clobetasol and Alopecia-Areata

Alopecia areata (AA) is a common non-scarring hair loss disorder that affects children and adults with a great psychological burden because of its recurrent and sometimes treatment-refractory nature.. To compare the efficacy of topical calcineurin inhibitor, topical potent steroid combined with vitamin D analogue versus topical superpotent steroid in treatment of localized AA.. Sixty subjects with chronic (>1 year) localized (SALT score < 25%) AA, confirmed clinically and dermoscopically, were randomized into three groups. Group I used topical 0.03% tacrolimus (Tarolimus®), group II used topical potent steroid combined with vitamin D analogue (Daivobet®). and group III used topical superpotent steroid (Dermovate®). All patients continued a daily therapy for three successive months and were followed up for three other months. Assessment was done using PULL test, SALT score, and dermoscopic comparison before and after therapy.. Group II showed comparable statistical results to group III with lower values in a non-statistically significant way. Group I achieved the least improvement among all groups.. Combined vitamin D analogues with potent steroid appears to be a more convenient treatment for localized AA than superpotent steroids because of less side effects and comparable efficacy. Tacrolimus needs further research or formula customization to be used as a topical therapy for AA.

Topics: Adult; Alopecia Areata; Child; Clobetasol; Humans; Tacrolimus; Treatment Outcome; Vitamin D

Alopecia areata is a chronic inflammatory disease that characterized by round or oval patches of non-scarring hair loss. From the past, Urginea maritima (white squill) was used for the treatment of hair loss in Iranian traditional medicine. We aimed the comparison of Clobetasol lotion and squill extract efficacy in treatment of alopecia areata in a randomized, double-blind clinical trial. The 42 patients were randomized into two groups. Both groups received topical squill and clobetasol lotion twice daily lotion for 12 weeks. Clinical evaluation included size of patches (using 1×1 cm

Topics: Administration, Topical; Adult; Alopecia Areata; Clobetasol; Double-Blind Method; Drimia; Female; Follow-Up Studies; Hair; Humans; Male; Middle Aged; Phytotherapy; Plant Extracts; Skin Cream; Treatment Outcome; Young Adult

Alopecia areata is an idiopathic cause of hair loss with limited therapeutic repertoire.. To compare the efficacy and safety of a high- vs low-potency topical corticosteroid in pediatric patients.. This single-center, randomized, blind, 2-arm, parallel-group, superiority trial was carried out over a 24-week period at a tertiary referral academic dermatology clinic at The Hospital for Sick Children in Toronto, Ontario, Canada. Forty-two children attending the outpatients clinic, 2 to 16 years of age with alopecia areata affecting at least 10% of scalp surface area, were eligible; 1 declined to participate. There were no withdrawals from the study. INTERVENTIONS FOR CLINICAL TRIALS: Patients were randomly assigned to receive clobetasol propionate, 0.05% cream, or hydrocortisone, 1%, cream. Patients applied a thin layer of the assigned cream twice daily to the areas of hair loss for 2 cycles of 6 weeks on, 6 weeks off, for a total of 24 weeks.. The primary outcome was the change in scalp surface area with hair loss over 24 weeks following enrollment. RESULTS All participants were assessed at 6, 12, 18, and 24 weeks (except 1 participant who missed the 6-week visit). After adjusting for baseline hair loss, the clobetasol group had a statistically significant (P < .001) greater decrease in the surface area with hair loss, compared with the hydrocortisone group at all time points except at 6 weeks. One patient with extensive alopecia areata experienced skin atrophy that resolved spontaneously in 6 weeks. There was no difference observed in the number of patients with abnormal urinary cortisol at the beginning and the end of the study.. Topical clobetasol propionate, 0.05%, cream is efficacious and safe as a first-line agent for limited patchy childhood alopecia areata. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01453686.

Topics: Administration, Topical; Adolescent; Alopecia Areata; Anti-Inflammatory Agents; Child; Child, Preschool; Clobetasol; Double-Blind Method; Female; Glucocorticoids; Humans; Hydrocortisone; Male; Time Factors; Treatment Outcome

Alopecia areata (AA) is an organ-specific, T-cell-mediated autoimmune disease that is characterized by non-scarring hair loss.. We aimed to find the factors that may affect the response to topical therapy in AA.. The study included a total of 60 patients with AA and 30 healthy control patients. The AA patients were randomized into two groups. 40 patients used 0.05% clobetasol propionate cream, and 20 patients used petrolatum (placebo). Both groups applied topical treatments to their lesions twice daily for 12 weeks.. The mean extent of AA was 21.88 ± 16.75% in patients with autoantibodies and 12.16 ± 13.55% in those who were negative for autoantibodies (P = 0.021). Ophiasic pattern and nail involvement were observed more frequently in patients with atopy (P < 0.05). Relapse was more frequent in patients with atopy (P = 0.002) and nail involvement (P = 0.02).. We observed that the presence of autoantibodies was associated with more extensive AA, and that ophiasic hair loss pattern and nail dystrophy were significantly associated with atopy. Topical clobetasol propionate treatment produced a modest advantage in hair regrowth as compared with placebo. Notably, atopic AA patients have a higher risk of relapse and redevelopment of AA after completing a course of topical corticosteroid treatment.

Topics: Administration, Topical; Adolescent; Adrenal Cortex Hormones; Adult; Alopecia Areata; Autoantibodies; Case-Control Studies; Clobetasol; Female; Humans; Male; Prognosis; Young Adult

Alopecia areata (AA) is a non-scarring hair loss.. We aimed the comparison of clobetasol propionate and pimecrolimus efficiency and tolerability in the treatment of AA.. The study included a total of 100 consecutive patients with AA. Patients were randomized into four groups. 30 patients used 1% pimecrolimus cream, 30 patients used 0.05% clobetasol propionate cream, 20 patients used petrolatum as placebo. Scalp of 20 patients was divided into two equal areas and one area was treated with 1% pimecrolimus cream and the other area with 0.05% clobetasol propionate cream.. At week 12 of treatment, the recovery rate of the pimecrolimus group was 53.73 ± 44.49 and the recovery score was 3.63 ± 2.07; that of the clobetasol propionate group was 47.00 ± 44.80 and the recovery score was 3.33 ± 2.20; that of the placebo group was 35.50 ± 40.53 and the recovery score was 2.75 ± 1.88. There was no statistically significant difference among the groups in terms of the percentage of recovery and the recovery score (p < 0.05).. In conclusion, we detected that topical pimecrolimus treatment is as effective as topical corticosteroids and is superior to topical corticosteroids in terms of side effects in the treatment of AA.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Alopecia Areata; Anti-Inflammatory Agents, Non-Steroidal; Child; Child, Preschool; Clobetasol; Dermatologic Agents; Female; Glucocorticoids; Humans; Male; Middle Aged; Petrolatum; Tacrolimus; Young Adult

Clinical efficacy of topical corticosteroids in alopecia areata (AA) is still controversial. Positive clinical results have been obtained using ointments with occlusive dressing but this approach has a low patient compliance. Recently, a new topical formulation (thermophobic foam: Versafoam) of clobetasol propionate 0.05% has been introduced on the market (Olux, Mipharm, Milan, Italy) (CF). This formulation is easy to apply. After application to the skin the foam quickly evaporates without residues and it has a good patient compliance. In vitro studies have also shown that this formulation enhances the delivery of the active compound through the skin.. To evaluate the efficacy, safety and tolerability of CF in the treatment of moderate to severe AA.. Thirty-four patients with moderate to severe AA (eight men, mean age 40+/-13 years) were enrolled in a randomized, double-blind, right-to-left, placebo-controlled, 24-week trial. Alopecia grading score (AGS) was calculated at baseline and after 12 and 24 weeks of treatment using a 0-5 score (0=no alopecia; 5=alopecia totalis). Clobetasol foam and the corresponding placebo foam (PF) were applied twice a day for 5 days/week for 12 weeks (phase 1) using an intrapatient design (right vs. left). From weeks 13 to 24 each enrolled patient continued only with the treatment (both on the right and left site) that was judged to have a greater efficacy than that on the contralateral side (phase 2). The primary outcome of the trial, evaluated on an intention-to-treat basis, was the hair regrowth rate, which was evaluated using a semiquantitative score (RGS) (from 0: no regrowth, to 4: regrowth of 75%).. At baseline the AGS was 4.1 (range: 2-5). Nine (26%) patients prematurely concluded the trial. At the end of phase 1, a greater hair regrowth was observed in 89% of the head sites treated with CF vs. 11% in the sites treated with PF. The RGS was 1.2+/-1.6 in the CF-treated sites and 0.4+/-0.8 in the PF-treated sites (P=0.001). A RGS of 2 (hair regrowth of more than 25%) was observed in 42% CF-treated sites and in 13% of PF-treated sites (P=0.027). In seven subjects (20%) a RGS of 3 to 4 (hair regrowth of 50%) was observed in CF-treated sites. In three subjects (9%) a RGS of 4 (hair regrowth of 75%) was observed in CF-treated sites. In one patient only, in a PF-treated region, a RGS of 3 was observed. The AS was reduced to 3.8 by CF treatment at the end of phase 1 and to 3.3 at the end of phase 2 (P=0.01). From weeks 12 to 24 the treatment with CF induced a further increase in the RGS (from 1.2 to 1.5+/-1.4). Forty-seven per cent of CF-treated patients had a RGS of 2 at the end of the trial. A total of eight patients (25%) at the end of the treatment with CF showed a RGS of 3. Folliculitis occurred in two patients. No significant modifications in cortisol and ACTH blood levels were observed during the trial.. This new formulation of clobetasol propionate foam is an effective, safe and well-tolerated topical treatment for AA. This formulation has a good cosmetic acceptance and patient compliance profile.

Topics: Administration, Topical; Adult; Alopecia Areata; Clobetasol; Double-Blind Method; Female; Glucocorticoids; Humans; Male; Middle Aged; Patient Compliance; Placebos; Severity of Illness Index; Treatment Outcome

Efficacy of topical steroids in alopecia areata is still discussed.. The purpose of this study was to evaluate the efficacy of clobetasol propionate 0.05% ointment under occlusion in 28 patients with alopecia areata totalis (AT) or AT/alopecia universalis.. A total of 28 patients were instructed to apply 2.5 g of clobetasol propionate to the right side of the scalp every night under occlusion with a plastic film. Treatment was performed 6 days a week for 6 months. When regrowth of terminal hair occurred, treatment was extended over the entire scalp. All patients were followed up for another 6 months.. Of the 28 patients included in the study, 8 were treated successfully (28.5%). Regrowth of terminal hair began on the treated side 6 to 14 weeks after the start of treatment. Of these 8 patients, 3 had a relapse and were not able to maintain hair regrowth.. Our study shows that clobetasol propionate 0.05% under occlusion is effective in inducing hair regrowth in patients with AT or AT/alopecia universalis. Occurrence of hair regrowth only on the treated half of the scalp clearly shows that efficacy of treatment is a result of a local and not systemic effect of the drug. Although only 17.8% of patients had long-term benefit by treatment, our results were obtained in a population of patients with severe and refractory forms of the disease.

Topics: Administration, Topical; Adolescent; Adult; Alopecia Areata; Anti-Inflammatory Agents; Clobetasol; Female; Glucocorticoids; Humans; Male; Ointments; Treatment Outcome

AA is a common autoimmune skin disease that causes hair loss on the scalp and sometimes other areas of the body. New therapy approaches for alopecia areata are emerging, with the goal of improving clinical outcomes. In this study, the effects of topical steroids against fractional Er:YAG laser followed by topical steroids in the treatment of alopecia areata will be compared. A total of 30 participants with alopecia areata were included in the study. Each patient's lesions were treated with one of two methods: topical clobetasol propionate or fractional Er:YAG laser followed by topical clobetasol propionate. SALT score, patient satisfaction, and dermoscopic imaging were used to evaluate therapeutic response. Both treatment modalities showed a significant clinical improvement in alopecia areata with a statistically significant reduction in the SALT score. The SALT score was more evident in the laser-steroid group. On comparing the dermoscopy findings in both treated areas before and after treatment, a significant reduction was found regarding all dermoscopic findings of alopecia areata in both modalities. Combining fractional Er:YAG laser with topical steroids is found to be a safe treatment modality and more effective than topical steroids in alopecia areata.

Topics: Alopecia Areata; Clobetasol; Erbium; Humans; Lasers, Solid-State; Steroids; Treatment Outcome

Topical corticosteroids are known to be effective in the treatment of alopecia areata, but the potential effects on intraocular pressure are a concern. The purpose of this retrospective study is to evaluate the effect of clobetasol propionate 0.05% under occlusion on patients with active phase alopecia areata and to examine the effects on intraocular pressure. We also wished to see if reducing the frequency of application of clobetasol increased the safety with respect to intraocular pressure. Elevation of intraocular pressure due to topical corticosteroids is unlikely to occur at the dose of 9.8 g or less per week used in this study; however, ophthalmologic examination at the start of treatment was thought to be worthwhile in identifying patients with latent glaucoma.

Topics: Administration, Topical; Adolescent; Adult; Alopecia Areata; Clobetasol; Female; Glucocorticoids; Humans; Intraocular Pressure; Male; Occlusive Dressings; Retrospective Studies

There is no universally accepted treatment for severe pediatric alopecia areata (AA). This prospective study comprised 73 patients (aged 1-18 years) with severe AA (>30% of scalp surface area): 37 received 1-day intravenous dexamethasone pulses (1-DP) and 36 received 3-day pulses (3-DP), monthly, for 6-12 months. Also, all patients applied topical clobetasol propionate under plastic wrap occlusion. Patients achieving >50% regrowth were considered good responders (GR). All patients reached short term, while 65/73 were available for the long-term follow-up (mean 33.3 ± 15.3 vs. 27.7 ± 14.3 months, 1-DP and 3-DP, respectively). Relapses during therapy were more frequent in 1-DP group. 3-DP patients were more frequently GR in comparison with 1-DP. 3-DP patients with disease duration <6 months had better outcomes. Patients without Hashimoto thyroiditis (HT) had 9.8-fold higher chance of being GR in comparison with HT patients. The best results were achieved in AA plurifocalis (AAP). No patient had severe short-term side-effects. At the long-term follow-up, 67% of 3-DP patients had stable results. Only 14.2% AAP patients experienced relapses. Patients had no long-term side-effects. 3-DP were more efficacious than 1-DP. Short disease duration and no HT were good prognostic factors. 3-DP protocol is well-tolerated, with beneficial effects and long-lasting results in severe pediatric AA.

Topics: Administration, Intravenous; Administration, Topical; Adolescent; Alopecia Areata; Child; Child, Preschool; Clobetasol; Dexamethasone; Drug Therapy, Combination; Female; Follow-Up Studies; Glucocorticoids; Hashimoto Disease; Humans; Infant; Male; Prospective Studies; Pulse Therapy, Drug; Recurrence; Severity of Illness Index; Time Factors; Treatment Outcome

Topics: Administration, Topical; Adolescent; Adult; Alopecia Areata; Antifungal Agents; Clobetasol; Drug Administration Schedule; Female; Humans; Ketoconazole; Male; Middle Aged; Neck; Steroids; Tinea Versicolor; Young Adult

Topics: Administration, Cutaneous; Adolescent; Adult; Alopecia Areata; Anti-Inflammatory Agents; Child; Clobetasol; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Tacrolimus

Topics: Adult; Alopecia Areata; Anti-Inflammatory Agents; Child, Preschool; Clobetasol; Dose-Response Relationship, Drug; Female; Foot Dermatoses; Hand Dermatoses; Humans; Hypopigmentation; Male; Nails, Ingrown; Nails, Malformed; Paronychia; Skin Pigmentation

Anecdotical experiences indicate that Koebner phenomenon (KP) can also be observed in alopecia areata (AA). The present short report gives an account of what has been observed in some patients with remitting-relapsing AA in multiple patches, in whom the phenomenon was accidentally caused by perilesional Trichogram. The almost immediate appearance of relapses of the disease (1-7 days) and their evolution can be useful to understand the physiopathology of AA and and emphasize the compelling need for a rapid and appropriate diagnosis and treatment in the acute phase of AA, even with the active participation of the patient adequately trained. The method of trichogram should be reserved for cases in which non-invasive methods such as the Pull Test or Trichoscopy are not sufficient to verify the activity of the disease.

Topics: Administration, Cutaneous; Administration, Oral; Adolescent; Adult; Alopecia Areata; Betamethasone; Clobetasol; Dermoscopy; Drug Therapy, Combination; Female; Glucocorticoids; Hair Follicle; Humans; Male; Quality of Life; Recurrence; Severity of Illness Index; Skin; Time Factors; Treatment Outcome

Topics: Adult; Alopecia Areata; Anti-Inflammatory Agents; Clobetasol; Crohn Disease; Female; Humans; Minoxidil; Vasodilator Agents

Alopecia areata (AA) is a tissue-specific, T-cell-mediated autoimmune disease characterized by non-scarring hair loss. Ustekinumab is a human immunoglobulin monoclonal antibody that binds with the p40-subunit of interleukin-12 (IL-12) and IL-23 and has been licensed for the treatment of moderate to severe plaque psoriasis. The exact pathogenesis of AA remains unclear. However, increased Th1 serum cytokine levels have been associated with this condition. Thus, IL-12 inhibitors (ustekinumab) would be expected to treat or at least to prevent hair loss. We report two cases of acute AA occurring while on ustekinumab administration.

Topics: Alopecia Areata; Anti-Inflammatory Agents; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Betamethasone; Clobetasol; Humans; Male; Middle Aged; Psoriasis; Treatment Outcome; Ustekinumab

Topics: Alopecia Areata; Biopsy; Clobetasol; Dermoscopy; Female; Glucocorticoids; Hair; Humans; Time Factors; Treatment Outcome; Young Adult

Topics: Adalimumab; Adult; Alopecia Areata; Antibodies, Monoclonal, Humanized; Biological Therapy; Clobetasol; Humans; Immunosuppressive Agents; Male; Psoriasis

Topics: Adolescent; Adult; Alopecia Areata; Capsaicin; Clobetasol; Humans; Middle Aged; Young Adult