clobetasol and Leg-Dermatoses

Erosive pustular dermatosis (EPD) is a rare chronic inflammatory condition of the scalp and legs that is often difficult to manage. Currently, there are no treatment guidelines.. To systematically assess the existing literature on various treatment modalities and their efficacies when used in the management of EPD.. We searched PubMed, Cochrane Libraries, Scopus, and clicnialtrial.gov databases for articles in the English language with no limited time frame. Emphasis was placed on articles that reported on treatment for EPD.. Of the 168 articles identified by the literature search, 92 met eligibility criteria and were included for qualitative analysis. Efficacious topical treatments included clobetasol, betamethasone, and tacrolimus. Ninety-three and 88% of cases utilizing clobetasol and betamethasone respectively demonstrated improvement or resolution. All 32 cases utilizing tacrolimus reported improvement. Efficacious systemic treatments included oral steroids such as prednisone, methylprednisolone, and dexamethasone. Topical dapsone, photodynamic therapy, systemic steroids, cyclosporine, and oral zinc derivatives were also described with some success.. According to available data, limited solely to case reports and case series, potent topical steroids are an effective treatment option for EPD. Topical tacrolimus may also be considered in cases that require long-term use or maintenance. Other treatment modalities shown to be successful based on high reported efficacy and low rates of recurrence after treatment include topical dapsone, systemic steroids, zinc derivatives, and cyclosporine. Further studies are needed to compare treatment modalities and to establish treatment protocols.

Topics: Administration, Cutaneous; Administration, Oral; Anti-Infective Agents; Betamethasone; Calcineurin Inhibitors; Clobetasol; Dapsone; Dexamethasone; Glucocorticoids; Humans; Leg Dermatoses; Methylprednisolone; Photochemotherapy; Scalp Dermatoses; Tacrolimus

Topics: Administration, Oral; Administration, Topical; Aged, 80 and over; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Biopsy; Clobetasol; Drug Therapy, Combination; Female; Humans; Leg Dermatoses; Lymphatic Metastasis; Melanoma; Neoplasm Metastasis; Neoplasm Staging; Pemphigoid, Bullous; Prednisone; Skin; Skin Neoplasms

Topics: Administration, Topical; Adult; Amyloidosis; Anti-Inflammatory Agents; Clobetasol; Humans; Leg Dermatoses; Lichenoid Eruptions; Male

Topics: Administration, Cutaneous; Anti-Bacterial Agents; Antifungal Agents; Antitrichomonal Agents; Clobetasol; Disease Progression; Drug Combinations; Genital Diseases, Male; Glucocorticoids; Groin; Humans; Leg Dermatoses; Male; Naphthalenes; Ofloxacin; Ornidazole; Terbinafine; Thigh; Tinea; Young Adult

Pretibial myxedema (PTM) is a rare manifestation of Graves' disease. There is paucity of data regarding long-term follow-up and response to treatment in PTM.. Retrospective study wherein 30 patients of PTM presenting during 2001-2011 attending dermatology and endocrinology outpatient departments were analyzed.. Among 30 patients with PTM, 12 were males and 18 females with a ratio of 1 : 1.5 males/females. Four morphological forms were identified: plaques (18 patients), diffuse non-pitting edema of both lower legs (five), nodules (five), and elephantiasis lesions (two). Eighty percent were diagnosed with hyperthyroidism before the development of dermopathy. Twenty-six patients presented with ophthalmopathy. Fourteen patients with plaque had an excellent response to topical clobetasol propionate ointment and attained complete resolution by 3.6 years. Out of 16 patients treated with combination therapy, which included nine treated with topical corticosteroids/intralesional triamcinolone and seven treated with oral, intralesional, and topical corticosteroids, nine attained complete resolution in the lesions by 3.4 years, and none relapsed anytime during four years of post-treatment follow-up. However, the remaining patients (elephantiasis and diffuse forms) failed to achieve complete resolution.. Plaques and nodules are common variants with a favorable clinical response to topical and intralesional corticosteroid; elephantine and diffuse forms responded poorly to therapy. Studies analyzing larger cohorts of patients with PTM and their long-term follow-up are limited, hence more such studies are required.

Topics: Administration, Cutaneous; Administration, Oral; Adult; Aged; Clobetasol; Drug Therapy, Combination; Elephantiasis; Female; Follow-Up Studies; Glucocorticoids; Graves Ophthalmopathy; Humans; India; Injections, Intralesional; Leg Dermatoses; Male; Middle Aged; Myxedema; Ointments; Prednisolone; Retrospective Studies; Tertiary Care Centers; Thyrotropin; Thyroxine; Time Factors; Treatment Outcome; Triamcinolone; Triiodothyronine

A five and a half year-old girl presented with a reddish-brown plaque on her right anterior tibia, first observed 1 year previously and without any history of injury or insect bite. Histological examination showed a dense dermal infiltrate composed of plasma cells and small lymphocytes, combined with lymphocytic exocytosis in the epidermis and interface dermatitis. In addition, a second biopsy found small epithelioid granulomas within the lymphoplasmocytic infiltrate. Infection was ruled out. No clonality was found. None of the treatments attempted was successful (antibiotics and steroids), and the lesion was stable but did not improve for 4 years. The same features typical of lymphoplasmocytic pseudolymphoma were observed on a third biopsy. A diagnosis of "pretibial lymphoplasmocytic plaque" was made on the basis of clinical and histological findings. Recently, 3 other cases of this type of lymphocytic and plasma cell cutaneous infiltrate with very distinctive clinical and histopathological features have been reported in children. Our case is instructive because it presents new and as yet undocumented histopathologic features including a lichenoid reaction with vacuolization of the basal cell layer and numerous apoptotic bodies, apparent in 2 of the 3 biopsies, and hypervascularity with thick-walled blood vessels lined with plump endothelial cells in the upper dermis. The clinicopathological presentation of these cases, including ours, is homogenous suggesting a specific entity described as "pretibial lymphoplasmocytic plaque in children". This seems to be a benign, chronic, reactive process, probably arising secondary to a local response to an unknown antigen.

Topics: Child, Preschool; Clobetasol; Dermatitis; Dermis; Diagnosis, Differential; Female; Glucocorticoids; Humans; Leg Dermatoses; Lymphocytes; Plasma Cells; Pseudolymphoma; Treatment Outcome

Topics: Biopsy, Needle; Breast Neoplasms; Carcinoma, Ductal, Breast; Chemotherapy, Adjuvant; Clobetasol; Combined Modality Therapy; Erythema; Female; Follow-Up Studies; Hand Dermatoses; Humans; Immunohistochemistry; Leg Dermatoses; Middle Aged; Severity of Illness Index; Treatment Outcome

Six patients with pemphigoid and three patients with pemphigus foliaceus were successfully treated with topical corticosteroids. This was especially effective in cases of pretibial localized pemphigoid and in mild cases of bullous pemphigoid and pemphigus foliaceus with negative or low-titer circulating autoantibodies.

Topics: Administration, Topical; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Betamethasone; Betamethasone Valerate; Clobetasol; Dexamethasone; Female; Fluocinonide; Glucocorticoids; Humans; Leg Dermatoses; Male; Middle Aged; Ointments; Pemphigoid, Bullous; Pemphigus; Triamcinolone

Two women with a distinctive rash on the legs are reported. The clinical features of erythema, erosions, crusting and pustular lakes, and the failure to respond to any treatment except very potent topical corticosteroids (Dermovate), are very similar to those of erosive pustular dermatosis of the scalp.

Topics: Administration, Topical; Aged; Clobetasol; Female; Humans; Leg Dermatoses; Middle Aged; Skin Diseases, Vesiculobullous

Topics: Betamethasone; Clobetasol; Female; Humans; Leg Dermatoses; Middle Aged; Necrobiosis Lipoidica