clobetasol and hydrocortisone-17-butyrate

Topics: Administration, Cutaneous; Adult; Atrophy; Betamethasone Valerate; Biopsy; Cell Count; Clobetasol; Drug Evaluation; Female; Glucocorticoids; Humans; Hydrocortisone; Keratinocytes; Male; Middle Aged; Occlusive Dressings; Pharmaceutical Vehicles; Prednisolone; Skin; Telangiectasis; Ultrasonography

To examine the effect of topical corticosteroid treatment on acute sunburn.. Randomized, double-blind clinical trial.. University dermatology department.. Twenty healthy volunteers with Fitzpatrick skin types I (highly sensitive, always burns easily, tans minimally) through III (sun-sensitive skin, sometimes burns, slowly tans to light brown).. Seven 34-cm(2) areas were marked on the upper aspect of the back of each participant. An untreated area was tested to determine UV sensitivity. Two areas were treated with excess amounts (2 mg/cm(2)) of either a moderate-potency corticosteroid or a high-potency corticosteroid 30 minutes before UV-B exposure as controls. Six or 23 hours after exposure to radiation, the remaining areas were treated with the 2 corticosteroid preparations.. The sunburn improvement factor (SIF) was determined by the following equation: SIF = MED (minimal erythema dose) on treated skin/MED on nontreated skin. An SIF greater than 1 indicated an effect of topical corticosteroids in sunburn relief.. The SIFs in the areas treated with either topical corticosteroid 30 minutes before UV-B exposure or high-potency corticosteroid 6 hours after UV-B exposure were significantly different from SIFs in areas that received no treatment (SIF 1.1-1.7; P < .05). Only the median SIF of 1.7 in the areas treated with high-potency corticosteroid 30 minutes before UV-B exposure was clinically relevant. The areas treated 23 hours after UV-B exposure and the areas treated with a moderate-potency corticosteroid 6 hours after UV-B exposure showed no significant reduction in redness.. Treatment with topical moderate-potency or high-potency corticosteroids does not provide a clinically useful decrease in the acute sunburn reaction when applied 6 or 23 hours after UV exposure.

Topics: Acute Disease; Administration, Topical; Adrenal Cortex Hormones; Adult; Clobetasol; Double-Blind Method; Drug Administration Schedule; Erythema; Female; Humans; Hydrocortisone; Male; Middle Aged; Sunburn; Treatment Failure

Five corticosteroid ointments and placebo were compared in 17 volunteers with regard to their influence on normal skin under occlusive conditions. Each volunteer had six simultaneous applications on the forearms and six on the back. The trial was double-blind and lasted 4 weeks. The ointments were placed in randomized order. The treatments were 0.1 and 0.03% domoprednate, 0.1% hydrocortisone butyrate, 0.1% betamethasone valerate, 0.05% clobetasole propionate and placebo. Skin thickness was measured on days 0, 7, 14, 21 and 28, transepidermal water loss on days 0, 14 and 28, while blood flow and telangiectasias were evaluated only on day 28 at termination of the trial. The skin thickness became significantly reduced on all corticosteroids, but not on placebo; 0.03% domoprednate, however, tended to have an intermediate position between placebo and the other ointments. The transepidermal water loss did not change. Rating of telangiectasia under stereomicroscope showed a significantly lower score after 0.03% domoprednate and placebo as compared to the other ointments. Assessment of telangiectasia by laser-Doppler flowmetry showed a similar tendency. It is concluded that 0.1% domoprednate is comparable to other topical corticosteroids with respect to atrophogeneity and formation of telangiectasia, but the 0.03% concentration seems to result in fewer side effects.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Atrophy; Betamethasone; Betamethasone Valerate; Clinical Trials as Topic; Clobetasol; Dermatologic Agents; Double-Blind Method; Female; Humans; Hydrocortisone; Male; Pregnadienes; Random Allocation; Skin; Telangiectasis; Ultrasonography

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

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

Corticosteroids are among the most commonly used topical drugs. Contact allergy to these exists, but can be easily missed. Corticosteroid screening markers have been included in the baseline series with the aim of detecting most of the sensitized patients.. To assess the prevalence of contact allergy to topical corticosteroids in Spain and examine the usefulness of corticosteroid markers to detect contact allergy to corticosteroids.. In total, 3699 patients referred to 20 dermatology departments across Spain for patch testing with the baseline series, including budesonide and tixocortol pivalate, were also tested with six supplementary corticosteroids (methylprednisolone aceponate, mometasone furoate, prednicarbate, clobetasol propionate, betamethasone 17-valerate, and betamethasone 17,21-dipropionate). Additionally, 2547 (68.8%) patients were tested with hydrocortisone 17-butyrate.. Fifty-four patients showed positive reactions to at least one of all tested corticosteroids (1.46%). Thirty-nine (1.05%) reacted to at least one of the additionally tested corticosteroids; among these, 24 of 39 (61.5%) did not react to any of the corticosteroid allergy screening markers tested.. More than half of the patients who were allergic to the additionally tested corticosteroids were not detected with the corticosteroid allergy markers. An update of the corticosteroid allergy screening markers is encouraged, with consideration of group 3 corticosteroids.

Topics: Administration, Cutaneous; Adult; Betamethasone; Betamethasone Valerate; Clobetasol; Dermatitis, Allergic Contact; Dermatologic Agents; Female; Humans; Hydrocortisone; Male; Methylprednisolone; Mometasone Furoate; Patch Tests; Predictive Value of Tests; Prednisolone; Prevalence; Prospective Studies; Spain

Topics: Administration, Topical; Anti-Inflammatory Agents; Clobetasol; Cushing Syndrome; Diaper Rash; Drug Overdose; Humans; Hydrocortisone; Infant; Male; Ointments; Patient Education as Topic; Treatment Failure

Corticosteroids (CS) are very potent immunosuppressive agents and are widely used to treat inflammatory diseases. On the basis of their clinical efficacy and potency CS have been divided into different classes. In the present study we investigated whether the class-associated effects of CS are correlated with a differential in vitro effect on cytokine production by T lymphocytes. Therefore, we determined the in vitro effects of CS on the production of Th1- and Th2-type cytokines. The addition of CS, in the range of 10(-9) to 10(-4) M, resulted in a class- and dose-dependent inhibition of the production of both IFN-gamma and IL-4. Notably, at the lowest doses tested, hydrocortisone and hydrocortisone 17-butyrate had a stimulatory effect on IL-4 production. CS class-dependently inhibited the IL-2 production by T cells but did not affect IL-2R expression of the T cells. Addition of rIL-2 could not completely restore the inhibitory effect of the CS on proliferation and on IFN-gamma and IL-4 production, indicating that CS act only partially via inhibition of IL-2 production. The demonstrated positive correlation between the clinical efficacy and the in vitro effects of the different classes of CS strongly suggests that the effect of CS on T-cell-mediated inflammation follows from inhibition of proliferation and cytokine production by T lymphocytes. The in vitro method used will be valuable for investigating and classifying new types of CS and other substances for applications in T-cell-mediated diseases.

Topics: Adrenal Cortex Hormones; Animals; Budesonide; Clobetasol; Cytokines; Drug Interactions; Humans; Hydrocortisone; In Vitro Techniques; Interferon-gamma; Interleukin-2; Interleukin-4; Lymphocyte Activation; Mice; Pregnenediones; Receptors, Interleukin-2; Th1 Cells; Th2 Cells

The aim of this study was to compare the activities of the two main classes of topical anti-inflammatory drugs in methyl-nicotinate-induced skin inflammation, using a new methodology based on laser-Doppler velocimetry. Six topical non-steroidal anti-inflammatory drugs (NSAIDs) (bufexamac, diclofenac, ibuprofen, indomethacin, phenylbutazone and niflumic acid) and three topical corticosteroids (clobetasol propionate, hydrocortisone and hydrocortisone butyrate) were tested. Drugs were commercially available (except indomethacin) and were applied under occlusion for 4 h to the forearms of 16 healthy male volunteers. Thirty minutes after excess drug removal, skin inflammation was induced by a 1-min application of methyl nicotinate (3 mM). This was repeated 44 h later. Each methyl-nicotinate application was followed by continuous skin blood flow recordings over 1 h. Overall, NSAIDs proved more effective than corticosteroids in inhibiting methyl-nicotinate-induced increases in skin blood flow. Diclofenac and indomethacin showed a potent prolonged inhibitory effect. Different types of activity were observed in the corticosteroid group: (a) At 30 min, hydrocortisone and hydrocortisone butyrate moderately inhibited methyl-nicotinate reactions whereas clobetasol propionate produced no detectable effects; (b) at 44 h, clobetasol propionate produced a significant inhibition whereas hydrocortisone butyrate and hydrocortisone exhibited either weak or no inhibitory action at all. These pharmacodynamic discrepancies between the corticosteroids tested could be related to differences in drug affinity to cutaneous receptors and in vasoconstrictive potency.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Betamethasone; Bufexamac; Clobetasol; Dermatitis, Contact; Diclofenac; Humans; Hydrocortisone; Ibuprofen; Indomethacin; Male; Nicotinic Acids; Niflumic Acid; Phenylbutazone; Regional Blood Flow; Skin

The effects of topical application of glucocorticoids on the epidermal beta-adrenergic adenylate cyclase response were investigated. A significant increase in this receptor response was observed 24 h following topical application of potent glucocorticoid ointments (0.12% betamethasone-17-valerate, 0.05% clobetasol-17-propionate). The application of a relatively weak glucocorticoid, hydrocortisone-17-butyrate, revealed no augmentation effect. There was no significant difference in other adenylate cyclase responses (adenosine-, and histamine-) between control and glucocorticoid-treated epidermis. UVB irradiation is known to augment the beta-adrenergic response of epidermis. Comparison of the effects revealed that topical glucocorticoid treatment had less effect than UVB irradiation, and when the UVB irradiation was combined with glucocorticoid treatment, the beta-adrenergic augmentation effect was not enhanced. Cyclic AMP phosphodiesterase activities were not significantly altered by the glucocorticoid-, UVB-, or combined treatments. Our data indicate that epidermal beta-adrenergic adenylate cyclase response is affected by topical application of 'potent' glucocorticoids in vivo. Although the effect is weaker than that induced by UVB irradiation, we believe the system might be a useful tool for dissecting the glucocorticoidal potency of topical preparations using the epidermal keratinocyte response in vivo.

Topics: Adenylyl Cyclases; Administration, Topical; Animals; Anti-Inflammatory Agents; Betamethasone Valerate; Clobetasol; Epidermis; Hydrocortisone; Swine; Ultraviolet Rays

Topics: Absorption; Administration, Topical; Adrenal Cortex Hormones; Anti-Inflammatory Agents; Betamethasone; Betamethasone Valerate; Clobetasol; Epidermis; Ethanol; Humans; Hydrocortisone; In Vitro Techniques; Solubility

The binding of 3H-triamcinolone acetonide to soluble macromolecules of cultured human skin fibroblasts was studied in an attempt to explain the mechanism underlying the inhibitory effects of glucocorticoids on cell growth. The results were as follows: Cultured human skin fibroblasts contain in cytosol a high affinity binding system for glucocorticoids. Various glucocorticoid derivatives competed for specific binding of 3H-triamcinolone acetonide. In some but not all instances this competition was related to the clinical efficacy of the derivatives under study and to their potency for the inhibition of cell growth. A specific glucocorticoid binding system was detectable in steroid-sensitive, low-density cell cultures (apparent Bmax = 200 fmoles/mg protein). The number of steroid binding sites was lower in high-density cell cultures (apparent Bmax = 125 fmoles/mg protein). The sensitivity to growth inhibition by glucocorticoids was markedly decreased in the high-density cell cultures. There were no differences in the affinity constants between these cell cultures (Kdiss. = 3.3 X 10-9 M). When cells were grown in medium containing glucocorticoid, renewal of the incubation medium led to disappearance of the growth-inhibitory effects, whereas specific binding was not affected. Nandrolone, an inhibitor of cell growth, abolished the growth-inhibitory effects of glucocorticoids but did not displace 3H-triamcinolone acetonide from its binding sites. The results suggest that in addition to a mechanism mediated by a glucocorticoid binding system with receptor like properties also other factors as well appear of relevance for the control of cell growth. These factors may be beyond the actual binding process of steroid and involve the action at the level of genomic expression of the cell.

Topics: Animals; Betamethasone Valerate; Binding Sites; Cell Division; Clobetasol; Culture Media; Fibroblasts; Glucocorticoids; Humans; Hydrocortisone; Infant; Male; Mice; Nandrolone; Receptors, Glucocorticoid; Receptors, Steroid; Skin; Triamcinolone Acetonide; Tritium

The penetration through the epidermis in vitro of various topically used corticosteroids was compared. The amount penetrating through the epidermis from an ethanolic solution showed good correlation with the polarity of the corticosteroids under study. Hydrocortisone, the most polar corticosteroid, penetrates the epidermis the most rapidly; clobetasone butyrate, the least polar, the slowest. Other corticosteroids, i.e., hydrocortisone-17-butyrate, triamcinolone acetonide, and clobetasol-17-propionate, form an intermediate group whose penetration rates and polarities decrease in the indicated sequence. The corticosteroid generally accepted as having greater clinical efficacy in creams or ointments did not permeate better from an ethanolic solution in vitro.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Epidermis; Hydrocortisone; In Vitro Techniques; Skin; Triamcinolone Acetonide