clobetasol and Burns

We have studied the antinociceptive and anti-inflammatory effects of topical glucocorticoids in human thermal injury. The right and left legs of 12 healthy volunteers were allocated randomly to be treated with either 0.05% clobetasol propionate cream or placebo in a double-blind trial. Thermal injuries were induced with a thermode, which was heated to 49 degrees C for 5 min under standardized pressure. Clobetasol propionate or placebo cream was applied to the skin 1 h before burn injury, immediately after the injury and every 12 h for the next 3 days. Heat pain detection thresholds (HPDT), heat pain tolerance (HPT), mechanical pain detection thresholds (MPDT) and the intensity of burn-induced erythema (erythema index, EI) were assessed inside the thermal injury and areas of hyperalgesia to pinprick outside the injury were determined before and regularly for 72 h after the burn injury. Burn injury caused a decrease in HPDT, HPT and MPDT, an increase in EI and development of mechanical, secondary hyperalgesia. Clobetasol propionate had no effect on any of the nociceptive or inflammatory variables studied.

Topics: Adult; Burns; Clobetasol; Double-Blind Method; Erythema; Female; Humans; Male; Pain; Pain Measurement; Pain Threshold; Skin; Time Factors

Lasers and potent topical corticosteroids are used as therapeutic options in hypertrophic burn scars.. To assess the therapeutic effect of fractional CO2 laser resurfacing in combination with potent topical corticosteroids on hypertrophic burn scars in pediatric age group.. Ten children (5-12 years) with postburn hypertrophic scars were treated with 3 to 5 sessions of fractional CO2 laser resurfacing at 1-month intervals, and triamcinolone suspension was applied immediately after each laser session. Patients were also instructed to apply clobetasol propionate gel for 1 week after each laser session. Response to treatment was assessed using Vancouver Scar Scale (VSS) and Physician Global Assessment (PGA). Tolerability for the procedure and adverse effects were also assessed.. Laser sessions were well tolerated under the effect of topical or local anesthesia. At the time of final assessment, there was mean reduction of 4.2 (range: 2.8-7) in VSS. Reduction of VSS by ≥4 points was observed in 8 of 10 cases, whereas PGA revealed excellent response in 6 of 10 cases. No significant adverse effects were reported by any patient.. Fractional CO2 laser resurfacing in combination with potent topical steroids leads to significant therapeutic benefits in children with postburn hypertrophic scars.

Topics: Administration, Topical; Burns; Child; Child, Preschool; Cicatrix, Hypertrophic; Clobetasol; Combined Modality Therapy; Female; Glucocorticoids; Humans; Lasers, Gas; Male

Deep erythema and inflammation after re-epithelialization of superficial wounds is a sign of scar formation. Corticosteroids may prevent scarring by suppression of inflammation and fibroblast activity. Tretinoin may increase the efficacy of corticosteroids in this setting.. To evaluate the efficacy of corticosteroids plus tretinoin for prevention of scars after superficial wounds.. In a retrospective study of patients with superficial partial thickness thermal skin burn, we compared the patients who received clobetasol plus tretinoin after re-epithelialization with patients who did not receive any medication. Clobetasol propionate 0.05% ointment was used twice daily with overnight occlusive dressing in conjunction with twice weekly topical tretinoin 0.05% cream.. Among 43 patients who had light pink or no erythema after re-epithelialization and consequently did not receive clobetasol + tretinoin, no scar was developed. Among patients who had deep erythema after re-epithelialization, rate of scar formation was significantly higher in 14 patients who did not receive clobetasol + tretinoin than in 21 patients who received clobetasol + tretinoin (64% and 19%, respectively; p = 0.01).. Clobetasol + tretinoin can significantly decrease the incidence of scar formation in patients with inflammation after re-epithelialization of superficial wounds.

Topics: Adolescent; Adult; Aged; Burns; Child; Child, Preschool; Cicatrix; Clobetasol; Dermatologic Agents; Erythema; Female; Glucocorticoids; Humans; Male; Middle Aged; Occlusive Dressings; Re-Epithelialization; Retrospective Studies; Skin; Tretinoin; Ulcer; Young Adult

Topics: Adult; Anti-Inflammatory Agents; Burns; Clobetasol; Female; Glucocorticoids; Humans; Hydrocortisone; Male; Treatment Outcome; Triamcinolone Acetonide

Burns are dynamic injuries that tend to progress over the course of several days. Steroids inhibit the formation of vasoconstrictive prostanoids that may contribute to this progression of injury. The authors hypothesized that adding topical steroids to a standard antimicrobial agent would reduce the progression of burns and accelerate reepithelialization without increasing infection rates.. This was a prospective, blinded, controlled, experimental trial. Forty-eight standardized second-degree burns were created by applying an aluminum bar preheated to 80 degrees C to the flanks of isoflurane-anesthetized young pigs for 20 seconds. Three equal sets of 16 burns were randomly treated with silver sulfadiazine cream (SSD), clobetasol propionate 0.05% (CP), or both (SSD+CP). Daily dressing changes were performed for 14 days. Full-thickness biopsies were taken after injury and at one, two, seven, ten, and 14 days for blinded histopathological evaluation using hematoxylin and eosin (H&E) staining. The primary outcome was the % reepithelialization (REP) calculated by dividing the length of the neoepidermis by the section's total length (interobserver correlation = 0.99). Depth of injury was measured for each dermal element (collagen; epithelial, mesenchymal, and vascular cells; and vessel thrombosis). Comparisons across groups were performed using one-way analysis of variance (ANOVA). A repeated-measures ANOVA was used to compare injury depths over time. This study had 80% power to detect a 33-percentage point difference in REP across groups (two-tailed alpha = 0.05).. Pretreatment burn depths were similar across groups. While burn depth changed over time, there was no difference between the groups in burn injury progression. There was no difference across the groups in REP or infection rates at all times.. Addition of a potent topical steroid to standard antimicrobial topical agents does not reduce burn depth or accelerate reepithelialization after burns.

Topics: Administration, Topical; Analysis of Variance; Animals; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Burns; Clobetasol; Drug Combinations; Glucocorticoids; Male; Silver Sulfadiazine; Skin; Swine; Wound Healing

Topics: Betamethasone; Burns; Clobetasol; Female; First Aid; Humans; Ointments