clobetasol and Keratosis--Actinic

Topics: Adjuvants, Immunologic; Aged; Aminoquinolines; Anti-Inflammatory Agents; Biopsy; Clobetasol; Humans; Imiquimod; Keratosis, Actinic; Male; Psoriasis; Treatment Outcome; Ultraviolet Therapy

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Clobetasol; Double-Blind Method; Drug Administration Schedule; Emulsions; Erythema; Female; Fluorouracil; Humans; Keratosis, Actinic; Male; Middle Aged; Pilot Projects; Treatment Outcome; Young Adult

Topics: Administration, Cutaneous; Adrenal Cortex Hormones; Adrenergic alpha-2 Receptor Agonists; Aminolevulinic Acid; Brimonidine Tartrate; Clobetasol; Denmark; Erythema; Humans; Keratosis, Actinic; Photochemotherapy; Photosensitizing Agents; Time Factors; Treatment Outcome

Ingenol mebutate (IngMeb) is approved for treatment of actinic keratoses (AK) and may cause unpredictable local skin responses (LSR).. We sought to investigate whether IngMeb-induced LSR, pain, and pruritus could be alleviated with a topical glucocorticoid and, further, to assess efficacy, cosmetic outcome, and patient satisfaction in patients with severe photodamage.. In this blinded, randomized controlled clinical trial, patients with multiple AK and field cancerization of the face or scalp were treated in 2 areas with IngMeb (0.015%) daily for 3 days. After finalized IngMeb treatment, 1 area was randomized to receive topical clobetasol propionate (0.05%) twice daily for 4 days. Assessments included LSR (0-24; days 1, 4, 8, 15, 57), pain (0-10) and pruritus (0-3; days 1-15), AK clearance (days 15, 57), and cosmetic outcome (0-3; day 57).. Clobetasol propionate application had no influence on LSR (P = .939), pain (P = .500), pruritus (P = .312), or AK cure rate (P = .991). Overall, IngMeb cleared 86% of all AK lesions, exerting a therapeutic effect on all AK severity grades; cure rates were 88%, 70%, and 60% for grade I, II, and III AK, respectively. Skin texture improved significantly in remedied areas (2.0 vs 1.0; P < .001); no hypopigmentation, hyperpigmentation, or scarring were observed.. These results do not provide safety and efficacy beyond 2 months of follow-up.. Application of clobetasol propionate does not alleviate IngMeb-induced LSR after 3 days of IngMeb treatment.

Topics: Administration, Topical; Adrenal Cortex Hormones; Aged; Aged, 80 and over; Clobetasol; Denmark; Diterpenes; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Facial Dermatoses; Female; Follow-Up Studies; Gels; Humans; Keratosis, Actinic; Male; Middle Aged; Pain; Pruritus; Risk Assessment; Scalp Dermatoses; Severity of Illness Index; Single-Blind Method; Treatment Outcome

Photodynamic therapy (PDT) is an effective and established treatment for actinic keratoses (AK) and nonmelanoma skin cancer. The main side-effects of PDT are post-treatment erythema and oedema, and pain during illumination. Severe erythema after PDT enhances the down time associated with the treatment.. To evaluate in a randomized intraindividual study whether use of a topical corticosteroid just before and just after PDT would reduce treatment-induced erythema compared with conventional PDT.. Twenty-two patients with multiple AKs in the face and scalp were treated with methyl aminolaevulinate PDT in two symmetrical areas. One area was randomized to superpotent corticosteroid (clobetasol propionate) before and just after PDT. Objective and visual erythema, protoporphyrin IX (PpIX) fluorescence and pain were evaluated.. Topical corticosteroid significantly reduced PDT-induced erythema (P = 0·012). The complete lesion response rate 3 months after PDT, and PpIX fluorescence prior to illumination did not differ significantly between the two treated areas.. Superpotent corticosteroid before and just after PDT reduced the erythema 24 h after treatment of multiple AKs on the face and scalp. The use of topical corticosteroid did not affect the efficacy of PDT and may be an easy way to make PDT treatment of large visible areas more acceptable.

Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Aminolevulinic Acid; Anti-Inflammatory Agents; Clobetasol; Erythema; Facial Dermatoses; Female; Fluoroscopy; Glucocorticoids; Humans; Keratosis, Actinic; Male; Pain; Photochemotherapy; Photosensitizing Agents; Protoporphyrins; Scalp Dermatoses; Treatment Outcome

Topics: Administration, Cutaneous; Aged, 80 and over; Aminolevulinic Acid; Clobetasol; Female; Humans; Keratosis, Actinic; Light; Ointments; Photochemotherapy; Photosensitizing Agents; Scalp Dermatoses; Tacrolimus; Treatment Outcome

Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Clobetasol; Dermatologic Agents; Drug Eruptions; Humans; Imiquimod; Keratosis, Actinic; Male; Scalp; Scalp Dermatoses; Treatment Outcome

Ingenol mebutate (IngMeb) is an effective treatment for actinic keratosis. In this study, we hypothesized that repeated treatments with IngMeb may prevent progression of UV-induced photodamage, and that concurrent application of a corticosteroid may reduce IngMeb-induced local skin responses (LSR).. Hairless mice (n = 60; 3 groups of 20 mice) were irradiated with solar simulated ultraviolet radiation (UVR) throughout the study. Five single treatments with IngMeb were given at 4-week intervals (Days 21, 49, 77, 105, and 133). Clobetasol propionate (CP) was applied once daily for 5 days prior to each IngMeb application, as well as 6 h and 1 day post treatment. One week after IngMeb treatment No. 1, 3, and 5 (Days 28, 84, and 140), biopsies from four mice in each group were collected for histological evaluation of UV-damage on a standardized UV-damage scale (0-12). LSR (0-24) were assessed once daily (Days 1-7) after each IngMeb treatment.. IngMeb prevented progression of photodamage in terms of keratosis grade, epidermal hypertrophy, dysplasia, and dermal actinic damage with a lower composite UV-damage score on day 140 (UVR 10.25 vs. UVR+IngMeb 6.00, p = 0.002) compared to UVR alone. IngMeb induced LSR, including erythema, flaking, crusting, bleeding, vesiculation, and ulceration. Concurrent CP increased LSR (max LSR Tx 1-5: UVR+IngMeb+CP 3.6-5.5 vs. UVR+IngMeb 2.6-4.3) and provided better prevention of photodamage compared to IngMeb alone (Day 140: UVR+IngMeb 6.00 vs. UVR+IngMeb+CP 3.00 p < 0.001).. Repeated field-directed treatments with IngMeb prevent progression of cutaneous photodamage in hairless mice, while CP cannot be used to alleviate IngMeb-induced LSR. The findings suggest that IngMeb may potentially serve as a prophylactic treatment for UV-induced tumors.

Topics: Animals; Clobetasol; Disease Progression; Diterpenes; Female; Keratosis, Actinic; Mice, Hairless; Ultraviolet Rays

Topics: Clobetasol; Facial Dermatoses; Female; Glucocorticoids; Humans; Keratosis, Actinic; Male; Scalp Dermatoses