clobetasol and fluocinolone

For an effective treatment of vitiligo, it is as important to arrest the progression of the disease (if it is still active) as it is to induce repigmentation in existing lesions. In patients having limited and slow-spreading vitiligo, we evaluated the efficacy of levamisole to control the activity of the disease process and to induce repigmentation of the vitiliginous areas.. Levamisole was given to 64 patients in an oral dose of 150 mg on two consecutive days every week for periods varying from 4-48 months. In 14 patients levamisole was used alone, in 38 patients it was combined with topical 0.1% fluocinolone acetonide acetate ointment massaged on the lesions once a day, and in 12 patients it was combined with topical 0.05% clobetasol propionate used in the same way. There was no other adjuvant therapy.. In 34 of the 36 patients (94%) having active disease, the progression of the disease could be arrested within 2-4 months. A variable degree of spontaneous repigmentation of the vitiliginous areas was seen in 9 patients (64%) treated with levamisole alone, 33 patients (87%) treated with levamisole and topical fluocinolone, and all the 12 patients treated with levamisole and topical clobetasol. The side effects with levamisole were minimal except in two cases where treatment had to be discontinued. Topical fluocinolone was fairly safe in the Indian patients, but clobetasol frequently produced atrophy and telangiectasia.. Levamisole seems to be a simple, safe, and fairly effective remedy for controlling the activity of the disease process in vitiligo patients who have limited and slow-spreading disease. Some patients develop spontaneous repigmentation as well. To achieve a faster rate of repigmentation, levamisole can be combined with other treatment methods such as topical corticosteroids.

Topics: Administration, Oral; Administration, Topical; Adolescent; Adult; Clobetasol; Drug Administration Schedule; Drug Therapy, Combination; Female; Fluocinolone Acetonide; Humans; Levamisole; Male; Vitiligo

Psoriasis is among the top dermatologic diagnoses for older adult patients, and the number of older adult psoriasis patients is expected to rise.. To characterize trends in older adult psoriasis health care practices of US ambulatory physician offices from 1993 to 2009.. We used data from the National Ambulatory Medical Care Survey to assess demographics, specialties seen, and treatment in visits by older adult patients, 55 years of age and older.. There were approximately 14.1 million outpatient visits for psoriasis among the older adult population during the study period. Older adult psoriasis patients were 52.4% female and 47.6% male. The most frequent older adult age group seen for psoriasis was the 55 to 64 year age group. Dermatologists saw 69.3% of patients, internists saw 14.5%, and general and family practitioners saw 11.6%. Topical corticosteroids were the most frequently prescribed medications. Dermatologists preferred clobetasol whereas non-dermatologists more commonly prescribed betamethasone. For both the 18 to 54 year age group and the 55 and older group, the leading 7 out of 10 medications prescribed were topical corticosteroids and calcipotriene. However, etanercept, coal tar, and fluocinolone were among the leading medications in the younger group but not in the 55 and older group.. Treatment approach for older adult psoriasis patients showed some differences among medical specialties and among the younger and older age groups. Further research specific to older adult psoriasis patients is needed to determine optimal treatment strategies for this patient population.

Topics: Administration, Cutaneous; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Ambulatory Care; Betamethasone; Calcitriol; Clobetasol; Coal Tar; Dermatologic Agents; Dermatology; Etanercept; Family Practice; Female; Fluocinolone Acetonide; Glucocorticoids; Health Care Surveys; Humans; Immunoglobulin G; Immunologic Factors; Internal Medicine; Keratolytic Agents; Male; Middle Aged; Practice Patterns, Physicians'; Psoriasis; Receptors, Tumor Necrosis Factor; United States; Young Adult

Glucocorticosteroids are beneficial in the treatment of osteoarthritis (OA) in humans, and have been shown to protect cartilage in animal models of OA. Therefore, we undertook the present study to investigate the in vitro effect of several glucocorticosteroids on cartilage degradation.. Bovine articular cartilage explants labeled with [35S] Sulfate and stimulated either with IL-1 alpha alone or with concomitant plasminogen plus IL-1 alpha were used in this study as an in vitro model of cartilage degradation. Clobetasol propionate, fluocinolone-acetonide-21-acetate, prednisolone, triamcinolone and triamcinolone hexacetonide were the glucocorticosteroids investigated in a series of experiments, at concentrations ranging from 10 picomolar to 10 micromolar. Degradation in [35S] Sulfate-labeled bovine articular cartilage explants was induced with IL-1 alpha or with concomitant IL-1 alpha plus human plasminogen. The effects of several glucocorticosteroids were studied, and a comparison between efficacy in explants stimulated with IL-1 alpha alone or IL-1 alpha plus concomitant plasminogen was made. Glucocorticosteroid efficacy was expressed as percent inhibition of degradation, and their IC50S were also calculated.. Glucocorticosteroids showed no protective effects on cartilage degradation in the presence of IL-1 alpha alone. When degradation was induced by IL-1 alpha in the presence of concomitant human plasminogen, all the glucocorticosteroids showed statistically significant.inhibition (p < 0.05) with calculated IC50S of 450-2500 picomolar.. The inhibition of cartilage degradation by glucocorticosteroids may be due to down-regulation of urokinase plasminogen activator (u-PA) activity. It has been shown that u-PA may be the first enzyme in the cascade of activation of pro-matrix metalloproteinases by the fibrinolytic system. Inhibition of u-PA activity may be one explanation for the efficacy of glucocorticosteroids observed in animal models of OA and with intraarticular injection in patients with OA.

Topics: Animals; Cartilage, Articular; Cattle; Clobetasol; Drug Combinations; Drug Synergism; Fluocinolone Acetonide; Glucocorticoids; In Vitro Techniques; Interleukin-1; Plasminogen; Prednisolone; Triamcinolone

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