clobetasol and Penile-Diseases

Topics: Anti-Inflammatory Agents; Clobetasol; Debridement; Humans; Hyperplasia; Lasers, Gas; Male; Penile Diseases; Penis; Precancerous Conditions

Lichen sclerosus (LS) is a skin condition that affects genital and extra genital epithelia in both males and females of all ages and it may occur in association with other autoimmune disease. Currently, the first line effective treatment is an ultra-potent topical corticosteroid. The long-term sequelae of LS include scarring, malignancy, which is rare, and psychosexual disfunction, which is common.

Topics: Administration, Topical; Anti-Inflammatory Agents; Anus Diseases; Clobetasol; Female; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Male; Penile Diseases; Sexual Dysfunctions, Psychological; Vulvar Diseases

To assess whether it is the steroid alone or the gentle physical retraction combined with ointment that is responsible for the excellent results observed with topical steroid treatment of unretractable foreskin.. Prospective, randomised, double-blind study.. University hospital, Sweden.. 30 Boys randomised to be treated with clobetasol propionate (n = 15) or placebo (n = 15).. The boys were examined 1, 2 and 6 months, respectively, after treatment.. Comparison between the effects of clobetasol propionate and placebo.. Two patients in the steroid group and one in the placebo group withdrew from the study. 10 Boys in the steroid group showed an improvement within 2 months. The remaining 3 boys had no effect and were circumcised. Histopathological examination showed lichen sclerosus et atrophicus. Seven boys in the placebo group improved. The 7 non-responders were prescribed clobetasol propionate ointment, and all 7 improved.. 17 of 27 boys referred with "phimosis" were successfully treated with an ointment and gentle traction. When clobetasol propionate was given the non-responders success rate was increased to 24/27 (89%).

Topics: Administration, Topical; Anti-Inflammatory Agents; Child; Child, Preschool; Circumcision, Male; Clobetasol; Diagnosis, Differential; Double-Blind Method; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Male; Penile Diseases; Phimosis; Prospective Studies; Treatment Outcome

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

Topics: Adult; Ainhum; Anti-Inflammatory Agents; Clobetasol; Constriction, Pathologic; Drug Therapy, Combination; Humans; Lichen Sclerosus et Atrophicus; Male; Penile Diseases; Tretinoin

Topics: Angiolymphoid Hyperplasia with Eosinophilia; Clobetasol; Humans; Immunosuppressive Agents; Male; Middle Aged; Penile Diseases; Penis

Lichen planus with simultaneous oral and genital involvement in males is a quite rare condition and often difficult to diagnose. The prevalence, treatment options, and management for this condition are far from being established, and research in this area primarily relies on anecdotes. We present the clinical features of eight cases of peno-gingival lichen planus and propose a management algorithm for this condition based on the best available published evidence.. Personal medical history was collected for all cases. Following careful examination of the oral and genital mucosae, pathology was obtained, previous treatments and duration of mucosal lesions ascertained, treatment initiated, and response evaluated at 8 weeks on both oral and genital lesions. The first-line drug was topical clobetasol propionate 0.05% cream in all cases; in case of failure, topical cyclosporin was used. A review of the literature on treatment options for this rare condition was performed based upon standard literature review practices.. Five cases presented gingival lesions that clinically resembled lichen planus. Glans penis was involved in all patients. All patients responded to treatment except for one. Oral candidiasis was the only observed side effect.. Genital lichen planus may be suspected in males when atrophic-erosive gingival lichen planus is found. A thorough multidisciplinary medical management and active early treatment are necessary to improve symptoms and prevent genital sequelae and, given the risk of squamous cell carcinoma, as a preventative strategy, although this area still needs investigation. Therapeutic trials relating to the treatment of peno-gingival lichen planus may be undertaken considering that current management relies exclusively on observations of case reports.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Candidiasis, Oral; Cheek; Clobetasol; Cohort Studies; Follow-Up Studies; Gingival Diseases; Glucocorticoids; Humans; Lichen Planus; Lichen Planus, Oral; Lip Diseases; Male; Medical History Taking; Middle Aged; Penile Diseases; Remission Induction; Tongue Diseases; Treatment Outcome

Using a highly sensitive polymerase chain reaction (PCR) technique, based on general GP5+/GP6+ PCR primers covering 34 different human papillomavirus (HPV) types, the presence of HPV DNA was studied in paraffin-embedded penile biopsies from 20 men treated topically with corticosteroids. Clobetasol propionate was applied for 2-16 (mean 7) weeks by 19 men (age 18-73; mean 40) with lichen sclerosus. High-risk HPV was detected prior to therapy in three patients (16%) who lacked clinical or histopathological signs of HPV infection. Following therapy high-risk HPV was detected in biopsies from four men (21%), of whom three also exhibited clinical and/or light microscopic signs of HPV infection. Low-risk HPV DNA was not detected in any of these samples. Four biopsies were collected during a 5-year period from a 51-year-old man who was treated repeatedly with topical mild-moderate potent corticosteroids at intervals of up to 10 weeks for penile erosive lichen planus, followed by nine clinical outbreaks of typical condylomas that consistently showed the presence of low-risk HPV DNA only. These observations indicate that long-lasting topical corticosteroid therapy occasionally may be associated with opportunistic reactivation of a latent high- and low-risk mucosotrophic HPV type infection. The importance of clinical follow-up is underlined.

Topics: Administration, Topical; Adolescent; Adult; Aged; Biopsy, Needle; Chi-Square Distribution; Clobetasol; Condylomata Acuminata; Culture Techniques; DNA, Viral; Humans; Lichen Planus; Lichen Sclerosus et Atrophicus; Male; Middle Aged; Papillomaviridae; Papillomavirus Infections; Penile Diseases; Polymerase Chain Reaction; Prospective Studies; Recurrence; Risk Assessment

Treatment with clobetasol propionate 0.05% cream is effective against lichen sclerosus et atrophicus (LSA) of the vulva.. The purpose of this study was to retrospectively evaluate whether clinical and histologic responses to topical clobetasol can be accomplished in penile LSA.. A self-assessment questionnaire was obtained from 22 men with LSA, and a clinical examination was performed in 21 of them. Biopsy specimens from 15 cases were compared before and after treatment.. Itching, burning, pain, dyspareunia, phimosis, and dysuria decreased significantly (P < .001 to .05) after 1 to 2 daily applications, for a mean of 7.1 weeks (2-16 weeks). Additional operation for phimosis was required in 6 of the 22 men. All histologic LSA criteria were significantly (P < .01 to .05) reduced after treatment.. Topical treatment of penile LSA with clobetasol propionate represents a safe and effective therapy with no risk of epidermal atrophy but with some potential for triggering latent infections, most importantly human papillomavirus.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Biopsy; Candidiasis; Clobetasol; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Male; Middle Aged; Papillomaviridae; Papillomavirus Infections; Penile Diseases; Retrospective Studies; Treatment Outcome; Tumor Virus Infections