clobetasol and Chronic-Disease

The potential for a variety of local and systemic side effects from the use of potent topical corticosteroids has long been recognized. However, adrenal suppression has only rarely been documented. We describe two patients with profound hypothalamic-pituitary-adrenal axis suppression resulting from the unregulated use of super potent topical corticosteroids.

Topics: Administration, Topical; Adrenal Glands; Adult; Anti-Inflammatory Agents; Betamethasone; Chronic Disease; Clobetasol; Depression, Chemical; Female; Glucocorticoids; Humans; Male; Ointments; Psoriasis; Self Medication

Lichen sclerosus (LS) is a chronic inflammatory skin disease that mostly affects the anogenital region of women and lowers patients' quality of life. Current standard treatment of LS is topical steroids.. To evaluate the efficacy of topical progesterone 8% ointment and compare to standard therapy with topical clobetasol propionate 0.05% in premenopausal women presenting with previously untreated early onset LS.. Randomized, double-blind, 2-arm, single center superiority trial in premenopausal women with histologically confirmed vulvar LS who were randomized in a 1:1 ratio to receive clobetasol propionate 0.05% ointment or progesterone 8% ointment. The primary outcome was the clinical severity LS score after 12 weeks, which consists of six clinical features assessed by the physician. Secondary outcomes were the symptom severity LS score, which consists of three symptoms rated by the patient, the Short Form SF-12 physical and mental health scores, and adverse events. Response to medication was assessed by biopsy at the end of the treatment to evaluate inflammatory parameters.. Overall, 105 women were screened, 102 underwent vulvar biopsy and 37 received a histologically confirmed diagnosis of LS and were randomized: 17 to progesterone and 20 to clobetasol propionate. At 12 weeks, the mean clinical LS scores improved from 4.6 (SD 2.0) to 4.5 (SD 1.7) in the progesterone arm, and from 4.6 (SD 2.8) to 2.9 (SD 2.2) in the clobetasol propionate arm (difference in favor of clobetasol 1.61; 95% CI 0.44 to 2.77, p = 0.009), and the mean symptom severity LS scores improved from 4.5 (SD 3.8) to 3.1 (SD 3.0) in the progesterone arm, and from 4.7 (SD 2.8) to 1.9 (SD 1.8) in the clobetasol propionate arm (difference in favor of clobetasol 1.32; 95% CI -0.25 to 2.89, p = 0.095). LS was in complete remission in 6 out of 10 patients (60%) with available biopsy in the progesterone arm, and in 13 out of 16 patients (81.3%) in the clobetasol propionate arm (odds ratio in favor of clobetasol 0.35; 95% CI 0.06 to 2.06, p = 0.234). No drug-related serious adverse event occurred during the trial.. Topical progesterone 8% ointment is inferior to standard therapy with topical clobetasol propionate 0.05% in previously untreated premenopausal women with vulvar LS after 12 weeks treatment.

Topics: Administration, Topical; Chronic Disease; Clobetasol; Female; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Ointments; Pilot Projects; Progesterone; Quality of Life; Vulvar Lichen Sclerosus

Topical corticosteroids are the mainstay of psoriasis treatment, with long-term safety considerations limiting their use. Combining them with tazarotene may optimize their efficacy and minimize safety and tolerability concerns.. To investigate the safety and efficacy of halobetasol propionate 0.01% plus tazarotene 0.045% (HP/TAZ) lotion in moderate-to-severe plaque psoriasis.. Two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies (N = 418) were conducted. Subjects were randomized (2:1) to HP/TAZ lotion or vehicle once daily for 8 weeks with a 4-week follow-up. The primary efficacy assessment end point was treatment success (at least a 2-grade improvement from baseline in Investigator's Global Assessment score and a score of clear or almost clear). Safety and treatment-emergent adverse events were evaluated throughout.. HP/TAZ lotion demonstrated statistically significant superiority over vehicle within as few as 2 weeks. By week 8, 35.8% (study 1) and 45.3% (study 2) of subjects were treatment successes compared with 7.0% and 12.5% of those treated with vehicle (P < .001). HP/TAZ lotion was also superior in reducing signs and symptoms of psoriasis and body surface area affected by psoriasis. The most frequently reported treatment-related adverse events were contact dermatitis (6.3%), application site pain (2.6%), and pruritus (2.2%).. Studies did not include subjects with more than 12% of their body surface area affected by psoriasis.. HP/TAZ lotion was associated with significant reductions in the severity of the clinical signs of psoriasis, with no safety concerns.

Topics: Administration, Cutaneous; Chronic Disease; Clobetasol; Dermatologic Agents; Double-Blind Method; Drug Combinations; Drug Synergism; Female; Humans; Male; Middle Aged; Nicotinic Acids; Psoriasis; Severity of Illness Index; Skin Cream; Treatment Outcome

The aim of this study was to evaluate efficacy, tolerability and safety of a combination treatment with fluticasone propionate 0.05% cream and clobetasole ointment 0.05% in patients suffering from chronic hand eczema.. The study examined 30 patients with a clinical diagnosis of chronic hand eczema.. The treatment with topical corticosteroids resulted effective and topical corticosteroids proved their efficacy in mild and moderate hand eczema.. In according to the severity of the disease, authors suggest two different clinical strategies in the management of hand eczema.

Topics: Administration, Cutaneous; Androstadienes; Anti-Inflammatory Agents; Chronic Disease; Clobetasol; Drug Therapy, Combination; Eczema; Emollients; Fluticasone; Hand Dermatoses; Humans; Ointments; Severity of Illness Index; Skin Cream; Treatment Outcome

Chronic hand dermatitis may have a significant detrimental effect on daily home-related and work-related activities, and quality of life (QOL). Clobetasol propionate foam, 0.05%, is indicated for the treatment of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses in patients aged 12 years and older.. To demonstrate superior efficacy, similar safety, and superior QOL outcomes in subjects with moderate to severe chronic hand dermatitis following treatment with clobetasol propionate foam, 0.05%, compared with vehicle foam.. In this randomized, double-blind, vehicle-controlled, parallel-group, multicenter study (ClinicalTrials.gov identifier NCT01323673), subjects aged 12 years and older with moderate to severe chronic hand dermatitis and an Investigator's Static Global Assessment (ISGA) score of 3 or 4 at baseline were randomized 1:1 to receive clobetasol propionate foam, 0.05%, or vehicle foam, twice daily over 15 days. The primary end point was the proportion of subjects who achieved treatment success, defined as improvement from baseline of ≥ 2 ISGA grades for the target hand at day 15.. In total, 125 subjects were enrolled: 62 subjects were randomized to the clobetasol propionate foam group and 63 subjects were randomized to the vehicle foam group. The proportion of subjects with treatment success at day 15 did not differ significantly between treatment groups. Adverse events (AEs) were reported in 18% of subjects in the clobetasol propionate foam group and 8% of subjects in the vehicle foam group. No serious AEs, AEs resulting in discontinuation of study product, or severe AEs were reported in the clobetasol propionate foam group.. Clobetasol propionate foam, 0.05%, was not significantly more efficacious than vehicle foam at improving chronic hand dermatitis on investigator-assessed end points. Emollient properties of the study product vehicle may be a confounder in the study.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Chronic Disease; Clobetasol; Double-Blind Method; Female; Hand Dermatoses; Humans; Male; Middle Aged; Severity of Illness Index; Young Adult

To assess the safety and efficacy of clobetasol propionate 0.05% emulsion formulation (EF) foam in subjects with mild-to-moderate chronic hand dermatitis.. This was a single-center, open-label pilot study of 30 adults with chronic hand dermatitis. Subjects were treated with clobetasol propionate 0.05% EF foam twice-daily and returned for assessment at day 8 and day 15. The primary efficacy endpoint was the proportion of subjects who achieved treatment success, defined as improvement of ≥ 1 grade in their chronic hand dermatitis as per the Investigator's Static Global Assessment (ISGA) from baseline to day 15. Safety and quality-of-life measures were also assessed.. A minimum 1-grade improvement in the ISGA was achieved by 96.7 percent (29/30) of subjects at day 15, with 80 percent (24/30) of subjects achieving a score of 0 (clear) or 1 (almost clear). Clobetasol propionate 0.05% EF foam appeared to be safe and well-tolerated, with only four subjects experiencing treatment-related adverse events. No pattern of adverse event occurrence or predisposition could be delineated from this study.. Clobetasol propionate 0.05% EF foam appeared to be safe and effective for the treatment of chronic hand dermatitis.

Topics: Adult; Aged; Chronic Disease; Clobetasol; Emulsions; Female; Glucocorticoids; Hand Dermatoses; Humans; Male; Middle Aged; Pilot Projects; Severity of Illness Index; Treatment Outcome; Young Adult

Many therapeutic modalities have been suggested for treatment of the chronic hand eczema. Despite good immediate efficacy of some of these treatments, there is high recurrence of the dermatitis following cessation of the treatment.. Regarding the beneficial effects of the zinc sulfate on the skin, we designed a double blind study to evaluate the efficacy of the '0.05% Clobetasol + 2.5% zinc sulphate' cream versus '0.05% Clobetasol alone' cream in the treatment of the chronic hand eczema.. This study was a double-blind, right to left, prospective, clinical trial. In total, 47 patients with chronic hand eczema admitted to dermatology center of Isfahan University of Medical Sciences were selected and their right hand or left hand were selected at random to be treated with either the '0.05% Clobetasol + 2.5% zinc sulphate' cream or '0.05% Clobetasol alone' cream twice daily for 2 weeks. All of the patients were treated for 2 weeks and were followed up at weeks 2, 4, 6 and 8 after starting the treatment. For determining the severity of chronic hand eczema, we assessed and scored 4 different characteristics of the lesions including redness; scaling; lichenification and pruritus. The data were analyzed using SPSS program (release 13) and statistical tests including Mann-Whitney test.. Overall, 47 patients (94 samples) were evaluated. All of these patients had similar and symmetrical lesions on their right and left hands. Out of them, 35 patients were females and 12 patients were male. In all of the evaluated characterisitics, the '0.05% Clobetasol + 2.5% zinc sulphate' cream was more effective than '0.05% Clobetasol alone' cream (P < 0.05). The recurrence rate of eczema was significantly lower in the group treated with this combination treatment (P < 0.05).. With regard to the encouraging results of the combination treatment with Clobetasol + zinc sulphate, we suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated. In addition, evaluation of this combination therapy against other inflammatory dermatosis seems to be logical.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Astringents; Child; Chronic Disease; Clobetasol; Double-Blind Method; Drug Therapy, Combination; Eczema; Female; Glucocorticoids; Hand; Humans; Male; Middle Aged; Ointments; Prospective Studies; Recurrence; Severity of Illness Index; Zinc Sulfate

We investigated the value of the dermoscope for monitoring the long term safety of high potency topical steroids in patients with chronic psoriasis. We observed for the first time that the overuse of topical steroids resulted in the appearance of clinically unapparent but dermoscopically apparent "red lines" (linear telangiectasias) in the treated plaques and/or skin adjacent to the treated plaques (P < .03). We concluded that dermoscopy may help reveal the early signs of impending steroid-induced atrophy ("red lines") before they become clinically evident with the naked eye and before the atrophy becomes permanent.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Atrophy; Calcitriol; Chronic Disease; Clobetasol; Dermatologic Agents; Dermoscopy; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Patient Compliance; Pilot Projects; Psoriasis

Many studies have shown the clinical efficiency of occlusion therapy for psoriasis, particularly corticosteroids used under hydrocolloid dressings. However, there are no data from comparative clinical studies evaluating the remission and relapse characteristics of such occlusion therapy compared with orthodox topical steroid monotherapy.. In a randomised, open-label, parallel group study from three centres, the remission and relapse characteristics were investigated for the use of a hydrocolloid dressing (HCD) over clobetasol propionate 0.05% lotion once a week compared with the same steroid in ointment formulation used unoccluded twice a day in 61 patients with stable chronic plaque psoriasis.. There was a pronounced treatment difference in favour of the HCD + clobetasol propionate lotion group with respect to time to clearance, but there was little evidence for a difference with respect to time to relapse.. The combination of the HCD + clobetasol propionate lotion provides a fast and highly effective remission induction.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Chronic Disease; Clobetasol; Colloids; Combined Modality Therapy; Drug Administration Schedule; Female; Glucocorticoids; Humans; Male; Middle Aged; Occlusive Dressings; Psoriasis; Recurrence; Remission Induction

Mometasone furoate [9a, 21-dichloro-llb, 17dihydroxy-16a-methyl-pregna-14-dione-3, 20-dione-17-(2furoate)] is a synthetic, 17-heterocyclic corticosteroid which has been shown to be highly effective as an anti-inflammatory agent which is approximately half as potent is suppressing hypothalamic-pituitary-adrenal (HPA) axis function as betamethasone valerate.. The present open, randomised, third party blinded, left-right sided study was designed to compare the therapeutic efficacy of mometasone furoate cream 0.1% with clobetasol propionate cream 0.05% applied twice daily in chronic eczema following a 3-week course of therapy.. Sixty consecutive patients with moderate to severe bilateral chronic eczema on the limbs were recruited into the study. The mean scores of various signs/symptoms including erythema, induration, crusting, scaling, excoriation and pruritus before and after 3 weeks treatment with mometasone furoate (MF) and clobetasol propionate (CP) cream, were compared. The baseline scores for MF and CP treated sites were almost identical. There was significant decrease in the mean scores of all signs/symptoms after 3 weeks treatment with MF and CP. There was also a significant difference in the mean scores between MF and CP treated sites after 3 weeks of treatment. The mean scores were significantly lower for CP treated sites than MF treated sites. More CP treated sites achieved "cleared" or "marked improvement" response than MF treated sites. There were more "excellent" or "good" grades on CP treated sites than MF treated sites at the end of 3 weeks of treatment. None of the patients showed any side-effects after 4 weeks of treatment.. Overall, 53% of patients considered the MF treated sites to be good or excellent vs 88% for CP treated sites.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Chronic Disease; Clobetasol; Drug Administration Schedule; Eczema; Female; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Treatment Outcome

Twenty-three patients with chronic idiopathic urticaria and 3 patients with urticaria pigmentosa received a 2-week treatment with daily application of potent topical steroid using plastic occlusion. Seventy per cent of the chronic urticaria patients had a statistically significant, immediate response, which, however, did not last until the final evaluation after 1.5 years. Relapse occurred after on average 3 weeks, but 39% reported less severity. The 3 patients with urticaria pigmentosa remained free from attacks for 6 to 9 months, after which they gradually relapsed. Two women were diagnosed during the follow-up period to have a carcinoma of the breast, and one patient developed systemic lupus erythematosus.

Topics: Administration, Topical; Adolescent; Adult; Anti-Inflammatory Agents; Breast Neoplasms; Chronic Disease; Clobetasol; Female; Follow-Up Studies; Glucocorticoids; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Occlusive Dressings; Recurrence; Retrospective Studies; Single-Blind Method; Surveys and Questionnaires; Treatment Outcome; Urticaria; Urticaria Pigmentosa

Topics: Administration, Topical; Anti-Inflammatory Agents; Bandages, Hydrocolloid; Chronic Disease; Clobetasol; Colloids; Female; Glucocorticoids; Hand Dermatoses; Humans; Male; Middle Aged; Occlusive Dressings; Ointments; Random Allocation; Solutions; Treatment Outcome

In a double-blind, parallel-group, multicenter trial in 134 patients with severe, localized, plaque psoriasis, the success rate (described as "healed" or "marked improvement") at the end of the study was 96% in the halobetasol propionate group and 91% in the clobetasol propionate group. A significantly larger proportion of patients treated with halobetasol had no disease or mild disease after 14 days compared with those treated with clobetasol (86% versus 70%, p = 0.023). Healing within 24 days of starting treatment was noted in 69% and 56% of patients treated with halobetasol and clobetasol, respectively. Adverse effects were reported in a smaller percentage of patients treated with halobetasol propionate ointment than in those treated with clobetasol propionate ointment (7% versus 12%). Cosmetic acceptability and ease of application were recorded as "very good" in a larger percentage of patients treated with halobetasol propionate ointment than in the group treated with clobetasol propionate (90% versus 80%).

Topics: Adult; Aged; Chronic Disease; Clobetasol; Double-Blind Method; Female; Humans; Male; Middle Aged; Ointments; Patient Satisfaction; Psoriasis; Remission Induction; South Africa; Vasoconstrictor Agents; Wound Healing

In a double-blind, parallel-group, multicenter comparative trial on 104 evaluable patients with severe, localized plaque psoriasis, 0.05% halobetasol propionate ointment demonstrated an 88.7% success rate assessed as "healed" or "marked improvement" compared with 78.5% for 0.05% betamethasone dipropionate ointment. Healing was observed within 24 days of the start of treatment in 40% and 25% of the patients who received halobetasol propionate and betamethasone dipropionate ointments, respectively. After 4 weeks' treatment, tolerability of both ointments was good. Neither skin atrophy nor systemic adverse effects were observed. Patient acceptance of halobetasol propionate ointment, based on cosmetic acceptability and ease of application, was significantly better (p = 0.02) than that of betamethasone dipropionate ointment.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Betamethasone; Chronic Disease; Clobetasol; Double-Blind Method; Female; Germany; Glucocorticoids; Humans; Male; Middle Aged; Ointments; Patient Satisfaction; Psoriasis; Remission Induction; Vasoconstrictor Agents; Wound Healing

In a double-blind, parallel-group, multicenter comparative trial in 84 evaluable patients with severe, localized plaque psoriasis, 0.05% halobetasol propionate ointment proved significantly superior (p = 0.02) to 0.1% betamethasone valerate ointment with respect to the success rate, as indicated by ratings of "healed" or "marked improvement" (88.1% versus 64.3%). The therapeutic effect was observed within 5 days of the start of treatment in 76% and 67% of the patients treated with halobetasol propionate and betamethasone valerate ointments, respectively. Both preparations were well tolerated. Minor adverse effects at the site of application were reported in only 2% of the patients in each treatment group. Neither skin atrophy nor systemic adverse effects were observed.

Topics: Adult; Aged; Betamethasone Valerate; Chronic Disease; Clobetasol; Double-Blind Method; Female; Humans; Male; Middle Aged; Ointments; Patient Satisfaction; Psoriasis; Remission Induction; Switzerland; Vasoconstrictor Agents; Wound Healing

In a double-blind, parallel-group, multicenter comparative trial in 127 evaluable patients with chronic, localized atopic dermatitis or lichen simplex chronicus, healing was reported in a higher percentage of patients treated with halobetasol propionate ointment than in those in the clobetasol propionate treatment group (65.1% versus 54.7%). The success rates (described as "healed" and "marked improvement") were practically identical in the two treatment groups (93.7% versus 92.2%). Early onset of therapeutic effect, that is, within 3 days of the start of treatment, was similar in the two treatment groups (24% versus 28%). Both preparations were well tolerated. Adverse effects were reported in 5% and 2% of the patients treated with halobetasol propionate and clobetasol propionate ointments, respectively.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; Clobetasol; Dermatitis, Atopic; Double-Blind Method; Female; Germany; Humans; Male; Middle Aged; Neurodermatitis; Ointments; Patient Satisfaction; Remission Induction; Vasoconstrictor Agents; Wound Healing

In a double-blind, parallel-group, multicenter, comparative trial in 120 evaluable patients with chronic, localized atopic dermatitis or lichen simplex chronicus, the success rate (described as "healed" and "marked improvement") was 91.5% in patients treated with halobetasol propionate ointment and 83.6% in those in the diflucortolone valerate treatment group. Of patients treated with halobetasol propionate ointment, 40.7% reported healing within 17 days, whereas of those in the diflucortolone valerate treatment group, 32.8% reported healing within that time. Early onset of therapeutic effect, that is, within 3 days of the start of treatment, was reported in a higher percentage of patients treated with halobetasol propionate ointment than in those treated with diflucortolone valerate ointment (70% versus 59%). Adverse effects at the site of application were less frequently reported in patients belonging to the halobetasol propionate treatment group than in those treated with diflucortolone valerate ointment (3% versus 8%).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Austria; Chronic Disease; Clobetasol; Dermatitis, Atopic; Diflucortolone; Double-Blind Method; Female; Humans; Male; Middle Aged; Neurodermatitis; Ointments; Patient Satisfaction; Remission Induction; Vasoconstrictor Agents; Wound Healing

In a multicenter, 14-day pediatric study in 81 evaluable patients with severe, localized corticosteroid-susceptible dermatoses, the combined treatment with halobetasol propionate cream once during the day and halobetasol propionate ointment once at night produced a very satisfactory therapeutic effect. The success rates, as indicated by ratings of "healed" and "marked improvement," were 100% and 90.9% in patients with atopic dermatitis and psoriasis vulgaris, respectively. Healing was reported in 86.8% and 72.7% of patients treated for atopic dermatitis and psoriasis, respectively. Both the cream and ointment preparations were well tolerated. Adverse effects at the site of application were reported in only 3 of 81 patients. Mild skin atrophy was observed in one patient. No systemic adverse effects were observed.

Topics: Administration, Cutaneous; Adolescent; Child; Child, Preschool; Chronic Disease; Clobetasol; Dermatitis, Atopic; Drug Tolerance; Female; Humans; Male; Ointments; Psoriasis; Remission Induction; Switzerland; Vasoconstrictor Agents; Wound Healing

The efficacy and safety of 0.05% halobetasol propionate ointment were evaluated in patients with chronic atopic or other eczematous dermatoses in two vehicle-controlled, double-blind studies: a paired-comparison study in 124 patients (study A) and a parallel-group study in 100 patients (study B). In study A, patients applied both treatments twice daily for 2 weeks and were evaluated by investigators on days 0, 7, and 14 with 0 to 3 severity scales and by self-assessment with two 5-step end-of-treatment rating scales. In study B, patients applied treatments twice daily for 2 weeks, and investigators made evaluations on days 0, 3, 7, and 14 with 0 to 6 scales and also made a 5-step end-of-treatment physician's global assessment. In study A, both severity scores and patient ratings favored halobetasol propionate significantly on days 7 (p less than or equal to 0.0013) and 14 (p less than 0.0001); in study B, severity scores on days 3 (p less than or equal to 0.045, pruritus, erythema, and overall lesion severity), 7, and 14 (p less than 0.001, all comparisons) also favored halobetasol propionate significantly, and global assessments showed complete resolution or marked improvement for 83% of patients using halobetasol propionate versus 28% of those using vehicle (p less than 0.0001). No instances of systemic effects or skin atrophy were reported in either study. We conclude that 0.05% halobetasol propionate ointment is highly effective and well tolerated in the treatment of the conditions studied, with the rapid action and high degree of clearing associated with superpotent corticosteroid formulations.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; Clobetasol; Dermatitis; Dermatitis, Atopic; Eczema; Female; Humans; Male; Middle Aged; Neurodermatitis; Ointments; Pharmaceutical Vehicles; Remission Induction; Safety; Treatment Outcome; United States; Vasoconstrictor Agents

Six investigators evaluated 0.05% halobetasol propionate cream and its vehicle in 111 patients with chronic atopic dermatitis and several other eczematous dermatoses. Patients applied treatment twice daily to bilateral lesions for 14 days. Investigators graded pruritus, erythema, scaling, papulation, and lichenification using 4-point severity scales on days 0, 7, and 14. On day 14 patients provided an assessment of efficacy for both treatments. Statistically significant differences favoring halobetasol propionate over the vehicle were seen for all signs and symptoms (p less than 0.001). Substantial improvements were achieved by the active treatment by day 7 (p less than 0.001). Patients assessments of efficacy were significantly higher for halobetasol cream than for vehicle (p less than 0.001). No instances of systemic effects or skin atrophy were reported and adverse experiences were limited to burning or stinging and other minor, nonspecific complaints distributed uniformly between active treatment and vehicle. These results demonstrate that 0.05% halobetasol propionate cream is highly effective in the treatment of atopic dermatitis and other eczematous dermatoses.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Chronic Disease; Clobetasol; Dermatitis; Dermatitis, Atopic; Double-Blind Method; Eczema; Female; Humans; Male; Middle Aged; Neurodermatitis; Patient Satisfaction; Pharmaceutical Vehicles; Remission Induction; Safety; Vasoconstrictor Agents

A prospective randomized trial of anthralin in Lassar's paste compared with anthralin in 0.0125% clobetasol propionate in the treatment of chronic plaque psoriasis was undertaken. The psoriatic skin of patients treated with the corticosteroid-anthralin combination cleared significantly more quickly than those treated with anthralin alone, with a mean time to clearance of 14.9 days compared with 18.5 days, and with lower concentrations of anthralin. No significant difference was found in the rate of relapse of the two treatment groups, with relapse occurring in over 80% of patients within one year. Anthralin in 0.0125% clobetasol propionate was found to be an effective agent in the treatment of chronic plaque psoriasis, and one that was cosmetically acceptable to patients and nursing staff. An important disadvantage, however, was the development of a staphylococcal folliculitis in four of the 35 patients in which it was used. Because of this, anthralin in Lassar's paste remains our standard inpatient therapy, although the ease of use and cosmetic acceptability of anthralin in clobetasol propionate make it a useful remedy for outpatient use.

Topics: Adolescent; Adult; Aged; Anthralin; Betamethasone; Chronic Disease; Clobetasol; Coal Tar; Combined Modality Therapy; Drug Combinations; Female; Humans; Male; Middle Aged; Prospective Studies; Psoriasis; Random Allocation; Staphylococcal Skin Infections; Ultraviolet Therapy

The clinical effect of two topical corticosteroids, one of very strong potency (clobetasol propionate), and one of medium potency (flupredniden acetate), was studied in the maintenance therapy of 55 patients with chronic hand eczema. Initially, 61 patients were treated on both hands continuously for 1 to 3 weeks with clobetasol only which brought about healing in 90% of cases (mean time to healing: 11 days). In a subsequent double-blind left/right study, the capacity of the two corticosteroids for keeping the dermatitis in remission was compared using an intermittent schedule of 2 applications a week. The protocol was followed by 46 patients and the mean observation period was 138 days. Treatment with clobetasol kept patients free from relapses during the entire observation period in 70%, with flupredniden in 30%. Relapses occurred with clobetasol after a mean of 66 days, with flupredniden after 36 days. Side-effects, occurring with similar frequency with both drugs, were few and mild. It is suggested that an intermittent schedule is advantageous when using a corticosteroid of high potency.

Topics: Betamethasone; Chronic Disease; Clinical Trials as Topic; Clobetasol; Dermatitis, Atopic; Double-Blind Method; Drug Administration Schedule; Eczema; Hand Dermatoses; Humans; Pregnadienetriols

Topics: Betamethasone; Chronic Disease; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Eczema; Female; Fluocortolone; Humans; Male; Pregnadienediols

Oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS) are common chronic inflammatory conditions, manifesting as painful oral lesions that negatively affect patients' quality of life. Current treatment approaches are mainly palliative and often ineffective due to inadequate contact time of the therapeutic agent with the lesions. Here, we developed the Dental Tough Adhesive (DenTAl), a bioinspired adhesive patch with robust mechanical properties, capable of strong adhesion against diverse wet and dynamically moving intraoral tissues, and extended drug delivery of clobetasol-17-propionate, a first-line drug for treating OLP and RAS. DenTAl was found to have superior physical and adhesive properties compared to existing oral technologies, with ~2 to 100× adhesion to porcine keratinized gingiva and ~3 to 15× stretchability. Clobetasol-17-propionate incorporated into the DenTAl was released in a tunable sustained manner for at least 3 wk and demonstrated immunomodulatory capabilities

Topics: Animals; Chronic Disease; Clobetasol; Dental Cements; Hydrogels; Lichen Planus, Oral; Propionates; Quality of Life; Swine

Chronic hand eczema (CHE) is a recurrent, frequently disabling skin condition that requires daily skin care to prevent transepidermal water loss, posing a significant burden of society and economy. In recent years, topical 0.05% clobetasol cream is widely used for the treatment of CHE for its efficacy, tolerability and safety. Whereas, no systematic review and meta-analysis has been updated up to now. Therefore, this work aims to assess the effectiveness and safety of topical 0.05% clobetasol cream in patients with CHE.. Study on topical 0.05% clobetasol cream for CHE will be searched from their inception to December, 2020 with the language restrictions of English and Chinese in 8 databases (PubMed, Cochrane Library, Embase, the web of science, VIP, CNKI, CBM, and WAN FANG). According to the heterogeneity test, a fixed or random-effect model will be used to synthesize data. The primary outcome is the proportion of patients achieving more than 75% reduction in signs and symptoms according to the Hand Eczema Severity Index (HECSI). The secondary outcomes include: scored for 4 different characteristics of the lesions (redness, scaling, lichenification, and pruritus), QoL questionnaire, adverse events, and recurrence events. STATA 13.0 and Review Manager software 5.3 will be used for analysis and synthesis. Two or more reviewers will independently conduct the selection of studies, data extraction, and data analysis.. The results of the study expect to provide a high-quality, evidence-based recommendation on topical 0.05% clobetasol cream in the treatment of CHE for clinicians.. The study will provide scientific and useful evidence for better use of topical 0.05% clobetasol cream in treating CHE.. This study is a protocol for an overview of SRs/MAs that did not involve individual data. Thus, ethical approval is not required.. DOI 10.17605/OSF.IO/SPHVZ.

Topics: Chronic Disease; Clobetasol; Eczema; Hand Dermatoses; Humans; Meta-Analysis as Topic; Pruritus; Quality of Life; Randomized Controlled Trials as Topic; Severity of Illness Index; Skin Cream; Systematic Reviews as Topic; Treatment Outcome

BACKGROUND Classical pyoderma gangrenosum is a rare, inflammatory, neutrophilic dermatosis that commonly presents with severe ulcerations on the lower extremities and is often misdiagnosed and mistreated. Delay in treatments can lead to worsening of the ulcerations and allows for multiple comorbid factors. Pyoderma gangrenosum is most commonly treated with immunosuppressants or anti-inflammatory agents and is often worsened by surgical procedures due to the presence of pathergy. In acute cases, a course of anti-inflammatory treatments works well in alleviating symptoms and reducing ulcerations and residual scarring. However, in chronic cases with the presence of severe scarring and necrotic ulcerations, the simple implementation of systemic immunosuppressants is frequently ineffective alone. Although not mentioned in most case reports on pyoderma gangrenosum, the chronicity of its inflammatory component can lead to necrosis and scarring and subsequent vascular insufficiency. CASE REPORT We present a severe case of chronic ulcerative pyoderma gangrenosum in a patient who had treatment-resistant ulcerations and cribriform edematous scarring with subsequent vascular insufficiency of the right lower extremity. This patient, while receiving topical clobetasol, had marked improvement in the healing of his ulcerations only after starting a novel course of cadexomer iodine, compression stockings, and pentoxifylline. CONCLUSIONS The efficacy of non-anti-inflammatory treatments indicates that chronic pyoderma gangrenosum with extensive scarring is commonly associated with the comorbid factors of vascular insufficiency, necrotic debris, and extensive wound fluid. In cases of ulcerations in chronic pyoderma gangrenosum that are resistant to anti-inflammatory treatments alone, one should identify and address other compounding factors that may inhibit wound healing.

Topics: Adult; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Chronic Disease; Cicatrix; Clobetasol; Combined Modality Therapy; Comorbidity; Humans; Iodophors; Leg; Leg Ulcer; Male; Pentoxifylline; Peripheral Vascular Diseases; Pyoderma Gangrenosum; Stockings, Compression; Vasodilator Agents

Topics: Administration, Topical; Adult; Chronic Disease; Clobetasol; Diagnosis, Differential; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Lichenoid Eruptions; Male; Myelodysplastic Syndromes; Penile Diseases; Stomatitis

Lichen sclerosus (LS) is a chronic, inflammatory condition of the skin, affecting primarily the anogenital region potentially leading to changes in vaginal architecture and vulvar squamous cell carcinoma. Current recommended treatment for LS is high-potency corticosteroids. Calcineurin inhibitors may also have a role.. The objective of this study is to introduce a treatment regimen involving clobetasol to induce remission, then tacrolimus to maintain remission in pediatric females with LS.. As a retrospective case series, we report 14 pediatric females between 2 and 10 years of age with LS treated with clobetasol 0.05% topical ointment and systematically bridged to tacrolimus 0.1% topical ointment. For each patient, gender, age at disease onset, and clinical symptoms and features were noted. Time in weeks to 75% clearance and to complete clearance were recorded.. Thirteen patients showed complete clearance. One patient showed significant clearance of the disease. The time to complete clearance averaged 43.1 weeks, with a range of 4-156 weeks.. The use clobetasol to induce remission and tacrolimus to maintain remission can be used to treat LS in pediatric females. This regimen may minimize side effects associated with long-term, high-potency corticosteroid use and reduce the risk of changes to genital architecture secondary to LS.

Topics: Calcineurin Inhibitors; Child; Child, Preschool; Chronic Disease; Clobetasol; Dermatologic Agents; Female; Glucocorticoids; Humans; Immunosuppressive Agents; Lichen Sclerosus et Atrophicus; Retrospective Studies; Tacrolimus

Chronic, non-healing wounds are often characterised by an excessive, and detrimental, inflammatory response. We review our experience of using a combined topical steroid, antibiotic and antifungal preparation in the treatment of chronic wounds displaying abnormal and excessive inflammation.. A retrospective review was undertaken of all patients being treated with a topical preparation containing a steroid (clobetasone butyrate 0.05%), antibiotic and antifungal at a tertiary wound healing centre over a ten-year period. Patients were selected as the primary treating physician felt the wounds were displaying excessive inflammation. Healing rates were calculated for before and during this treatment period for each patient. Changes in symptom burden (pain, odour and exudate levels) following topical application were also calculated.. Overall, 34 ulcers were identified from 25 individual patients (mean age: 65 years, range: 37-97 years) and 331 clinic visits were analysed, spanning a total time of 14,670 days (7,721 days 'before treatment' time, 6,949 days 'during treatment' time). Following treatment, 24 ulcers demonstrated faster rates of healing, 3 ulcers showed no significant change in healing rates and 7 were healing more slowly (p=0.0006). Treatment generally reduced the burden of pain and exudate, without affecting odour.. In normal wound healing, inflammation represents a transient but essential phase of tissue repair. In selected cases, direct application of a steroid containing agent has been shown to improve healing rates, presumably by curtailing this phase. Further evaluation is required to establish the role of preparations containing topical steroids without antimicrobials in the management of chronic wounds.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antifungal Agents; Chronic Disease; Clobetasol; Drug Combinations; Female; Glucocorticoids; Humans; Inflammation; Male; Middle Aged; Nystatin; Ointments; Oxytetracycline; Retrospective Studies; Wound Healing

This study investigates the health-related quality of life in patients with vulvar lichen sclerosus (LS) and the patient-defined therapeutic benefit of clobetasol.. A survey analysis of 96 women with LS after treatment with clobetasol was performed. Quality of life was assessed with the Skindex-29. The Patient Benefit Index (PBI) was used to determine the therapeutic benefit.. The overall response rate was 59.2%. Quality of life was most impaired by somatic symptoms (scale 'Symptoms' score 3.2) and emotional stress (scale 'Emotions' score 3.1), while social interactions (scale 'Functioning' score 1.9) played an inferior role (p < 0.001). Primary therapeutic goals 'to have confidence in the therapy' and 'to be free of itching' were achieved in 73.2 and 69.0% of patients who indicated the goal applied to them. The global PBI score was 3.06. In 93.2% of patients it was >1, indicating a potential benefit from clobetasol.. Topical clobetasol is of potential therapeutic benefit for patients with vulvar LS and might therefore improve quality of life.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Inflammatory Agents; Chronic Disease; Clobetasol; Emotions; Female; Humans; Middle Aged; Patient Satisfaction; Quality of Life; Social Participation; Surveys and Questionnaires; Vulvar Lichen Sclerosus; Young Adult

Atrophic plaques with white borders are occasionally seen on sun-exposed areas of the skin. These patients are usually elderly and have solar elastosis. This condition is referred to as annular atrophic plaques of skin and we describe a typical case.

Topics: Aged; Atrophy; Biopsy; Chronic Disease; Clobetasol; Diagnosis, Differential; Epidermis; Humans; Keratosis; Male; Sclerosis; Skin Diseases

Oral lichen planus, or OLP, is a common mucocutaneous immunological disease. The objective of this study was to describe the patient profile, disease progression and treatment responses.. The authors conducted a retrospective, descriptive study using information from patient records at a tertiary referral center. The study included 229 patients with OLP who were seen in the oral medicine clinic at the University of California, San Francisco, between September 1996 and August 2000, for the first time or for a follow-up visit. Signs and symptoms at various clinic visits were quantified. Responses to treatment and disease progression were determined by comparing scores with baseline scores.. The mean age at onset of the disease was 55 years, and 154 (67 percent) of the patients were female. Symptoms generally correlated directly with the severity of OLP forms, which ranged from reticular to erosive. Corticosteroids were effective in reducing symptoms, healing ulcers and reducing erythema. At last follow-up, 65 percent of the patients had the same type of OLP seen initially or the disease had progressed to a more severe type, while 35 percent of patients had less-severe forms than that seen at the initial visit. Four patients (1.7 percent) developed oral squamous-cell carcinoma during the follow-up period.. OLP is a chronic disease with no known cure. Symptoms can improve with corticosteroids; however, the lack of long-term (that is, lifetime) treatment compliance and the adverse side effects of the drugs limit optimal results.. Patients with OLP should be treated if symptoms are significant. Follow-up--including supervision of medication use and monitoring of side effects, as well as periodic examinations for possible malignant transformation--is necessary.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Azathioprine; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Chronic Disease; Clobetasol; Disease Progression; Female; Fluocinonide; Follow-Up Studies; Glucocorticoids; Humans; Immunosuppressive Agents; Lichen Planus, Oral; Male; Middle Aged; Mouth Neoplasms; Prednisone; Retrospective Studies; Statistics, Nonparametric; Treatment Outcome

The authors describe an 11-year-old boy who had persistent oral lesions that clinically mimicked first-episode herpetic stomatitis. A biopsy revealed noncaseating sterile granulomas. Investigation of the small and large bowels revealed that the child had Crohn's disease. The oral lesions responded favorably to topical steroid therapy. The authors also discuss the range of oral lesions in inflammatory bowel disease and the differential diagnoses.

Topics: Administration, Topical; Anti-Inflammatory Agents; Child; Chronic Disease; Clobetasol; Crohn Disease; Diagnosis, Differential; Glucocorticoids; Humans; Male; Oral Ulcer; Sarcoidosis; Stomatitis

The lesions of 141 patients with chronic skin diseases unresponsive to therapy were treated once a week with clobetasol propionate lotion left under the completely occlusive patch Duoderm. In 131 patients the lesions resolved completely, while partial remission was observed in the remaining 10. The mean interval to complete remission was: for chronic plaque psoriasis, 12 days; psoriasis on palms and soles, 2.5 weeks; palmoplantar pustulosis, 2.2 weeks; skin lesions of Reiter's syndrome, 3 weeks; chronic lichenified eczema, 2.0 weeks; neurodermatitis, 3.1 weeks; breast eczema, 9 days; discoid lupus erythematosus, 3.7 weeks; lichen planus, 2.8 weeks; sarcoidosis, 4 weeks; and lichen sclerosus et atrophicus, 2 weeks. Other conditions benefitting from the treatment were pompholyx, necrobiosis lipoidica, granuloma annulare and pretibial myxedema. The amount of topical corticosteroids needed was reduced to at most 1/20 and to as little as 1/100, compared with common topical steroid preparations.

Topics: Adult; Bandages, Hydrocolloid; Chronic Disease; Clobetasol; Colloids; Humans; Occlusive Dressings; Skin Diseases; Treatment Outcome

During recent years, 48 patients with therapy-resistant chronic skin lesions of atopic dermatitis have been treated once a week with clobetasol propionate lotion left under Duoderm occlusive patches. They had previously failed to respond, or responded only sparsely, to topical corticosteroids. The lesions resolved completely in 44 patients, while partial remission was observed in the remaining 4. The mean time needed to obtain complete remission was, for lichenifications, 2 weeks; pruriginous lichenoid papules, 12 days; chronic hand eczema, 2.5 weeks; nummular eczema, 8 days; perioral eczema, 11 days, and breast eczema, 10 days. Adverse experiences were mild and infrequent. The amount of topical corticosteroid required was reduced to at most one-twentieth and to as little as one-hundredth of the amount of common topical steroid treatment needed. We conclude that clobetasol propionate and Duoderm once a week is the best treatment for resistant lesions of atopic dermatitis.

Topics: Adolescent; Adult; Aged; Bandages, Hydrocolloid; Child; Chronic Disease; Clobetasol; Colloids; Dermatitis, Atopic; Female; Humans; Male; Middle Aged; Occlusive Dressings

The lesions of 161 patients with chronic skin diseases that were unresponsive to therapy were treated once a week with clobetasol propionate lotion left under the completely occlusive patch Duoderm. The lesions completely resolved after a period of nine days to four weeks in 148 patients, while partial remission was observed in the remaining 13. The following diseases responded favourably: chronic plaque psoriasis, psoriasis on palms and soles, palmoplantar pustulosis, skin lesions related to Reiter's syndrome, chronic lichenified eczema, neurodermatitis, breast eczema, discoid lupus erythematosus, lichen planus, sarcoidosis, lichen sclerosus et atrophicus and lymphocytic infiltrate of Jessner. Relapses were infrequent when complete histological remission had been achieved. Other diseases which improved with this treatment were pompholyx, necrobiosis lipoidica, granuloma annulare and pretibial myxoedema.

Topics: Administration, Cutaneous; Adult; Bandages, Hydrocolloid; Chronic Disease; Clobetasol; Colloids; Humans; Occlusive Dressings; Skin Diseases

Topics: Adolescent; Atrophy; Chronic Disease; Clobetasol; Humans; Male; Thumb

Twelve children with chronic atopic dermatitis and elevated IgE levels (age range: 2-13 years; mean age = 8.2 +/- 3.5 years) were selected for the study and treated with clobetasone butyrate (0.05% cream) thrice daily during the first week, then twice daily for three weeks. Adrenocortical function was evaluated at the beginning and the end of treatment period. The results show that there was no statistically significant change in adrenal function during the study period (tetracosactrin test). The results of the immunological studies, namely total IgE using the paper disc radioimmunoassay technique, specific IgE using the radioallergosorbent test and immunoglobulin levels are given.

Topics: Adolescent; Adrenal Cortex; Adrenal Cortex Function Tests; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Chronic Disease; Clobetasol; Dermatitis, Atopic; Eczema; Female; Humans; Hydrocortisone; Immunoglobulin E; Male; Time Factors

A study to demonstrate methods of using topical preparations to control chronic skin conditions is described. 25 patients with atopic eczema or psoriasis were followed for an average of 10 months. Both self-assessment using a diary card and clinical assessment were used to evaluate the treatment. The study shows that, when used correctly, topical corticosteroids can provide an effective means of controlling these intractable conditions without producing the side-effects associated with their misuse.

Topics: Administration, Topical; Betamethasone; Butyrates; Chronic Disease; Clobetasol; Drug Evaluation; Eczema; Humans; Patient Education as Topic; Propionates; Psoriasis