clobetasol and Dermatitis--Seborrheic

Topical antifungals and corticosteroids are the mainstay of treatment for seborrhoeic dermatitis. The short-contact clobetasol propionate 0·05% shampoo (CP) is an efficacious and safe once-daily treatment for scalp psoriasis.. To evaluate the efficacy and safety of CP alone and combined with ketoconazole shampoo 2% (KC) in the treatment of moderate to severe scalp seborrhoeic dermatitis.. This randomized and investigator-blinded study consisted of three phases, each lasting 4 weeks. During the treatment phase, subjects were randomized to receive KC twice weekly (K2), CP twice weekly (C2), CP twice weekly alternating with KC twice weekly (C2 + K2) or CP four times weekly alternating with KC twice weekly (C4+K2). All subjects received KC once weekly during the maintenance phase and were untreated during the follow-up phase.. At the end of the treatment phase, all three CP-containing regimens were significantly more efficacious than K2 in decreasing the overall disease severity (P < 0·05). Both combination regimens were also significantly more efficacious than K2 in decreasing each individual sign of the disease (P < 0·05). While the C2 and C4 + K2 groups experienced slight worsening during the maintenance phase, the efficacy of C2 + K2 was sustained and remained the highest among all groups. All regimens were well tolerated without inducing any skin atrophy. Similarly low incidences of telangiectasia, burning and adverse events were observed among the four groups.. The combination therapy of twice-weekly CP alternating with twice-weekly KC provided significantly greater efficacy than KC alone and a sustained effect in the treatment of moderate to severe scalp seborrhoeic dermatitis.

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Antifungal Agents; Clobetasol; Dermatitis, Seborrheic; Dermatologic Agents; Drug Combinations; Female; Humans; Ketoconazole; Male; Middle Aged; Scalp Dermatoses; Severity of Illness Index

Seborrheic dermatitis (SD), a common dermatosis associating hyperseborrhea, erythema, itching, and dandruff, has frequent scalp involvement. Malassezia furfur infection seems to play an important role in the condition's etiopathology. Treatment of SD usually consists of corticosteroids or antifungals, such as ketoconazole. The aim of this multicenter, randomized, investigator-blinded, parallel-group pilot study was to evaluate the efficacy and safety of clobetasol propionate shampoo 0.05% after different short-contact application times compared with its vehicle and ketoconazole foaming gel 2% in the treatment of SD of the scalp. For 4 weeks, 55 subjects received one of the following treatments twice weekly: clobetasol propionate shampoo for 2.5, 5, or 10 minutes; clobetasol propionate vehicle for 10 minutes; or ketoconazole foaming gel for 5 minutes before rinsing off. Efficacy criteria included total severity score (TSS) and individual scores of signs such as itching and global improvement. Safety included reporting of burning, overall tolerance, and adverse events. Results showed that an application of clobetasol propionate for 5 and 10 minutes provided a similar mean percentage decrease of TSS, and the mean percentage decrease of TSS for all active groups was significantly superior to that of the vehicle (P < .01). Overall and local safety were good for all treatment groups. The present pilot study demonstrated that a short-contact application of clobetasol propionate shampoo is effective and safe in the treatment of SD of the scalp.

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Clobetasol; Dermatitis, Seborrheic; Female; Hair Preparations; Humans; Male; Pilot Projects; Scalp Dermatoses; Severity of Illness Index; Single-Blind Method; Treatment Outcome

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Antifungal Agents; Clobetasol; Dermatitis, Seborrheic; Double-Blind Method; Glucocorticoids; Humans; Ketoconazole

Although topical corticosteroid ointments were once viewed as the best vehicle for treating inflammatory skin diseases, the recognition of the problem of poor compliance and patients' preferences for other vehicles has led to the development of corticosteroid products in alternative formulations.. To describe patterns of use of newer vehicle formulations including foams, shampoos, sprays, and lotions for the treatment of psoriasis and other dermatoses.. The use of non-traditional vehicles was identified using visit with diagnoses for psoriasis and other dermatoses from the National Ambulatory Medical Care Survey 2000-2010 data. Trends in corticosteroid vehicles mentions were evaluated over the study period to determine how the use of non-traditional vehicles has changed. The odds ratios of being prescribed a nontraditional vehicle were reported for patient and office-based characteristics of visits.. Approximately 2.3% and 1.9% of visits mentioned foam and other non-traditional vehicles (shampoo, lotion, spray), respectively. The use of corticosteroids in shampoo, lotion, or spray preparations increased by 0.5% annually (p=0.008) but did not significantly change for corticosteroids in a foam preparation (p=0.10). Psoriasis and seborrheic dermatitis were the leading diagnoses at visits prescribed corticosteroids in nontraditional vehicles. Dermatologists were more likely than non-dermatologists to prescribe foam products [OR: 8.4 (3.6, 19.9)] or clobetasol in another non-traditional vehicle [OR: 49.7 (10.3, 240.5)].. Product vehicle was not specified for all corticosteroids.. Although there was increasing use of non-traditional vehicles, the rate of use has remained low. Dermatologists appear to have greater familiarity with the use of these newer vehicle formulations than do physicians in other specialties.

Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents; Clobetasol; Dermatitis; Dermatitis, Seborrheic; Dermatologic Agents; Female; Humans; Male; Medication Adherence; Pharmaceutical Vehicles; Psoriasis; Skin Cream

The fact that this patient's rash was limited to his chest provided an important diagnostic clue.

Topics: Acantholysis; Acneiform Eruptions; Administration, Oral; Administration, Topical; Biopsy; Clobetasol; Dermatitis, Seborrheic; Dermatologic Agents; Diagnosis, Differential; Drug Eruptions; Folliculitis; Histamine Antagonists; Humans; Ichthyosis; Male; Middle Aged; Skin; Terfenadine; Treatment Outcome

Seborrheic dermatitis is a subacute or chronic disease of the skin, affecting the seborrhea afflicted areas and presenting with erythema and desquamation. The inflammatory reaction towards the fungi Malassezia spp. is considered to have a basic etiologic connection with this disease. Taking into consideration the pathogenesis, treatment of the dermatitis should be directed towards eradication of Malassezia spp., reduction of the skin lipids, and suppression of the inflammatory response. A wide variety of agents presented in different forms--ointments, shampoos and drugs--can offer quick, safe and effective treatment alternatives. The purpose of the present study was to monitor the therapeutic effects of the anti-fungal drug fluconazole in patients with seborrheic dermatitis. We compared two study groups of patients: Group I--27 patients with seborrheic dermatitis stage I, II and III, treated with fluconazole, 50 mg/day for two weeks. As topical therapy we applied clobetasol propionate 0.05% ointment. After the completion of the therapeutic course, 85% of the patients in this group were clinically cured and their symptoms faded away. Fifteen percent of the subjects in this group--mainly stage III seborrheic dermatitis patients, showed partial but significant clinical improvement. The specific fungal test for Malassezia spp. on Dixon agar was negative in 93% of the cases in this group. Group II--eleven patients with similar clinical indexes were treated with fluconazole 50 mg/day only, for the same time period. The therapeutic results in this group were also satisfactory--31.5% of the patients were cured and 68.5% showed clinical improvement. In 74% of the patients the specific test for Malassezia spp. was negative after treatment. Fluconazole treatment in patients with seborrheic dermatitis proves to be successful, effective and safe.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Antifungal Agents; Clobetasol; Dermatitis, Seborrheic; Drug Therapy, Combination; Female; Fluconazole; Humans; Malassezia; Male; Treatment Outcome

A group of 16 male patients with infertility had dermatitis of the scrotum and groins giving lichenified oedematous skin; the resulting thickening and loss of rugosity produced a characteristic appearance that we have termed wash leather scrotum. Treatment of the dermatosis resulted in an improvement in sperm count and motility in most patients, and 5 couples produced one or more pregnancies.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Clobetasol; Dermatitis; Dermatitis, Seborrheic; Female; Humans; Male; Neomycin; Nystatin; Oligospermia; Pregnancy; Scrotum; Sperm Count

Topics: Adolescent; Adult; Alopecia; Betamethasone; Child; Child, Preschool; Clobetasol; Dermatitis, Seborrheic; Female; Humans; Male; Middle Aged; Neurodermatitis; Pharmaceutical Vehicles; Pityriasis; Psoriasis; Scalp Dermatoses; Switzerland