clobetasol and Prurigo

Pemphigoid nodularis is a rare form of pemphigoid that joins the clinical picture of prurigo nodularis and the immunological features of bullous pemphigoid, which is therapeutically challenging. Here, we analyze five female patients with a long-lasting course of nodular pemphigoid in terms of clinical and immunological characteristics and therapy. All the patients fulfilled clinical and immunological criteria of nodular pemphigoid. We applied numerous techniques allowing the proper diagnosis: direct and indirect immunofluorescence, salt split skin, ELISA, BIOCHIP, and fluorescence overlay antigen mapping using laser scanning confocal microscopy. Our study showed that 4 of 5 patients fulfilled the clinical and immunological criteria of nodular bullous pemphigoid. Two out of 4 patients presented exclusively nodular lesions; in the other two patients, blisters and erythematous lesions preceded prurigo-like lesions by a few years. The remaining patient had clinical and immunological criteria of nodular mucous membrane pemphigoid, presenting oral erosions, scarring conjunctivitis, and numerous disseminated nodules on the skin. All the patients were treated with multiple medicines; however, it was observed that the use of clobetasol propionate on the entire body plus antidepressants best controlled the disease. Pemphigoid nodularis mainly occurs in elderly women. In cases with coexisting psychological problems, antidepressants should be considered as an important complementary therapy to the basic one with clobetasol propionate.

Topics: Aged; Clobetasol; Female; Follow-Up Studies; Humans; Pemphigoid, Bullous; Prurigo; Skin

Prurigo nodularis (PN) is a chronic, benign neurodermatitis of unclear etiology characterized by excoriated, intensely pruritic nodules secondary to an intense itch-scratch cycle. PN treatment is still a challenge, and it is frustrating for both dermatologists and patients. The evidence for the effectiveness of a readily available treatment like cryotherapy is limited. To compare the efficacy of cryotherapy vs 0.05% clobetasol propionate in PN patients attending the RDTC, Northern Tanzania, from October 2018 to July 2019. Based on previous year data, it was expected to enroll nine patients. Assent and consent were obtained. Fourteen patients were enrolled, 11 analyzed; intra-subject control done each one-half of the body received either intervention randomly. The cryotherapy was given in two cycles from 5 to 10 s in one session and clobetasol propionate was applied twice daily for 4 weeks. The patients were followed-up weekly by telephone reminded them to apply clobetasol. Data entry and analysis was done in SPSS version 20. Ethical considerations were observed. Eleven patients were analyzed; four (36%) males and seven (64%) females. Cryotherapy had nodule clearance in the 11 patients of 75% to 100% in 11 (100%) and clobetasol propionate only in three of the patients. Seven patients (63.6%) preferred cryotherapy. Cryotherapy preferred above clobetasol propionate.

Topics: Clobetasol; Female; Humans; Male; Neurodermatitis; Prurigo; Tanzania; Tertiary Care Centers; Treatment Outcome

Recent findings have established the 308-nm xenon chloride excimer laser (EL) as a new option in the area of ultraviolet (UV) B phototherapy. As this laser enables high radiant exposure of narrowband UVB and precise targeting of affected skin, it appears to be a promising treatment for the prurigo form of atopic dermatitis (AD).. To investigate the efficacy and safety of the EL compared with clobetasol propionate (CP) in the prurigo form of AD.. In a prospective randomized within-patient controlled study, 13 patients with a prurigo form of AD were randomized to receive EL on one side and topical CP on the other side. Laser treatment was performed twice a week for 10 weeks. Clinical responses were evaluated using Physician Assessment of Individual Signs, Physician Global Assessment, Patient Global Assessment and photographic documentation. Histopathological changes were evaluated and duration of remission was monitored during a 6-month follow-up period.. Both treatments resulted in a significant improvement of all outcome measures after 10 weeks of treatment. During follow up, the EL showed more improvement compared with CP. Histopathology demonstrated marked decrease of epidermal thickness and inflammatory infiltrate at the EL-treated sites. No significant side-effects occurred.. This study suggests that the EL can safely and effectively be used in the treatment of the prurigo form of AD. For the long term, the EL might be a good alternative to topical corticosteroids and an option in case of therapy-resistant patients.

Topics: Adult; Aged; Biopsy; Clobetasol; Dermatitis, Atopic; Dermatologic Agents; Epidemiologic Methods; Female; Glucocorticoids; Humans; Lasers, Excimer; Male; Middle Aged; Prurigo; Skin; Treatment Outcome

Topics: Administration, Topical; Aged; Anti-Bacterial Agents; Chloramphenicol; Clobetasol; Dermatitis, Allergic Contact; Follow-Up Studies; Glucocorticoids; Humans; Male; Microbial Collagenase; Ointments; Patch Tests; Prurigo; Treatment Outcome; Varicose Ulcer

Topics: Child; Clobetasol; Drug Resistance; Female; Glucocorticoids; Humans; Hypohidrosis; Prurigo; Skin Cream

Little attention has been given to the involvement of sweat glands/ducts in the pathogenesis of prurigo nodularis (PN). According to recent studies, PN is likely to develop under conditions characterized by dry skin, such as atopic dermatitis (AD), suggesting a strong impact of skin dryness on PN development. No therapeutic modalities produced complete resolution of PN without exacerbations. We previously reported that increases in skin dryness by sweating disturbance could initiate the development of AD. We investigated whether sweating responses were impaired in refractory PN lesions; and, if so, we asked whether the PN lesions could resolve by restoring sweating disturbance. Using the impression mold technique, which allows an accurate quantification of individual sweat gland/duct activity, we examined basal sweating under quiescent conditions and inducible sweating responses to thermal stimulus in PN lesions and normal-appearing skin in the same patients before and after treatment with a moisturizer or topical corticosteroids. Sweating disturbance, either basal or inducible, was most profoundly detected in the "hub" structure corresponding to the center of PN papule before the treatment. This sweating disturbance was immunohistochemically associated with the leakage of sweat into the dermis. This disturbance was restored by treatment with a moisturizer. Our limitations include a relatively small patient cohort and lack of blinding. Sweating disturbance could be one of the aggravating factors of PN development. Refractory PN with low skin hydration may resolve by restoring sweating disturbance.

Topics: Adult; Aged; Child; Clobetasol; Cohort Studies; Disease Progression; Drug Resistance; Drug Therapy, Combination; Female; Glucocorticoids; Heparinoids; Humans; Male; Middle Aged; Prurigo; Severity of Illness Index; Skin Cream; Sweat Glands; Sweating; Treatment Outcome; Young Adult

A 71-year-old man with a penile verrucous carcinoma presenting as a large cutaneous horn is described. Both verrucous carcinoma and penile cutaneous horn are relatively uncommon entities and have not been previously reported to occur concomitantly. A brief review of the relevant medical literature and methods of therapy is included.

Topics: Administration, Topical; Aged; Betamethasone; Carcinoma, Papillary; Child; Clobetasol; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Penile Neoplasms; Photosensitivity Disorders; Prurigo; Skin; Sunlight

Actinic prurigo is a chronic familial photodermatosis that occurs mostly in Amerindians. Eight patients with actinic prurigo were given intermittent 3- to 14-day courses of topical 0.05% clobetasol 17-propionate cream or ointment in 1988 and 1989. Seven out of eight patients cleared or markedly improved. All of the patients had been resistant previously to milder topical corticosteroids. There have been no side effects. This therapy offers an effective alternative to systemic corticosteroids, oral psoralen with long-wave UV radiation in the A range, or thalidomide.

Topics: Administration, Topical; Adolescent; Betamethasone; Child; Clobetasol; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Photosensitivity Disorders; Prurigo; Sunlight

Prurigo pigmentosa is a rare dermatosis which is most common in Japan. Although the histological features are non-specific, the clinical appearance is striking and is dominated by gross reticular pigmentation. A Chinese patient with prurigo pigmentosa is described.

Topics: Administration, Topical; Adult; Clobetasol; Humans; Male; Pigmentation Disorders; Prurigo; Skin