clobetasol and Acute-Disease

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

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

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

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

The term Pseudoainhum is used in medical literature to elaborate the presence of constricting bands around the digits of hands and feet due to variety of etiologies. This phenomenon can lead to irreversible damage to the supplying neurovasculature and sequential autoamputation of the affected digits. The report herein, describes the rare presentation of pseudoainhum occurring concomitantly in acute psoriasis. Timely recognition of such rare disease entities by physicians is imperative to avoid unnecessary complications.

Topics: Acitretin; Acute Disease; Aged; Ainhum; Anti-Inflammatory Agents; Biopsy; Clobetasol; Constriction, Pathologic; Female; Fingers; Humans; Keratolytic Agents; Male; Psoriasis; Treatment Outcome