clobetasol and Dermatitis--Contact

Psoriasis is a chronic, inflammatory disease that may differ in prevalence and clinical presentation among patients from various racial and ethnic groups. Two phase 3 studies demonstrated efficacy and safety of halobetasol propionate (HP) 0.01% lotion in the treatment of moderate-to-severe plaque psoriasis (NCT02514577, NCT02515097). These post hoc analyses evaluated HP 0.01% lotion in Hispanic participants.. Participants were randomized (2:1) to receive once-daily HP or vehicle lotion for 8 weeks, with a 4-week posttreatment follow-up. Post hoc efficacy assessments in Hispanic participants (HP, n=76; vehicle, n=43) included treatment success (≥2‑grade improvement in Investigator’s Global Assessment and score of ‘clear’ or ‘almost clear’), psoriasis signs, and affected body surface area (BSA). Treatment-emergent adverse events (TEAEs) were evaluated.. At week 8, 38.8% of participants achieved treatment success with HP versus 10.3% on vehicle (P=0.001). HP‑treated participants achieved greater improvements in psoriasis signs, compared with vehicle (P<0.01 all). HP group had a greater reduction in affected BSA versus vehicle (P=0.001). Treatment-related TEAEs with HP were application site infection and dermatitis (n=1 each).. Once-daily HP 0.01% lotion was associated with significant reductions in disease severity in Hispanic participants with moderate-to-severe psoriasis, with good tolerability and safety over 8 weeks. J Drugs Dermatol. 2021;20(3):252-258. doi:10.36849/JDD.5698.

Topics: Administration, Cutaneous; Adult; Clobetasol; Dermatitis, Contact; Dermatologic Agents; Double-Blind Method; Drug Administration Schedule; Female; Hispanic or Latino; Humans; Male; Middle Aged; Psoriasis; Severity of Illness Index; Treatment Outcome; Vasoconstrictor Agents

Previous results from two phase 3 studies demonstrated efficacy and safety of fixed combination halobetasol propionate 0.01%/tazarotene 0.045% (HP/TAZ) lotion in participants with moderate-to-severe plaque psoriasis. This post hoc analysis evaluated sex-specific efficacy and safety of HP/TAZ lotion.. In two randomized, double-blind, phase 3 studies, participants were randomized (2:1) to receive HP/TAZ or vehicle lotion once daily for 8 weeks. Male and female participants were evaluated separately in this pooled analysis. Efficacy assessments included treatment success (at least 2‑grade improvement in Investigator's Global Assessment [IGA] score and score of clear/almost clear), impact on individual signs of psoriasis, and affected Body Surface Area (BSA).. The analysis included 272 males (HP/TAZ, n=175; vehicle, n=97) and 146 females (HP/TAZ, n=101; vehicle, n=45). Significantly more participants achieved overall treatment success at week 8 with HP/TAZ versus vehicle in both male (38.4% vs 9.8%) and female (44.5% vs 9.9%) subgroups (P<0.001, both). Erythema, plaque elevation, and scaling were also reduced by week 8 in both males and females, with significantly more HP/TAZ-treated participants achieving at least 2‑grade improvement in each sign of psoriasis than vehicle-treated participants (P<0.001 each, both groups). Mean reductions in affected BSA were significantly greater with HP/TAZ versus vehicle lotion in both males and females (P≤0.001, both). The most frequent treatment-related adverse events were contact dermatitis, pruritis, and application site pain (each 4.0%) in females and contact dermatitis (7.6%) in males.. HP/TAZ lotion was highly effective and safe in both males and females with moderate-to-severe psoriasis over 8 weeks of once-daily use. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.5021.

Topics: Adult; Aged; Clobetasol; Dermatitis, Contact; Double-Blind Method; Drug Combinations; Female; Humans; Male; Middle Aged; Nicotinic Acids; Pain; Pruritus; Psoriasis; Severity of Illness Index; Sex Factors; Skin Cream; Treatment Outcome

Background: The use of topical therapy is a key component in the management of almost all psoriasis patients. Topicals are considered first-line therapy for mild disease and are having an increasing role in moderate or severe psoriasis as an integral part of combination therapy. Halobetasol has been shown be effective in moderate or severe localized plaque psoriasis, and tazarotene affords important effects on epidermal hyperproliferation that may be important in more severe disease.\ \ Objective: To investigate the efficacy, safety and tolerability of a once-daily application of a fixed combination halobetasol propionate 0.01% and tazarotene 0.045% (HP/TAZ) lotion in comparison with its vehicle in patients with severe localized plaque psoriasis (as defined by an Investigator Global Assessment (IGA) of 4 and Body Surface Area (BSA) of 3%-12%.\ \ Methods: Post hoc analysis of two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies. Sixty-two patients with severe localized psoriasis (mean BSA 7.4) randomized (2:1) to receive HP/TAZ lotion or vehicle, once-daily for 8 weeks, with a 4-week posttreatment follow-up. Efficacy assessments included treatment success (defined as at least a 2-grade improvement from baseline in the IGA score and a score of ‘clear’ or ‘almost clear’), impact on individual signs of psoriasis (erythema, plaque elevation, and scaling) at the target lesion, BSA, reduction in mean baseline IGAxBSA and achievement of a clinically meaningful response (number of patients who achieved at least a 75% improvement in IGAxBSA). Safety and treatment emergent adverse events (TEAEs) were evaluated throughout.\ \ Results: By week 8, 34.8% of patients were treatment successes compared with 0.0% on vehicle (P=0.004). HP/TAZ lotion was also significantly superior in reducing psoriasis signs and symptoms and improving BSA. At week 8, 47.4% (erythema), 66.4% (plaque elevation), and 65.4% (scaling) subjects achieved at least a 2-grade improvement, compared with 14.0% (P=0.016), 14.8% (P<0.001) and 14.7% (P<0.001) respectively with vehicle. Patients treated with HP/TAZ lotion achieved a 32.8% reduction in baseline mean BSA, compared with a 39.6% increase with vehicle (P=0.013). HP/TAZ lotion achieved a statistically significant superior reduction in mean IGAxBSA compared to vehicle from week 2 (P<0.001 versus vehicle). By week 8, almost half of the patients treated with HP/TAZ lotion achieved a clinically meaningful response (IGAxBSA-75) and

Topics: Adult; Clobetasol; Dermatitis, Contact; Dermatologic Agents; Double-Blind Method; Drug Combinations; Female; Humans; Male; Middle Aged; Nicotinic Acids; Pain; Pruritus; Psoriasis; Severity of Illness Index; Skin Cream; Treatment Outcome

Herbs and minerals have been used in clinical dermatology for hundreds of years and herbal ingredients are becoming increasingly popular with the public in treatment of various dermatological conditions characterised by inflammation and pruritus. The aim of this study was to compare the efficacy of traditional topical therapeutic agents with a moderate potency topical glucocorticoid on experimental contact dermatitis and contact urticaria. The effects of ichthammol 10% pet, zinc oxide 20% pet, camphor 20% pet, levomenthol 10% pet, tea tree oil 20 or 50% and clobetason butyrate 0.05% ointment were studied in the following experimental models: elicitation of allergic contact dermatitis to nickel, irritant contact dermatitis to benzalkonium chloride, and in immediate reactions to histamine and benzoic acid (non-immunological contact utricaria) respectively. Delayed reactions were evaluated using a clinical scoring system and immediate reactions were estimated by planimetry. Histamine-induced pruritus was evaluated using VAS. Tea tree oil reduced allergic contact dermatitis by 40.5% (p = 0.003), zinc oxide by 17.4% (p = 0.04) and clobetason butyrate by 23.5% (p = 0.01). Zinc oxide reduced histamine induced flare by 18.5% (p = 0.01), ichthammol by 19.2% (p = 0.02) and clobetason butyrate by 44.1% (p = 0.02). Irritant contact dermatitis and non-immunological contact urticaria were not influenced by the pre-treatments. Pruritus induced by histamine also remained unchanged. In conclusion, tea tree oil seems to be a more effective anti-eczematic agent than zinc oxide and clobetasone butyrate, while clobetasone butyrate is superior to both ichthammol and zinc oxide in topical treatment of urticarial reactions.

Topics: Adult; Aged; Benzalkonium Compounds; Benzoic Acid; Camphor; Clobetasol; Dermatitis, Contact; Female; Histamine; Humans; Male; Menthol; Middle Aged; Nickel; Quaternary Ammonium Compounds; Tea Tree Oil; Zinc Oxide

The emollient base of a topical corticosteroid, through its moisturizing properties, can be a useful treatment adjunct.. To compare the healing properties of Eumovate trade mark (clobetasone butyrate) 0.05% cream with its emollient base, hydrocortisone 1% cream and with no treatment.. A single-centre, double-blind, intra-individual, comparative study that involved 18 volunteers with nickel-induced contact dermatitis. Following a positive patch test to nickel, sub-therapeutic amounts (10 micro l = 3 mg cm(-2)) of each of the treatments were applied twice daily for seven days to each of the four test sites.. In terms of the primary endpoint, a physician's global assessment after 7 days of treatment, clobetasone butyrate (CB) 0.05% cream showed a significantly better response than hydrocortisone (HC) 1% cream (78% vs 39%, difference -0.4, 95% CI -0.7 to -0.1; p = 0.046) or no treatment (78% vs 28%, difference -0.5, 95% CI -0.9 to -0.1; p = 0.016). CB 0.05% cream also showed a better response than its emollient base (78% vs 56%), though statistical significance was not achieved. In terms of moisturizing effects, there was no difference in transepidermal water loss (TEWL) between CB 0.05% cream and its emollient base. CB 0.05% cream treated sites did, however, have significantly lower values (i.e. were more moisturized) than untreated sites (difference -8.5, 95% CI -12.0 to -4.86; p < 0.001) or HC 1% treated sites (difference -7.1, 95% CI -11.0 to -3.4; p < 0.001). In terms of skin blanching activity, as expected the steroid-based creams achieved lower colorimetric values than the emollient base cream.. These results from experimentally induced skin inflammation indicate that CB 0.05% (as Eumovate 0.05% cream) has both more effective anti-inflammatory activity and better moisturizing properties than hydrocortisone 1% cream and that these effects are in part due to its efficient emollient base.

Topics: Administration, Cutaneous; Administration, Topical; Adolescent; Adult; Analysis of Variance; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Contact; Double-Blind Method; Female; Humans; Hydrocortisone; Middle Aged; Nickel; Ointments; Patch Tests; Treatment Outcome; Water Loss, Insensible

In this study, we investigated the effect of calcipotriol, prednicarbate and clobetasol 17-propionate on skin thickness over a treatment period of 6 weeks. The study was conducted as a controlled, randomized, double-blind comparison. The influence of these drugs on normal skin under occlusive conditions was assessed visually and by measuring skin thickness using 20 MHz B mode ultrasound. Both topically applied glucocorticosteroids lead to a significant decrease in skin thickness. In contrast to the glucocorticosteroid-induced atrophy, calcipotriol application on normal skin leads to an increase in skin thickness in all volunteers. The effect remains constant for the duration of treatment. The cause of this increase seems to be an irritative reaction of the skin which was histologically investigated in one volunteer. The histological features of this reaction are characteristic for a subacute dermatitis. The implications of these findings for the therapeutic mechanism of calcipotriol are discussed.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Atrophy; Calcitriol; Clobetasol; Dermatitis, Contact; Dermatologic Agents; Double-Blind Method; Female; Glucocorticoids; Humans; Male; Middle Aged; Prednisolone; Skin; Ultrasonography

The inhibitory effects of topical glucocorticosteroid treatment on the immediate dermal allergic reaction were studied in 10 patients in a double, randomized, placebo-controlled fashion. The aim was to study whether a prolongation of the treatment time would enhance the inhibitory effect beyond the 30-40% reduction previously reported after 1 week of treatment, and whether any changes in skin reactivity were accompanied by changes in the level of mast cells or histamine at the challenge site. Allergen and histamine skin-prick tests were performed on both forearms before the start of the study and after 2 and 4 weeks of treatment with placebo cream on one forearm and with 0.05% clobetasol-17-propionate cream on the other. Punch biopsies from the skin treated actively and with placebo were taken after 4 weeks in eight of the patients. The specimens were used for the light-microscopic evaluation of mast cell density and for the measurement of histamine and protein content. After 4 weeks of treatment we found a reduction in the allergen-induced weal (72%; P less than 0.001) and flare (62%; P less than 0.05) response. There was also a minor reduction in the histamine-induced weal (38%; P less than 0.05) but not the flare response, suggesting that the glucocorticoid treatment induced a reduced mediator release at allergen challenge. This could be partially explained by the finding of a reduction in the number of detectable skin mast cells (85%; from 0.78 to 0.11 mast cells per unit area) and in the histamine content of the skin as related to the tissue wet weight (36%; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Betamethasone; Cell Count; Clinical Trials as Topic; Clobetasol; Dermatitis, Contact; Double-Blind Method; Histamine; Humans; Male; Mast Cells; Placebos; Proteins; Random Allocation; Skin; Skin Tests

The effect of prolonged topical dermal glucocorticosteroid treatment on the immediate and late-phase allergic skin reaction was studied in a double-blind, randomized, placebo-controlled study. Seventeen patients with hay fever and with a positive skin test for timothy and/or birch pollen allergens were studied in a pollen-free season. Skin prick tests for these two allergens as well as a negative saline and a positive histamine control were made with a preloaded standardized prick test needle. The area of the induced wheal-and-flare reaction was measured 15 minutes after allergen application, and any induced late-phase responses were measured after 6 hours. After a baseline recording, the patients treated the volar aspect of one forearm twice daily with a cream of 0.05% clobetasol 17-propionate and the other forearm with the equivalent vehicle in a randomized, double-blind fashion. After 1 week the skin prick test was repeated on both arms. A statistically significant reduction of the allergen-induced wheal-and-flare response was found after active treatment as compared to control and pretreatment values. A reduction was also found in the histamine-induced flare but not the wheal reaction as compared to the control. A late-phase dermal reaction was found in six of the patients, and this was statistically significantly reduced by the glucocorticosteroid pretreatment. Thus, in similarity to findings in vivo on the human nose and bronchus, we found, in addition to the well-known glucocorticosteroid-induced reduction of the allergic late-phase response, an inhibition of the dermal immediate allergic reaction as well.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Topical; Adolescent; Adult; Betamethasone; Clinical Trials as Topic; Clobetasol; Dermatitis, Contact; Double-Blind Method; Female; Histamine Release; Humans; Male; Pollen; Random Allocation; Skin Tests

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

In a double-blind, randomized study, 0.05% clobetasone butyrate cream was found to be as effective as 0.1% betamethasone valerate in the treatment of 48 patients with atopic or contact dermatitis, after 2 weeks as well as after 4 weeks of treatment. Side-effects with both drugs were rare and mild.

Topics: Adolescent; Adult; Aged; Betamethasone; Betamethasone Valerate; Child; Clobetasol; Dermatitis, Atopic; Dermatitis, Contact; Double-Blind Method; Female; Humans; Male; Middle Aged; Time Factors

Topics: Anti-Inflammatory Agents; Cephalexin; Clobetasol; Dermatitis, Contact; Diphenhydramine; Female; Histamine Antagonists; Humans; Irritants; Knee Prosthesis; Middle Aged; Phototherapy; Prednisone; Ultraviolet Rays

An experimental animal model of contact dermatitis (CD) was used to investigate the effects of free and nanoencapsulated clobetasol propionate on the skin and on the oxidative profile of liver tissue.. Female Wistar rats were divided into six groups, each containing eight rats. The first group, control (C), was sensitized with solid vaseline. Group 2, (CD), was sensitized with 5% NiSO(4). Groups 3 and 4 were sensitized with 5% NiSO(4) and treated with free (FC) and nanoencapsulated (NC) clobetasol (0.42 mg/g), respectively, daily for 5 days. Group 5 was treated with nanoencapsulated clobetasol (0.42 mg/g) on days 1, 3, and 5 (C135) and group 6 received a hydrogel containing empty nanoparticles (NP) daily for 5 days. Thiobarbituric acid reactive substances (TBARS), carbonyl levels, non-protein sulfhydryl groups (NPSH) and catalase activity were measured in liver homogenates.. A significant increase was observed in the levels of TBARS, NPSH, and catalase activity for the groups CD and NP.. Our results suggest that both NiSO(4) sensitization and NP administration induced oxidation of cellular lipids and activated the antioxidant enzyme catalase to protect from this damage. These results also indicated that daily treatment with the free and nanoencapsulated clobetasol, as well as treatment with the nanoencapsulated clobetasol every other day, were able to prevent these redox alterations and protect against histological damage.

Topics: Animals; Catalase; Clobetasol; Dermatitis, Contact; Drug Carriers; Female; Lipid Peroxidation; Nanostructures; Oxidative Stress; Rats; Rats, Wistar; Superoxide Dismutase

We developed a dermatological nanomedicine containing clobetasol propionate-loaded nanocapsules and evaluated its efficacy in a model of contact dermatitis after topical administration in rats. Hydrogels containing clobetasol propionate-loaded lipid-core nanocapsules or nanoemulsion (HG-CP-NC and HG-CP-NE, respectively) were prepared to evaluate the influence of the polymeric wall. They presented adequate pH values (5.50-6.50) and drug content (0.5 mg g(-1)) and their rheograms exhibited a non-Newtonian pseudoplastic behavior. The best in vitro drug release control was obtained for HG-CP-NC (1.03±0.11 μg cm(-2) h) compared to the HG-CP-NE (1.65±0.19 μg cm(-2) h) and the hydrogels containing nonencapsulated drug (HG-CP) (2.79±0.22 μg cm(-2) h). A significant increase in NTPDase activity was observed in lymphocytes for the group treated with 0.05% HG-CP-NC every other day compared to the group treated with 0.05% HG-CP every day using the in vivo model of contact dermatitis. The nanoencapsulation of clobetasol in nanocapsules led to a better control of the drug release from the semisolid nanomedicine and provided better in vivo dermatological efficacy.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Contact; Female; Hydrogels; Hydrogen-Ion Concentration; Lymphocytes; Nanocapsules; Nanomedicine; Particle Size; Rats; Rats, Wistar

Most studies investigating steroid allergy have been performed with tixocortol pivalate, hydrocortisone butyrate and budesonide. Betnovate and Dermovate are widely prescribed in the U.K. but little is known about the frequency of sensitization to them.. To determine the optimum method to detect contact allergy to betamethasone valerate (BV) and clobetasol propionate (CP).. Seven centres tested consecutive patients attending for investigation of suspected allergic contact dermatitis to these steroids at a range of concentrations in different vehicles.. Of 1562 patients tested, 16 (1%) reacted to either BV or CP. Ten patients (0.7%) reacted to BV and 13 (0.8%) to CP. Two patients of a further centre were included in analysis of dilutions and vehicles. Sixteen of a total of 25 reactions (64%) were identified with a 1% dilution in ethanol.. Consideration should be given to adding BV and CP to a standard allergy series, given that both are frequently used in the treatment of eczema and that most patients sensitized to them are not identified with currently used markers of steroid allergy. If patch tests to BV and CP are initially negative, but an allergy is suspected, the patient should be further investigated. Further studies are required to identify the ideal patch test material.

Topics: Adult; Aged; Aged, 80 and over; Beclomethasone; Clobetasol; Dermatitis, Contact; Drug Hypersensitivity; Ethanol; False Negative Reactions; Female; Glucocorticoids; Humans; Male; Middle Aged; Patch Tests; Predictive Value of Tests; Prevalence

Involvement of the eye and related structures is rarely reported in lichen planus. Only eleven cases with eyelid involvement are reported in the literature. Lesions on the eyelids may be the only manifestation of lichen planus or it may be a part of the disease process present on other parts of the body. When only eyelids are involved, clinical diagnosis may be difficult. Lichen planus should be considered in the differential diagnosis of erythematous papular lesions on the eyelids.

Topics: Administration, Topical; Adolescent; Adult; Ankle; Anti-Inflammatory Agents; Biopsy; Clobetasol; Dermatitis, Contact; Diagnosis, Differential; Eyelids; Female; Forearm; Glucocorticoids; Humans; Leg; Lichen Planus; Male; Middle Aged; Skin; Triamcinolone Acetonide; Wrist

Burckhardt proposed the alkali resistance method as a means of assessing the integrity of the stratum corneum barrier in 1947. Researchers after Burckhardt largely found the test unreliable and nonreproducible; it therefore fell into disuse worldwide. We have upgraded the procedure by exposing the skin to 1.0 M sodium hydroxide under strictly specified conditions for successive 1-min periods until the emergence of the first erosions, revealed by staining with nitrazine yellow. Histology showed that the erosions were follicular and limited to the epidermis. The test was highly reproducible and repeatable. We demonstrated the usefulness of the test in the following ways: (1) the erosion time increased with aging, correlating with a thickened horny layer; (2) as few as five Scotch tape strippings greatly decreased the erosion time, although transepidermal water loss was only slightly increased; (3) slight damage to the horny layer by a 24-h exposure to 0.01% sodium lauryl sulfate sharply reduced the erosion time; (4) the erosion time decreased after daily open applications for 3 weeks of clobetasol propionate, corresponding to the thinned horny layer; (5) daily applications of petrolatum increased the erosion time. This new version of the alkali resistance test, renamed the sodium hydroxide erosion assay, promises to be a useful tool for studying the horny layer barrier in healthy and diseased skin.

Topics: Administration, Topical; Adult; Age Factors; Aged; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Contact; Drug Resistance; Female; Glucocorticoids; Histocytochemistry; Humans; Irritants; Male; Middle Aged; Reproducibility of Results; Skin; Skin Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Surface-Active Agents; Water Loss, Insensible

Patients often tell about reduced effectiveness of topical steroids on repeated use. Tachyphylaxis to these agents has been demonstrated in humans for vasoconstriction and histamine-induced wheal suppression in normal skin, but not in diseased skin. Relevance of these data to diseased skin is not clear. Further, the clinical impression does not appear to match tachyphylaxis shown in normal skin with regard to the time course.. To examine whether tachyphylaxis to histamine-induced wheal suppression by a topical steroid occurs in dermatitic skin and to determine its time course vis-à-vis normal skin.. Pharmacodynamic response to 0.05% clobetasol propionate applied daily under occlusion was measured by histamine-induced wheal suppression assay in 10 individuals. This test was performed on a steroid-treated normal site, on a steroid-treated site where dermatitis was induced by occlusive application of 40% croton oil, and on a vehicle-treated site in each individual at different intervals up to 14 days.. Suppression of wheal volume started from second day in steroid-treated sites. There was significant difference in the wheal volume in steroid treated normal vs. dermatitic sites from day 2 to day 10. Maximum wheal suppression occurred earlier in dermatitic skin (day 4 vs. day 6). After this, the volume of wheal started increasing and became equal to control (complete tolerance) on 12th day in dermatitic skin and on 14th day in normal skin.. Time courses of tachyphylaxis to the action of 0.05% clobetasol propionate were significantly different in normal skin and dermatitic skin. Complete tolerance occurred earlier in dermatitic skin compared to normal skin.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Clobetasol; Croton Oil; Dermatitis, Contact; Glucocorticoids; Histamine; Humans; Irritants; Male; Skin; Tachyphylaxis; Urticaria

Topics: Administration, Cutaneous; Clobetasol; Dermatitis, Contact; Drug Hypersensitivity; Female; Humans; Middle Aged

A new echographic evaluation method employing a B scanner and a dedicated software (Dermavision 2D, Cortex Technology, Hadsund, Denmark) was used in assessing the potency of three different corticosteroids. Experimental lesions were induced by patch tests with nickel sulfate 5% in petrolatum in 10 sensitized subjects and treated with two medications of different steroids (clobetasol propionate, fluocinolone acetonide or clobetasone butyrate) performed 16 and 40 h after the application of the nickel patch tests. Clinical and echographic evaluations were carried out at the beginning of the experiment and 64 h after the induction of the reactions. After obtaining echographic images, these were processed by software, enabling the selection of amplitudes of interest, the highlighting of parts of images and their assessment by a value corresponding to the number of pixels (picture elements). For evaluations a low reflecting band was chosen, marking edema and inflammatory infiltration. At positive patch test sites we observed a progressive increase in the number of low reflecting pixels, in accordance with the intensity of the reaction. Therapeutic response was assessed as the difference between values of treated and untreated test sites. The rank order of the efficacy of test substances as determined echographically was identical to the rank order generally accepted for these steroids. This evaluation method of topical corticosteroid activity could be usefully employed besides traditional evaluation methods.

Topics: Administration, Topical; Adult; Clobetasol; Dermatitis, Contact; Female; Fluocinolone Acetonide; Humans; Image Enhancement; Skin; Ultrasonography

The immunosuppressive macrolide antibiotics FK 506 and rapamycin were tested for topical activity in experimental allergic contact dermatitis of farm pigs. This species was used because pig skin, in comparison to rodent skin, resembles human skin more closely. For comparison, cyclosporine A (CyA), which is orally but not topically active in patients with skin disease, dexamethasone, and clobetasol propionate were used. Treatment was performed twice, 30 min and 6 h after elicitation of challenge reaction. Topical application of 0.4 to 0.04% FK 506 caused a pronounced inhibition of inflammatory skin reactions of hypersensitivity to dinitrofluorobenzene. The treatment response was similar to the activity of 0.13% clobetasole. Dexamethasone (1.2%) was less active than clobetasol. In contrast, rapamycin and CyA were inactive at concentrations of 1.2 and 10%, respectively. Because the pig data on corticosteroids and cyclosporine A are in agreement with clinical findings, these studies indicate that immunosuppressive macrolides of the type FK 506 may be useful drugs for the topical treatment of human skin diseases that respond to local corticosteroids and oral treatment with cyclosporine A.

Topics: Animals; Clobetasol; Cyclosporine; Dermatitis, Contact; Dexamethasone; Disease Models, Animal; Female; Molecular Structure; Polyenes; Sirolimus; Swine; Tacrolimus

A patient is described who had allergies to several sesquiterpene lactone-containing plants, but the reaction to Magnolia grandiflora was extremely severe. The condition was a chronic lichenified dermatitis that was unresponsive to treatment but cleared with protective measures. Primary allergy to Magnolia is rarely reported, even though some studies of cross-reactivity suggest that sensitivity is far from rare.

Topics: Clobetasol; Dermatitis, Contact; Dermatitis, Occupational; Humans; Male; Middle Aged; Patch Tests; Protective Clothing; Trees

The aim of this study was to compare the activities of the two main classes of topical anti-inflammatory drugs in methyl-nicotinate-induced skin inflammation, using a new methodology based on laser-Doppler velocimetry. Six topical non-steroidal anti-inflammatory drugs (NSAIDs) (bufexamac, diclofenac, ibuprofen, indomethacin, phenylbutazone and niflumic acid) and three topical corticosteroids (clobetasol propionate, hydrocortisone and hydrocortisone butyrate) were tested. Drugs were commercially available (except indomethacin) and were applied under occlusion for 4 h to the forearms of 16 healthy male volunteers. Thirty minutes after excess drug removal, skin inflammation was induced by a 1-min application of methyl nicotinate (3 mM). This was repeated 44 h later. Each methyl-nicotinate application was followed by continuous skin blood flow recordings over 1 h. Overall, NSAIDs proved more effective than corticosteroids in inhibiting methyl-nicotinate-induced increases in skin blood flow. Diclofenac and indomethacin showed a potent prolonged inhibitory effect. Different types of activity were observed in the corticosteroid group: (a) At 30 min, hydrocortisone and hydrocortisone butyrate moderately inhibited methyl-nicotinate reactions whereas clobetasol propionate produced no detectable effects; (b) at 44 h, clobetasol propionate produced a significant inhibition whereas hydrocortisone butyrate and hydrocortisone exhibited either weak or no inhibitory action at all. These pharmacodynamic discrepancies between the corticosteroids tested could be related to differences in drug affinity to cutaneous receptors and in vasoconstrictive potency.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Betamethasone; Bufexamac; Clobetasol; Dermatitis, Contact; Diclofenac; Humans; Hydrocortisone; Ibuprofen; Indomethacin; Male; Nicotinic Acids; Niflumic Acid; Phenylbutazone; Regional Blood Flow; Skin

Two cases of contact allergy to clobetasol propionate are described. Neither patient had positive epicutaneous tests to other structurally similar fluorinated steroids or to other steroids with the propionate ester, but both had multiple positive tests within the European standard battery. Comparison with previously reported cases reveals that multiple contact allergies are a frequent finding in patients with allergy to this topical steroid.

Topics: Administration, Topical; Adult; Betamethasone; Clobetasol; Dermatitis, Contact; Drug Eruptions; Female; Humans; Male; Middle Aged

A primary irritant dermatitis to 3,4,5-trichloropyridazine was observed on the hands of a chemist after accidental exposure. Healing was rapid in comparison to a report on 3,4,6-trichloropyridazine toxicity. Prompt treatment with a potent topical corticosteroid, wet soaks, and an oral antihistamine brought resolution within 14 days.

Topics: Administration, Cutaneous; Clobetasol; Dermatitis, Contact; Dermatitis, Occupational; Diphenhydramine; Humans; Irritants; Male; Middle Aged; Protective Clothing; Pyridazines

Allergic contact dermatitis to pharmaceutical topical products containing corticosteroids are not uncommon. The study of these cases must combine patch test with standard series, vehicles, special components of each commercial cream and tixocortol pivalate. The importance of these substance is specially emphasized in that paper.

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Betamethasone; Chemical Phenomena; Chemistry; Clobetasol; Cresols; Dermatitis, Contact; False Negative Reactions; Female; Humans; Hydrocortisone; Middle Aged; Skin Tests

Topics: Adult; Betamethasone; Clobetasol; Dermatitis, Contact; Drug Eruptions; Facial Dermatoses; Hand Dermatoses; Humans; Male

Topics: Adult; Betamethasone; Clobetasol; Dermatitis, Contact; Female; Humans; Patch Tests

A mouse model for assessment of the anti-inflammatory effect of topical glucocorticoids is described. Mice, sensitized to picryl chloride, had both ears painted with the sensitizer followed 2 hours later by the application of the topical steroid to one ear and the corresponding vehicle to the other. The contact sensitivity reaction, measured by swelling of the ear, was recorded 24 hours later. Dilutions of the steroid formulations inhibited the ear swelling in a manner related to dose-response. Suppression of the contact sensitivity reaction of the vehicle-treated ear as well was regarded as a systemic effect of the glucocorticoid. There seems to be a good correlation between the efficacy of the topical steroids assessed in this mouse model and the vasoconstrictor test on intact human skin.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Biological Assay; Clobetasol; Dermatitis, Contact; Disease Models, Animal; Dose-Response Relationship, Immunologic; Ear, External; Glucocorticoids; Hydrocortisone; Male; Mice; Mice, Inbred C57BL; Mice, Inbred CBA; Picryl Chloride

The effect of topical clobetasol propionate and a 1% topical indomethacin gel which could inhibit UV erythema was measured on anthralin inflammation by change in skin-fold thickness and erythema. The time course of the inflammatory oedema and erythema were different, as was their response to the drugs studied. The oedema of anthralin inflammation was completely inhibited by clobetasol propionate but the erythemal response showed a small and non-significant reduction. Indomethacin had no effect on anthralin oedema but produced a small but significant reduction in erythema in the first 24 h after anthralin application. These results suggest that either anthralin inflammation is not due to production of prostenoids, or that if it is, it occurs by other than the classical enzymic pathway.

Topics: Adult; Aged; Anthracenes; Anthralin; Betamethasone; Clobetasol; Dermatitis, Contact; Edema; Erythema; Female; Humans; Indomethacin; Male; Middle Aged; Skin Diseases; Ultraviolet Rays

The inflammatory dose-response to anthralin was measured in human skin 24 h after pretreatment with topical corticosteroids and anthralin, and 48 h after removal of the stratum corneum with adhesive tape. Anthralin inflammation was increased after 1% hydrocortisone application and decreased by 0.1% betamethasone valerate and 0.05% clobetasol propionate; although the difference between these effects was not significant, the difference between the effect of hydrocortisone and clobetasol propionate was. Anthralin inflammation was not significantly affected by pretreatment with anthralin and was reduced, although not significantly by removal of the stratum corneum. The finding that anthralin inflammation is not altered in skin in which aryl hydrocarbon hydroxylase (AHH) activity is increased and that anthralin inflammation may be altered in situations in which AHH activity is unchanged, excludes a direct relationship between anthralin inflammation and AHH activity.

Topics: Administration, Topical; Adult; Aged; Anthracenes; Anthralin; Anti-Inflammatory Agents; Betamethasone Valerate; Clobetasol; Dermatitis, Contact; Dose-Response Relationship, Drug; Epidermis; Female; Glucocorticoids; Humans; Hydrocortisone; Male; Middle Aged; Skinfold Thickness

Topics: Adult; Betamethasone; Clobetasol; Dermatitis, Contact; Humans; Male; Nonprescription Drugs; Pruritus Ani

Topics: Aged; Betamethasone; Clobetasol; Dermatitis, Contact; Drug Eruptions; Humans; Male

Topics: Betamethasone; Clobetasol; Dermatitis, Contact; Female; Humans; Middle Aged; Pruritus

2 case reports are given of patients with positive patch test reactions to clobetasol propionate. One of the patients also reacted to clobetasone butyrate. 30 other steroids that were chemically very closely related to these two 21-chloro-9-alpha-fluoro-corticosteroids, were patch test negative. The literature on contact dermatitis reactions to corticosteroids is reviewed.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Betamethasone; Chemical Phenomena; Chemistry; Clobetasol; Dermatitis, Contact; Female; Humans; Male; Patch Tests

Topics: Aged; Betamethasone; Clobetasol; Dermatitis, Contact; Humans; Male; Middle Aged; Ointments

Topics: Administration, Topical; Adult; Aged; Betamethasone; Clobetasol; Dermatitis, Atopic; Dermatitis, Contact; Female; Humans; Male; Middle Aged

Topics: Adult; Clobetasol; Cresols; Dermatitis, Atopic; Dermatitis, Contact; Female; Humans; Male; Pharmaceutic Aids; Propylene Glycols

Assays of steroidal and non-steroidal drugs in an experimental model of dermatitis induced in the ear of the rabbit by the application of a solution of croton oil revealed clearly differentiable inhibitory effects on the rise in skin temperature, the oedema and the increase in tissue mass due to the inflammatory process. The results obtained in this test system fairly accurately reflect the relative therapeutic potencies of known dermatocorticoids and, in conjunction with those found by other methods, afford a more exact characterization of the activity profiles of non-steroidal contra-inflammatory agents.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Aspirin; Body Temperature; Clobetasol; Croton Oil; Dermatitis, Contact; Drug Evaluation; Ear, External; Flumethasone; Hydrocortisone; Indomethacin; Rabbits; Salicylates; Skin