3.6) (p > 0.05). Local steroid does not influence circulating leptin levels, suggesting that regulation of body weight is unaffected.

Topics: Administration, Topical; Case-Control Studies; Child; Child, Preschool; Clobetasol; Dermatitis, Atopic; Female; Glucocorticoids; Humans; Immunoglobulin E; Infant; Leptin; Male; Prospective Studies

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Aminoquinolines; Antineoplastic Agents; Carcinoma in Situ; Clobetasol; Contraceptives, Oral; Female; Humans; Imiquimod; Papillomavirus Infections; Pemphigus; Treatment Outcome; Vulvar Diseases; Vulvar Neoplasms

Chondrodermatitis nodularis chronica helicis is characterized by the presence of small, intensely painful nodules on the free border of the helix of the ear with unknown origin. The lesion is typically localized unilaterally on the right ear. Pressure and trauma may play a role.

Topics: Cartilage Diseases; Clobetasol; Dermatitis; Ear Cartilage; Ear Diseases; Female; Humans; Middle Aged; Ointments

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Allergic Contact; Female; Humans; Patch Tests; Sulfites

Our objective was to evaluate the response to Trimovate cream in patients with Zoon's balanitis. Patients attending the penile dermatosis clinic between October 1996 and October 1999 with the clinical and histological features diagnostic of Zoon's balanitis were included in this study. They were treated with Trimovate cream for a varying length of time according to clinical response, having declined circumcision as first-line treatment. All cases had photographs taken before and after treatment. Ten cases of histologically-confirmed Zoon's balanitis were treated. Clinical resolution was observed in all cases, all of whom remain on long-term follow-up. In conclusion, topical Trimovate cream is an effective treatment for Zoon's balanitis.

Topics: Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Balanitis; Clobetasol; Drug Combinations; Humans; Male; Middle Aged; Nystatin; Ointments; Oxytetracycline; Treatment Outcome

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Allergic Contact; Humans; Male; Patch Tests

Pityriasis rosea is a relatively common skin disorder. In its typical form it is easily recognizable; however, atypical forms can pose diagnostic problems. We report a 44-year-old woman with an acute onset of a localized eruption on her left breast. The morphology of the rash and the time course were typical of pityriasis rosea. Localized pityriasis rosea is an unusual variant, which has been described previously.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Clobetasol; Female; Humans; Pityriasis Rosea

Topics: Administration, Topical; Adult; Anti-Allergic Agents; Anti-Inflammatory Agents; Cetirizine; Clobetasol; Drug Therapy, Combination; Facial Dermatoses; Female; Humans; Immunoglobulins, Intravenous; Vasculitis, Leukocytoclastic, Cutaneous

We report the quantification of skin surface thickness of topical agents by in vivo fluorescence spectroscopy, and demonstrate its potential uses for assessment of application technique and substantivity. A series of studies were performed on forearm skin of eight normal subjects using three creams which have intrinsic fluorescence: a sunscreen (Neutrogena SPF15 waterproof cream), an antiseptic (Hewlett's cream) and a steroid (Trimovate (clobetasone butyrate) cream). Initially, the dose-response relationship was established for each agent by applying a series of five doses (0.5-8 microliters/cm2) and measuring cream fluorescence using appropriate excitation and emission wavelengths. Next, the influence of application technique was examined by comparing light application of cream with firm rubbing. Substantivity of the three creams was assessed on dry skin by taking fluorescence measurements over 8 h. Finally, water resistance of 2 microliters/cm2 of sunscreen and antiseptic cream were compared by measuring fluorescence after each of four water immersions. The fluorescence intensity was strongly correlated with the logarithm of surface density. r = 1.0, 0.92 and 0.98 for sunscreen, antiseptic and steroid creams, respectively, allowing derivation of a simple expression for equivalent thickness. Surface thickness of each cream was lower following firm rubbing compared with light application (P < 0.01). The rate constants for reduction of surface density of the three creams with time on dry skin were not significantly different. However, on washed skin, the rate constant was higher for Hewlett's than Neutrogena cream (0.503 and 0.243 h. respectively, P = 0.02), with a higher rate for each cream on wet compared with dry skin (P < 0.001). Hence, fluorescence spectroscopy is a simple, rapid method for measurement of cream thickness in vivo. The many potential applications in dermatology include quantitative assessment of application technique and substantivity of topical agents.

Topics: Administration, Cutaneous; Adult; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Clobetasol; Dermatologic Agents; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Ointments; Skin Absorption; Spectrometry, Fluorescence; Sunscreening Agents; Water

The human skin blanching assay is a well established method for ranking the efficacy of corticosteroids after epicutaneous application. Vasoconstriction is a pharmacological activity, which correlates well with the clinical efficacy, the intensity of skin blanching after a single application under occlusion corresponding, generally, to the clinical efficacy after repeated application without occlusion. However, in studies dealing with the comparison between the vasoconstriction assay and the evaluation of the clinical effects on inflammatory skin diseases, some exceptions to this correlation have been reported. Therefore, in a pre-clinical phase, it would be useful to combine the blanching assay with at least one anti-inflammatory assay. In the present study the blanching assay and the allergic contact dermatitis inhibition test were performed in parallel, in order to compare the two testing procedures in the same group of subjects, utilizing standardized study designs supported by objective means of evaluation. Three commercial preparations of corticosteroids containing clobetasol propionate (CP), clobetasone butyrate (CB) and hydrocortisone acetate (HA), respectively, were employed both to treat nickel-induced positive patch test responses on the volar forearms, and to perform a vasoconstrictor assay on normal forearm skin in 16 nickel-sensitized healthy volunteers. For evaluating skin blanching, we employed colorimetric measurements, whereas for the quantitative determination of the inhibition of the intensity of allergic patch test reactions, 20 MHz B-scanning supported by image analysis was used. Both colorimetric and echogenicity values enabled us to distinguish between the three corticosteroids (at the 17 h evaluation and the 64 h assessment, respectively). A fair correlation was noted between colorimetric and echogenicity values. Both testing procedures ranked the three corticosteroids in the expected order. Corticosteroid preparations should be compared using methods which allow different effects to be simultaneously monitored, without involving a high number of patients. We are proposing this double procedure for the parallel intraindividual evaluation of the vasoconstrictory action and the anti-allergic activity of topical steroids.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Clobetasol; Colorimetry; Dermatitis, Allergic Contact; Drug Evaluation; Female; Humans; Hydrocortisone; Image Processing, Computer-Assisted; Male; Nickel; Patch Tests; Skin; Ultrasonography; Vasoconstriction; Vasoconstrictor Agents

To assess by electrophysiologic testing the effect of photorefractive keratectomy (PRK) on the retina and optic nerve.. Eye Clinic, S. Salvatore Hospital, L'Aquila University, Italy.. Standard pattern electroretinograms (P-ERGs) and standard pattern visual evoked potentials (P-VEPs) were done in 25 eyes of 25 patients who had myopic PRK for an attempted correction between 5.00 and 15.00 diopters (D) (mean 8.00 D). Testing was done preoperatively and 3, 6, 12, and 18 months postoperatively. The contralateral eyes served as controls. During the follow-up, 3 patients (12%) developed steroid-induced elevated intraocular pressure (IOP) that resolved after corticosteroid therapy was discontinued.. No statistically significant differences were seen between treated and control eyes nor between treated eyes preoperatively and postoperatively.. Myopic excimer laser PRK did not seem to affect the posterior segment. The transient steroid-induced IOP rise did not seem to cause functional impairment.

Topics: Adult; Anti-Inflammatory Agents; Clobetasol; Cornea; Electroretinography; Evoked Potentials, Visual; Female; Follow-Up Studies; Humans; Intraocular Pressure; Lasers, Excimer; Male; Middle Aged; Myopia; Ocular Hypertension; Optic Nerve; Photorefractive Keratectomy; Retina

Steroid creams applied topically to the skin are routinely used in the treatment of many dermatoses. Their use on the face in severe atopic eczema is relatively common. We report a series of three patients who whilst using topical facial steroids developed advanced glaucoma. A further two cases of ocular hypertension secondary to topical facial steroids are also described. This is the first series of cases to be reported demonstrating the potentially blinding complications of topical facial steroids. Recommendations are made with regard to screening such patients for glaucoma.

Topics: Administration, Topical; Adolescent; Adult; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Atopic; Desoximetasone; Facial Dermatoses; Female; Glaucoma; Humans; Hydrocortisone; Male; Ocular Hypertension; Prednisolone; Vision Disorders; Visual Acuity

A new echographic evaluation method employing a B scanner and a dedicated software (Dermavision 2D, Cortex Technology, Hadsund, Denmark) was used in assessing the potency of three different corticosteroids. Experimental lesions were induced by patch tests with nickel sulfate 5% in petrolatum in 10 sensitized subjects and treated with two medications of different steroids (clobetasol propionate, fluocinolone acetonide or clobetasone butyrate) performed 16 and 40 h after the application of the nickel patch tests. Clinical and echographic evaluations were carried out at the beginning of the experiment and 64 h after the induction of the reactions. After obtaining echographic images, these were processed by software, enabling the selection of amplitudes of interest, the highlighting of parts of images and their assessment by a value corresponding to the number of pixels (picture elements). For evaluations a low reflecting band was chosen, marking edema and inflammatory infiltration. At positive patch test sites we observed a progressive increase in the number of low reflecting pixels, in accordance with the intensity of the reaction. Therapeutic response was assessed as the difference between values of treated and untreated test sites. The rank order of the efficacy of test substances as determined echographically was identical to the rank order generally accepted for these steroids. This evaluation method of topical corticosteroid activity could be usefully employed besides traditional evaluation methods.

Topics: Administration, Topical; Adult; Clobetasol; Dermatitis, Contact; Female; Fluocinolone Acetonide; Humans; Image Enhancement; Skin; Ultrasonography

Vulvitis chronica plasmacellularis (Zoon's vulvitis) is rare. We describe a case in whom all the typical features, as delineated by Zoon, are demonstrated.

Topics: Clobetasol; Female; Humans; Middle Aged; Vulva; Vulvitis

Fluorometholone and clobetasone butyrate have been developed as ophthalmic corticosteroids because of their lesser potential to elevate intraocular pressure. Nevertheless, their primary use is the inhibition of an inflammatory response. Quantification of their anti-inflammatory effect in the rabbit cornea indicates that 0.1% fluorometholone and 0.1% clobetasone butyrate are effective, but weak, anti-inflammatory agents. An increase in concentration of fluorometholone to 0.25% failed to enhance its anti-inflammatory effectiveness significantly, while an increase in concentration of clobetasone butyrate to 0.5% did significantly increase its anti-inflammatory effect. As with all other corticosteroid bases studied to date, formulation of fluorometholone as an acetate derivative significantly increased its effectiveness, rendering it as effective as 1.0% prednisolone acetate, the most effective of commercially available ophthalmic corticosteroids.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Cell Movement; Clobetasol; Fluorometholone; Glaucoma; Keratitis; Neutrophils; Prednisolone; Rabbits

The clinical and histological response to 12 weeks of treatment with a very potent topical fluorinated steroid was studied in 15 patients with vulval lichen sclerosus (LS) who were treated with twice daily applications of clobetasol propionate 0.05% cream (Dermovate, Glaxo U.K.). Thirteen patients completed the study and all showed a marked clinical improvement. Histological measurements of skin biopsies taken before and after treatment showed a significant reduction in the characteristic features of LS. One patient developed contact sensitivity to clobetasol propionate. There was no evidence of infection or skin atrophy during the study. Patients completing the study have been followed up for up to 22 months and have been maintained in remission with moderately potent topical steroids which had previously been ineffective.

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Clobetasol; Female; Follow-Up Studies; Humans; Middle Aged; Skin; Skin Diseases; Vulvar Diseases

This study describes the bioavailability of Clobetasone, which is topically applied as an anti-inflammatory drug. Right eyes of Chinchilla rabbits received Clobetasone eye drops 3 times daily over a period of consecutive 14 days. 30 min up to 96 h after the last application animals were killed at different times and the eyes removed immediately. Nine different eye tissue samples were prepared for Clobetasone estimation by radioimmunoassay (RIA) using 3H-labeled Clobetasone and an antibody directed against Clobetasone. Results indicate that Clobetasone penetrates relatively fast into the different eye tissues. The concentrations are different in the various tissues and show a relationship to the distance from cornea to vitreous. Concentrations decline in the following order: cornea greater than conjunctiva, sclera, iris (200 ng/g) greater than lens, vitreous, aqueous humour (5-15 ng/g). In all samples investigated Clobetasone levels decrease with time. No accumulation of the drug has been measured at any time. Clobetasone levels in the left, untreated eye, indicate that the compound has a small systemic resorption.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Biological Availability; Clobetasol; Eye; Rabbits; Radioimmunoassay; Tissue Distribution

The effects of topical corticosteroid therapy upon human epidermal Langerhans cell surface markers were studied. The reduction in numbers of human leukocyte antigen-DR+/T6+ Langerhands cells proved to be a potency-related effect and Langerhans cell enumeration may therefore have some use as an adjunct in the assessment of steroid potency. Further studies showed that corticosteroid therapy also reduced the function of Langerhans cells in terms of epidermal cell alloantigen-presenting capacity. However, experimental variation and the high antigen-presenting potency of residual flow cytomterically sorted human leukocyte antigen-DR+/T6+ Langerhans cells following steroid application (1) mean that such functional assessments of epidermal cell alloantigen-presenting capacity cannot be recommended as an easily reproducible method for measuring steroid potency.

Topics: Administration, Topical; Anti-Inflammatory Agents; Antigens, Surface; Betamethasone Valerate; Cell Count; Clobetasol; Dose-Response Relationship, Drug; Epidermal Cells; Epidermis; Fluorescent Antibody Technique; Glucocorticoids; Humans; Langerhans Cells; Skin; Vasoconstriction

Topics: Administration, Topical; Adolescent; Betamethasone; Child; Child, Preschool; Clobetasol; Dermatitis, Atopic; Dermatologic Agents; Detergents; Drug Evaluation; Drug Therapy, Combination; Eczema; Emollients; Female; Humans; Male; Plant Extracts; Surface-Active Agents

We have investigated the mechanisms by which topical corticosteroids modulate cutaneous immune reactions in man. Volunteers applied clobetasone butyrate 0.05% (Eumovate; EV), betamethasone valerate 0.1% (Betnovate; BV), clobetasol propionate 0.05% (Dermovate; DV), and control vehicles twice daily to forearm skin for 7 days. Steroid therapy significantly decreased the number of HLA-DR/T6 (CD1a) positive Langerhans cells (LCs) per mm2 in suction blister-derived epidermal sheets, expressed as a mean percentage of controls, as follows: EV 69.2%; BV 67.3%; DV 37.8%. LC antigen presenting capacity was determined in the allogeneic and autologous epidermal cell-lymphocyte reactions. The LC-dependent allostimulatory capacity of epidermal cells, expressed as a mean percentage of controls, was also significantly reduced by steroid therapy: EV 45.1%; BV 41.9%; DV 23.4%. Following therapy with clobetasol propionate 0.05%, the capacity of epidermal cells to present tetanus toxoid to, and to augment concanavalin A mediated lymphocyte stimulation of, autologous lymphocytes was reduced to 33.6% and 19.7% respectively of controls. Depression of epidermal cell allostimulatory capacity was not the result of a steroid-induced decrease in the production of epidermal cell-derived thymocyte activating factor (ETAF)/interleukin 1 by keratinocytes, since it could not be reversed by addition of exogenous interleukin 1. Indomethacin, added to block any potential prostaglandin synthesis during the culture period, did not restore the allostimulatory capacity of epidermal cells from steroid-treated sites. Addition of epidermal cells from DV-treated sites depressed the capacity of control epidermal cells to stimulate lymphocytes in the allogeneic epidermal-lymphocyte reaction. Our results demonstrate that the anti-inflammatory action of topical corticosteroids in man is associated not only with a reduction in the number of HLA-DR/T6 positive LCs, but also with a marked decrease in Langerhans cell-dependent T lymphocyte activation. The effects of the different steroids on both of these parameters correlated with their potency as determined in the standard occlusive vasoconstrictor assay. Topical corticosteroids are widely used for the treatment of inflammatory skin disorders, and inhibit not only the elicitation phase, but also the induction phase, of allergic contact dermatitis reactions.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Antigen-Presenting Cells; Betamethasone; Betamethasone Valerate; Clobetasol; Fluorescent Antibody Technique; HLA-D Antigens; HLA-DR Antigens; Humans; Langerhans Cells; Psoriasis

Prurigo pigmentosa is a rare dermatosis which is most common in Japan. Although the histological features are non-specific, the clinical appearance is striking and is dominated by gross reticular pigmentation. A Chinese patient with prurigo pigmentosa is described.

Topics: Administration, Topical; Adult; Clobetasol; Humans; Male; Pigmentation Disorders; Prurigo; Skin

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Female; Glucocorticoids; Humans; Male; Skin Diseases

Twelve children with chronic atopic dermatitis and elevated IgE levels (age range: 2-13 years; mean age = 8.2 +/- 3.5 years) were selected for the study and treated with clobetasone butyrate (0.05% cream) thrice daily during the first week, then twice daily for three weeks. Adrenocortical function was evaluated at the beginning and the end of treatment period. The results show that there was no statistically significant change in adrenal function during the study period (tetracosactrin test). The results of the immunological studies, namely total IgE using the paper disc radioimmunoassay technique, specific IgE using the radioallergosorbent test and immunoglobulin levels are given.

Topics: Adolescent; Adrenal Cortex; Adrenal Cortex Function Tests; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Chronic Disease; Clobetasol; Dermatitis, Atopic; Eczema; Female; Humans; Hydrocortisone; Immunoglobulin E; Male; Time Factors

Thirty-eight patients suffering from dermatological conditions of various natures were treated by means of the simultaneous application of a combination of three creams, the bases of which were sodium fusidate, ketoconazole and clobetasone butyrate respectively. Positive results, in the form of remission of symptoms, were obtained in 86.7% of the cases. Local tolerance was excellent in all cases and no adverse reactions were observed.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clobetasol; Dermatologic Agents; Drug Therapy, Combination; Female; Fusidic Acid; Humans; Infant; Ketoconazole; Male; Middle Aged; Skin Diseases

RU 486 [17 beta-hydroxy-11 beta-(4-dimethylaminophenyl)17 alpha-(prop-1-ynyl)estra-4,9-dien-3-one] is a synthetic steroid receptor antagonist. To evaluate the peripheral antiglucocorticoid action of this compound, we investigated its ability to antagonize cutaneous steroid-induced vasoconstriction. This phenomenon, produced by three different topical steroids in six normal men, was consistently and significantly attenuated or abolished by oral administration of 6 mg/kg RU 486. This demonstration of a peripheral action of RU 486 is important in relation to the potential therapeutic use of this well tolerated drug in states of hypercortisolism. It also indicates that the cutaneous vasoconstrictor effects of topical steroids are mediated by occupancy of glucocorticoid receptors.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Double-Blind Method; Estrenes; Humans; Hydrocortisone; Male; Mifepristone; Random Allocation; Receptors, Glucocorticoid; Skin; Vasoconstriction

Forty out-patients suffering from a variety of skin diseases were treated over a period of 7 to 14 days (mean 9.6 days) with twice-daily applications of an extempore combination of sodium fusidate, clobetasone butyrate and ketoconazole creams. The severity of symptoms was assessed before, after 5 days and at the end of treatment and an overall evaluation made of response to therapy. The findings indicated that there was clinical cure or significant improvement in 37 (92.5%) of the patients, with excellent tolerance and no reports of any adverse reactions.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Antifungal Agents; Child; Child, Preschool; Clobetasol; Drug Combinations; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases

Forty-one patients with skin diseases of various origins were treated with an extempore combination of three creams containing clobetasone butyrate, sodium fusidate and ketoconazole. A mixture of the creams was applied once to 3-times daily for periods ranging from 5 to 15 days (mean 8.5 days). Assessments were made before, during and at the end of the treatment period using a symptom severity rating scale. The results showed that all symptoms regressed to a significant extent and by the end of the treatment period there had been complete disappearance or improvement with satisfactory remission in 97.6% of the patients. Local tolerance was excellent or good in all patients and there were no reports of any side-effects.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Anti-Infective Agents, Local; Antifungal Agents; Clobetasol; Drug Combinations; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases, Infectious

Topics: Adult; Betamethasone; Clobetasol; Dermatitis, Contact; Humans; Male; Nonprescription Drugs; Pruritus Ani

Topics: Aged; Betamethasone; Clobetasol; Dermatitis, Contact; Drug Eruptions; Humans; Male

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clobetasol; Eczema; Female; Humans; Male; Middle Aged; Ointments; Psoriasis; Skin Diseases

The effect of several steroid creams on epidermal phospholipase A2 (PLA2) activity in symptomless psoriatic and normal epidermis was studied. The magnitude of PLA2 inhibition produced by the steroids was directly proportional to the initial level of the enzyme activity. This differential inhibition resulted in PLA2 activity approaching or attaining the normal range regardless of its initial level. Clobetasol propionate 0.05% (Dermovate) produced more enzyme inhibition than betamethasone valerate 0.1% (Betnovate) but there was no difference in inhibition between this latter steroid and clobetasone butyrate 0.05% (Eumovate). All were more inhibitory than hydrocortisone I% (Efcortelan).

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone Valerate; Clobetasol; Fluocinolone Acetonide; Glucocorticoids; Humans; Hydrocortisone; Phospholipases; Phospholipases A; Phospholipases A2; Psoriasis; Skin; Time Factors

Topics: Aged; Betamethasone; Clobetasol; Drug Eruptions; Eyelids; Facial Dermatoses; Female; Humans

2 case reports are given of patients with positive patch test reactions to clobetasol propionate. One of the patients also reacted to clobetasone butyrate. 30 other steroids that were chemically very closely related to these two 21-chloro-9-alpha-fluoro-corticosteroids, were patch test negative. The literature on contact dermatitis reactions to corticosteroids is reviewed.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Betamethasone; Chemical Phenomena; Chemistry; Clobetasol; Dermatitis, Contact; Female; Humans; Male; Patch Tests

The concentrations of clobetasone butyrate and betamethasone were measured in aqueous humour of patients undergoing cataract extraction 12.5 to 18.5 hours after application into the lower conjunctival sac of an ointment containing 0.1% of the steroid. Samples were assayed from 10 patients receiving clobetasone butyrate and 13 patients receiving betamethasone phosphate. There were measurable concentrations in only 2 samples in the former group, and both were 0.1 ng/ml. In the betamethasone group measurable concentrations were found in 11 samples, and the concentrations ranged from 0.5 to 20.3 ng/ml, with the highest concentrations between 12.5 and 13.5 hours after application. The concentration of betamethasone in the aqueous humour decreased by about 90% in the 6 hours from 12.5 to 18.5 hours after application. It is speculative as to whether it is these differences in pharmacokinetic behaviour, or other differences in biological or physicochemical properties, which are responsible for the minimal effect on intraocular pressure induced by clobetasone butyrate compared with betamethasone.

Topics: Aged; Anti-Inflammatory Agents; Aqueous Humor; Betamethasone; Cataract Extraction; Clobetasol; Female; Humans; Male; Middle Aged; Ointments; Time Factors

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Eczema; Female; Humans; Hydrocortisone; Kinetics; Male; Middle Aged; Ointments; Psoriasis; Radioimmunoassay

Two currently used steroids (clobetasone butyrate and betamethasone valerate) reproducibly cause vasoconstriction on topical application to human forearm skin. Progesterone, deoxycorticosterone, testosterone, and estradiol, even at 100- to 200-fold higher concentrations, cause no vasoconstriction when applied alone. Applied with clobestasone butyrate, testosterone and estradiol are without antagonist effect; in contrast, both progesterone and deoxycorticosterone antagonize the vasoconstrictor response in a dose-related fashion, with a half-maximal effect at 20-30 times the concentration of clobetasone. Neither progesterone nor deoxycorticosterone affects the vasoconstriction produced by the intradermal injection of epinephrine. In most glucocorticoid-responsive systems, progesterone and deoxycorticosterone are glucocorticoid antagonists, and estradiol and testosterone are inactive. We interpret these studies as evidence that the vasoconstrictor effects of topical steroids are mediated by occupancy of classical glucocorticoid receptors, rather than by nonspecific pharmacological mechanisms.

Topics: Adult; Anti-Inflammatory Agents; Betamethasone Valerate; Clobetasol; Desoxycorticosterone; Dose-Response Relationship, Drug; Epinephrine; Estradiol; Female; Humans; Male; Middle Aged; Progesterone; Receptors, Glucocorticoid; Receptors, Steroid; Steroids; Testosterone; Vasoconstriction

The value of hyperimmune gammaglobulin (HGG) therapy in ulcerative herpetic keratitis was assessed in rabbits. HGG treated of early disease in normal rabbits was very effective, producing a 10-fold rise in the virus concentration needed to infect 50% of sites (CID50) and an 88% inhibition of ulceration after 2 days. The efficacy of the gammaglobulin preparations tested depended on their anti-HSV antibody content. Established disease was considerably less responsive to HGG therapy. No conclusive effect of HGG therapy could be demonstrated in rabbits with a previous HSV skin infection ('immunised'). Corticosteroid-induced geographic ulceration in immunised rabbits was not prevented by concurrent HGG therapy. The findings indicate that HGG is unlikely to represent a useful therapy for ulcerative herpetic keratitis but that it may be valuable in primary disease and in long-term prophylaxis.

Topics: Animals; Clobetasol; Corneal Ulcer; gamma-Globulins; Immunization; Keratitis, Dendritic; Rabbits; Time Factors

The effect of the topical corticosteroid clobetasone butyrate on enzyme activity and morphology of duodenal mucosa was studied in 9 patients with coeliac disease and 10 controls using organ culture techniques. There was significant increase in mucosal alkaline phosphatase, lactase and maltase activities, but inclusion of a soluble extract of gluten reduced this effect. When clobetasone butyrate was also included in the culture medium significant elevations in enzymes were again observed. Enterocyte height was not affected by incorporation of gluten into the medium. Intra-epithelial lymphocyte counts fell significantly during the culture period. This improvement was also inhibited by gluten and overcome by addition of steroid.

Topics: Adult; Alkaline Phosphatase; alpha-Glucosidases; beta-Galactosidase; Betamethasone; Celiac Disease; Clobetasol; Culture Media; Humans; Intestinal Mucosa; Jejunum; Organ Culture Techniques

We produced experimental immune reactions by exchanging peripheral corneal transplants between rabbits. Clobetasone butyrate 0.1% and dexamethasone phosphate 0.1% eye drops were equally effective in delaying corneal allograft rejection.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Clobetasol; Cornea; Corneal Transplantation; Dexamethasone; Graft Rejection; Rabbits

Since the great majority of patients possess immune response to herpes simplex virus (HSV), the influence of a topical anti-inflammatory corticosteroid (0.1% clobetasone butyrate) on ulcerative herpetic keratitis was studied in rabbits with a previous HSV skin infection (immunised) and compared with that in normal rabbits. Corticosteroid treatment had a much greater ulceration-exacerbating effect in immunised than in normal animals. On day 7 the mean area of ulceration in immunised rabbits were 3 times greater in treated eyes. 0.01% clobetasone butyrate treatment had less effect on immunised rabbits; 0.001% had no effect. It is concluded that the immunised rabbit provides a useful experimental model for studying the relationship between concentration of topical anti-inflammatory agents and enhancement of herpetic ulceration.

Topics: Animals; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Corneal Ulcer; Disease Models, Animal; Dose-Response Relationship, Drug; Immunization; Keratitis, Dendritic; Rabbits

The effect of clobetasone butyrate eye drops on ocular pressure was tested in 15 steroid responders suffering from different types of conjunctivitis and compared with betamethasone eye drops. Elevated intraocular pressure following application of 0.1% betamethasone eye drops decreased significantly within 2 weeks under medication with 0.1% clobetasone butyrate 4 times daily, whereas fellow eyes kept under treatment with betamethasone suffered further increases in IOP. The therapeutic effect and subjective compatibility of the two steroids were found to be approximately equal.

Topics: Betamethasone; Clobetasol; Conjunctivitis; Humans; Intraocular Pressure; Ophthalmic Solutions

Two topical corticosteroids, clobetasol propionate and clobetasone butyrate, have been studied in hairless mice for their effects on DNA synthesis in the epidermis, thymus and spleen. Following topical application, both clobetasol propionate and clobetasone butyrate showed significant activity at the site of application throughout the range of concentrations tested (20 microliters; 0.0001-0.1%; 20 ng to 20 micrograms). However, whereas 20 ng clobetasol propionate also elicited significant effects in the distal (untreated) epidermis and the thymus, more than 2 micrograms of clobetasone butyrate were required to produce similar effects in these tissues. This finding was supported by the results obtained following intravenous administration of equivalent doses (0.01 and 0.001%; 200 microliters dose) of the same two steroids. Only clobetasol propionate showed significant activity in the epidermis and thymus. Clobetasone butyrate showed slight, non-significant effects in the epidermis at the highest concentration (200 microliters; 0.01%), but not in the thymus or spleen. An unexpected finding was that the effects following intravenous injection were generally lower than those following topical application. In conclusion, these results establish that (a) effects on DNA synthesis in the epidermis at a site distal to the application site are indicative of systemic activity from topically applied corticosteroids, (b) the thymus is especially sensitive to corticosteroids eliciting systemic effects and (c) an equivalent dose of a topical corticosteroid administered intravenously produces less inhibition of thymic and epidermal DNA synthesis than the same dose applied topically.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Betamethasone; Clobetasol; DNA; Dose-Response Relationship, Drug; Epidermis; Female; Injections, Intravenous; Male; Mice; Mice, Hairless; Spleen; Thymus Gland

Acute and subacute toxicities of clobetasone-17-butyrate, a new anti-inflammatory corticosteroid, were studied in mice and rats. In the acute toxicity tests intraperitoneal LD50 values of the drug were estimated to be around 5 g/kg for both sexes of mice, 1.51 g/kg for male and 1.66 g/kg for female rats. Subcutaneous and oral administration induced no fatal cases at dose of 3.6 (mice, s.c.), 2.6 (rats, s.c.) and 6.0 g/kg (mice and rats, p.o.). As for the toxic signs in both mice and rats after the i.p. and s.c. administrations, emaciation was marked, and atrophy of thymus, spleen and adrenals were observed. No marked symptoms, however, were induced in animals administered orally. In the subacute toxicity tests male and female rats were subcutaneously administered with the drug at daily doses of 0.01, 0.03, 0.1, 1.0, 10 and 100 mg/kg for one month. Dose dependent symptoms such as suppression in body weight gain, emaciation, regressive changes in adrenal, lymphatic and hematopoietic tissues, decrease in circulating white blood cell and lymphocyte counts, and increase in total cholesterol level of serum were induced in the rats administered at 0.1 mg/kg/day and more than that, indicating that the maximum nontoxic dose in this experimental condition was 0.03 mg/kg/day. In recovery tests it was observed that the rats, which had been administered with the drug at 1.0 mg/kg/day for one month, were almost normal two months after the final administration.

Topics: Administration, Oral; Adrenal Cortex Hormones; Animals; Anti-Inflammatory Agents; Betamethasone; Body Weight; Clobetasol; Female; Injections, Intraperitoneal; Injections, Subcutaneous; Lethal Dose 50; Male; Mice; Organ Size; Rats

Chronic toxicity of clobetasone-17-butyrate, an anti-inflammatory corticosteroid, was investigated in rats. Subcutaneous administration with the drug at dose of 0.003, 0.01 and 0.03 mg/kg/day for three and six months induced no significant changes in the rats. At 0.1 and 0.3 mg/kg/day, however, some dose-dependent symptoms such as suppression of body weight gain, emaciation, regressive changes in adrenals, lymphatic and hematopoietic tissues, decrease in circulating white blood cell and lymphocyte counts, which have been known as toxic effects of synthetic corticosteroids, were induced. The results indicates that the maximum no-toxic dose of clobetasone-17 butyrate was 0.03 mg/kg/day on this experimental condition. In the recovery test for two months no significant differences in the treated rats from controls were found, suggesting that the toxic effects were reversible in the animals treated at 0.3 mg/kg/day and lower than that.

Topics: Adrenal Glands; Animals; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Dose-Response Relationship, Drug; Female; Growth; Hematopoietic System; Kidney; Male; Rats

Clobetasone butyrate is a new corticosteroid, selected for study because of its combination of good activity in the vasoconstriction test and low systemic activity in animals. Formulated as an 0.05% ointment and cream (Molivate) it was clinically effective in patients with eczema, its activity being significantly greater than that of hydrocortisone 1% or fluocortolone 0.2% (Ultradil). Under conditions that predispose to maximal percutaneous absorption clobetasone butyrate ointment had minimal effect on hypothalamic-pituitary-adrenal function. In an animal model of cutaneous atrophy it caused less thinning of the epidermis than steroids other than hydrocortisone. Clobetasone butyrate 0.05% ointment and cream gave every indication of offering clinically effective topical anti-inflammatory activity with a wide margin of safety.

Topics: Administration, Topical; Animals; Betamethasone; Clobetasol; Cosyntropin; Eczema; Fluocortolone; Humans; Insulin; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Psoriasis; Skin; Swine

Topics: Betamethasone; Clobetasol; Humans; Hydrocortisone; Skin