(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Skin-Diseases

Inhaled corticosteroids (ICS) are mainstay in controlling the symptoms of asthma. Previous studies have demonstrated that ICS have minimal systemic effects, at doses of up to 400 micrograms per day for children and up to 1000 micrograms per day for adults. At higher doses some systemic effects can be seen. But to date there is no convincing evidence that this gives rise to any of the well known clinical sequelae of corticosteroid excess. To determine the dosage of ICS, it is important to weigh up the potential benefits and risks in each patient. The use of spacer devices and mouth rinsing may reduce local and systemic adverse effects.

Topics: Administration, Inhalation; Adult; Anti-Inflammatory Agents; Beclomethasone; Bone Density; Cataract; Child; Child Development; Glycolipids; Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Skin Diseases

A major aetiologic role for foods has been demonstrated in urticaria, atopic eczema and dermatitis herpetiformis. In some patients with urticaria, whealing occurs within minutes of the ingestion of a particular food. In most, but not necessarily all cases, this appears to be a consequence of IgE-mediated cutaneous mast cell degranulation, i.e. a classical type I hypersensitivity response. In other patients with recurrent urticaria, the whealing may be provoked by foods by a much slower and more insidious reaction. This type of reaction has been established in the case of several common food additives, notably azo dyes, but other foods may be able to cause urticaria in a similar fashion. Foods appear to play an important provocative role in many patients with atopic eczema. The reaction in such cases appears to be slow and insidious, almost always unrecognized by the patient and not detected by skin testing or tests for IgE antibodies. There can be no real doubt that dietary gluten is responsible for most, if not all dermatitis herpetiformis, though this relationship was revealed only by the finding of concurrent and usually asymptomatic jejunal villous atrophy in affected individuals. The mechanisms responsible for the slow food reactions in urticaria, atopic eczema and dermatitis herpetiformis remain largely unknown, but are likely to be different in each case.

Topics: Aging; Animals; Azo Compounds; Beclomethasone; Benzoates; Cattle; Child; Child, Preschool; Dermatitis Herpetiformis; Dermatitis, Atopic; Eggs; Food Additives; Food Hypersensitivity; Glutens; Humans; Immunoglobulin A; Immunoglobulin E; Infant; Infant, Newborn; Intestinal Diseases; Milk; Skin Diseases; Sulfones; Time Factors; Urticaria

Topics: Administration, Topical; Aerosols; Anti-Inflammatory Agents; Arthritis, Rheumatoid; Asthma; Beclomethasone; Dexamethasone; Fluprednisolone; Glucocorticoids; Humans; Hydrocortisone; Injections, Intra-Articular; Prednisolone; Rhinitis; Skin Diseases; Triamcinolone Acetonide

Fluticasone propionate (FP) is generally considered to have twice the efficacy of beclomethasone dipropionate (BDP) on a weight-to-weight basis for the control of asthma, and may have lesser effects on adrenal function. However, the effects of FP and BDP on skin integrity and bone metabolism markers require further examination. Sixty-nine asthmatic subjects were enrolled in a double-blind crossover study in which, after a baseline period, they received BDP or FP (at half the dose of BDP) for two 4-month periods each. A questionnaire on skin bruising, a skin examination, tests of adrenal function and of markers of bone metabolism were performed after 2 months of each period. The number of asthma exacerbations was not significantly different for the two treatment periods (eight for BDP and nine for FP), nor were various indices of asthma control. Whereas the frequency of bruising reported by the questionnaire was not different, there were more bruises on examination for BDP (1.6+/-2.5) than for FP (1.2+/-2.3) (p=0.04). Although baseline serum cortisol was not significantly different for the two drugs, the increase in cortisol after cortrosyn was lower for BDP (357+/-158 micromol x dL(-1)) than for FP (422+/-144 micromol x dL(-1)) (p<0.01). Serum osteocalcin levels were significantly lower in subject on BDP (2.8+/-1.7 microg x mL(-1)) than on FP (3.5+/-1.9 ng x mL(-1)) (p=0.003). Other markers of bone metabolism were not significantly altered. The three major side-effects were loosely, but significantly correlated with the periods on BDP and FP. However, skin bruises, increase in cortisol after Cortrosyn and osteocalcin were not significantly correlated for the period on either BDP or FP. In conclusion, whereas fluticasone propionate used at half the dose of beclomethasone dipropionate has a comparable effect on the control of asthma, fluticasone propionate demonstrated fewer side-effects in terms of skin bruising, adrenal suppression and bone metabolism.

Topics: Administration, Inhalation; Administration, Topical; Androstadienes; Anti-Asthmatic Agents; Anti-Inflammatory Agents; Asthma; Beclomethasone; Contusions; Cross-Over Studies; Double-Blind Method; Female; Fluticasone; Humans; Hydrocortisone; Male; Middle Aged; Osteocalcin; Prospective Studies; Skin Diseases

Forty patients with skin diseases were treated by the simultaneous application of three creams, the respective bases of which were beclomethasone dipropionate, sodium fusidate and ketoconazole. The treatment yielded positive results in 92.5% of the treated cases with good relief of symptoms, arrest of growth of pathogenic agents, and good local and systemic tolerance. No adverse reactions of any kind were observed.

Topics: Administration, Topical; Adolescent; Adult; Aged; Bacterial Infections; Beclomethasone; Child; Dermatitis, Contact; Dermatomycoses; Drug Combinations; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases; Skin Diseases, Infectious

Forty-two infants and young children with skin diseases of various kinds were treated by the simultaneous application of a combination of three creams, the respective ingredients of which were beclomethasone dipropionate, sodium fusidate and ketoconazole. The treatment produced good results in 97.6% of cases, with eradication of pathogenic agents and satisfactory relief of symptoms. The combination was well tolerated in almost all cases, both locally and systemically, and no adverse reactions were reported.

Topics: Administration, Topical; Bacterial Infections; Beclomethasone; Child; Child, Preschool; Dermatomycoses; Diaper Rash; Drug Therapy, Combination; Female; Fusidic Acid; Humans; Infant; Ketoconazole; Male; Skin Diseases

Forty-two patients undergoing cryosurgery for skin diseases were treated by means of the simultaneous application of three creams, the respective bases of which were beclomethasone dipropionate, sodium fusidate and ketoconazole. The treatment produced excellent results, preventing bacterial and/or mycotic superinfections and relieving the edema and erythema caused by the operation in 97.6% of cases. Local tolerance was optimal in all cases; no adverse reactions of any kind being reported.

Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Antifungal Agents; Beclomethasone; Child; Combined Modality Therapy; Cryosurgery; Drug Combinations; Erythema; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases

Forty outpatients with skin diseases were treated with an extempore combination of three creams, the respective bases of which were beclomethasone dipropionate, sodium fusidate and ketoconazole. Positive results were obtained in 97.5% of the cases with good relief of symptoms and excellent local tolerance in all cases treated.

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

Forty-three patients with skin diseases of poorly defined natures, often related to lengthy periods of hospitalization, were treated for 10 days with a combination of three creams, the active ingredients of which were beclomethasone dipropionate (0.025%), ketoconazole (2%) and sodium fusidate (2%), respectively. Positive results were obtained in 81.4% of the patients treated with good remission of symptoms and good healing of initial lesions. Local tolerance was excellent, and no adverse effects were observed.

Topics: Administration, Topical; Adolescent; Adult; Aged; Beclomethasone; Drug Combinations; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases; Time Factors