clobetasol and Skin-Diseases

Both halobetasol propionate and clobetasol 17-propionate exerted very marked antiinflammatory, antiproliferative, and vasoconstrictive effects during evaluation in a range of dermatopharmacologic models. Halobetasol propionate was distinctly more potent than clobetasol 17-propionate in the ultraviolet-induced dermatitis inhibition assay in guinea pigs and in the rat model of oxazolone-induced late inflammatory reaction. Halobetasol propionate was slightly more potent than clobetasol 17-propionate in inhibiting croton oil-induced ear edema in rats and mice and in the mouse model of oxazolone-induced early inflammatory reaction. In the cotton-pellet granuloma assay in rats and the epidermal hyperplasia inhibition assay in guinea pigs, halobetasol propionate was distinctly superior to clobetasol 17-propionate. There was a trend in favor of halobetasol propionate in the cutaneous vasoconstriction assay performed in volunteers with ethanol solutions of halobetasol propionate and clobetasol 17-propionate. In a further vasoconstriction assay, performed with a 0.05% concentration of both halobetasol propionate and clobetasol 17-propionate in cream and ointment formulations, halobetasol propionate ointment yielded the highest blanching score. In a hypothalamic-pituitary-adrenal axis study in volunteers, effects of 0.05% halobetasol propionate ointment and 0.05% clobetasol 17-propionate ointment on serum cortisol levels were similar. The overall efficacy trends demonstrated in these dermatopharmacologic studies are in agreement with predictions made from corticosteroid structure and activity relationships and the results of two clinical trials comparing halobetasol propionate and clobetasol 17-propionate ointments in the treatment of plaque psoriasis.

Topics: Animals; Clobetasol; Female; Guinea Pigs; Humans; Male; Mice; Rats; Skin Diseases; Vasoconstrictor Agents

There is a lack of evidence on the best treatment option for umbilical granuloma. The primary aim of this study was to compare three treatments for umbilical granuloma: standard treatment with topical silver nitrate, clobetasol propionate cream (0.05%) and ethanol wipes. The secondary aim was to evaluate whether the treatment could be successfully administered by a parent at home, rather than in the outpatient clinic.. A total of 109 infants were randomised to one of three groups and 94 infants completed the assigned treatment: 30 infants received standard treatment with silver nitrate (99%) in the outpatient clinic, 30 infants had topical clobetasol propionate cream (0.05%) applied at home, and 34 infants received cleansing with ethanol wipes (82%) at home.. Silver nitrate and clobetasol propionate cream (0.05%) were significantly superior to ethanol wipes, with shorter healing times and higher resolution rates (p = 0.0001). Healing time and resolution rates were identical for silver nitrate and clobetasol propionate cream (0.05%). Mild side effects were occasionally reported, all of which were self-limiting.. Treating umbilical granuloma with topical clobetasol propionate cream (0.05%) at home is as effective as treating it with topical silver nitrate (99%) in the clinic.

Topics: Administration, Topical; Anti-Infective Agents, Local; Clobetasol; Ethanol; Female; Glucocorticoids; Granuloma; Humans; Infant; Male; Silver Nitrate; Skin Diseases; Umbilical Cord

To compare the atrophogenic effects of fluocinonide cream 0.1% versus clobetasol propionate cream 0.05%, 20 participants with corticosteroid-responsive dermatoses were randomly assigned to receive fluocinonide cream 0.1% on one arm and clobetasol propionate cream 0.05% on the other arm. Study medications were applied to disease-free target areas on the inner arms twice daily for 2 weeks. The epidermal thickness of pretreatment and posttreatment punch biopsy specimens was measured. Skin examinations were performed evaluating clinical signs of atrophy. No significant reduction in epidermal thickness was observed in the fluocinonide-treated sites (mean, -0.0318 mm; standard deviation, 0.0239; P=.1991). A significant reduction in epidermal thickness was seen in the clobetasol-treated sites (mean, -0.1825 mm; standard deviation, 0.0239; P<.0001). This reduction was significantly greater than results from sites treated with fluocinonide cream 0.1% (difference, -0.1507; standard deviation, 0.0131; P<.0001). Although topical corticosteroids often are the first-line treatment for patients with various dermatoses, a side effect of continuous use is cutaneous atrophy. Our study demonstrated that clobetasol propionate cream 0.05% caused a significantly greater reduction in epidermal thickness compared with fluocinonide cream 0.1% when used twice daily for 2 weeks (P<.001). However, neither drug caused significant clinical signs of atrophy.

Topics: Administration, Cutaneous; Adult; Atrophy; Clobetasol; Double-Blind Method; Drug Administration Schedule; Epidermis; Fluocinonide; Glucocorticoids; Humans; Skin Diseases

Prolonged topical corticosteroid use is often associated with atrophic skin changes. This trial compared signs of skin atrophy related to 3 super-high-potency corticosteroids: fluocinonide 0.1% cream, clobetasol propionate 0.05% cream, and 0.05% foam.. The test treatments were applied to the forearms 10 females twice daily for 21 days. Skin characteristics were assessed pretreatment and posttreatment for atrophic changes. Further punch biopsies obtained from 5 subjects were assessed histologically.. Clobetasol foam produced mild changes in noninvasive tests, but stained skin biopsies revealed structural changes nearly comparable to clobetasol cream, which showed substantial atrophic changes. Fluocinonide cream was the least atrophogenic, producing no or only mild effects that were slightly greater than vehicle.. Fluocinonide cream has a lower potential to produce atrophic changes of the skin than either clobetasol cream or clobetasol propionate foam.

Topics: Administration, Cutaneous; Adult; Atrophy; Clobetasol; Dose-Response Relationship, Drug; Emollients; Erythema; Female; Fluocinonide; Glucocorticoids; Humans; Middle Aged; Severity of Illness Index; Skin; Skin Diseases; Telangiectasis; Water Loss, Insensible

Both halobetasol propionate and clobetasol 17-propionate exerted very marked antiinflammatory, antiproliferative, and vasoconstrictive effects during evaluation in a range of dermatopharmacologic models. Halobetasol propionate was distinctly more potent than clobetasol 17-propionate in the ultraviolet-induced dermatitis inhibition assay in guinea pigs and in the rat model of oxazolone-induced late inflammatory reaction. Halobetasol propionate was slightly more potent than clobetasol 17-propionate in inhibiting croton oil-induced ear edema in rats and mice and in the mouse model of oxazolone-induced early inflammatory reaction. In the cotton-pellet granuloma assay in rats and the epidermal hyperplasia inhibition assay in guinea pigs, halobetasol propionate was distinctly superior to clobetasol 17-propionate. There was a trend in favor of halobetasol propionate in the cutaneous vasoconstriction assay performed in volunteers with ethanol solutions of halobetasol propionate and clobetasol 17-propionate. In a further vasoconstriction assay, performed with a 0.05% concentration of both halobetasol propionate and clobetasol 17-propionate in cream and ointment formulations, halobetasol propionate ointment yielded the highest blanching score. In a hypothalamic-pituitary-adrenal axis study in volunteers, effects of 0.05% halobetasol propionate ointment and 0.05% clobetasol 17-propionate ointment on serum cortisol levels were similar. The overall efficacy trends demonstrated in these dermatopharmacologic studies are in agreement with predictions made from corticosteroid structure and activity relationships and the results of two clinical trials comparing halobetasol propionate and clobetasol 17-propionate ointments in the treatment of plaque psoriasis.

Topics: Animals; Clobetasol; Female; Guinea Pigs; Humans; Male; Mice; Rats; Skin Diseases; Vasoconstrictor Agents

In a randomized double blind study, we investigated the systemic effects of 3 different ointments containing corticoids. Every 7 patients out of a total of 21 patients suffering from various skin diseases were daily treated with 40 g of one of the 3 corticoid preparations over 8 days (group A: 0.05% clobetasol-17-propionate; group B: 0.25% fluocortolone trimethyl acetate; group C: 0.25% fluocortolone trimethyl acetate + 0.25% fluocortolone capronate). The plasma cortisol levels were determined by radioimmune assay. In group B and C, we did not observe any effect on the pituitary-adrenal axis, whereas in group A the plasma cortisol levels were extremely low already after 1 day of corticoid application. This adrenal suppression did not return to normal within 4 days after discontinuation of the corticoid. Our results suggest that highly potent topical corticoids are capable of adrenal suppression even without occlusive dressing and even in healthy persons.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Clinical Trials as Topic; Clobetasol; Dose-Response Relationship, Drug; Double-Blind Method; Female; Fluocortolone; Humans; Hydrocortisone; Male; Middle Aged; Random Allocation; Skin Diseases; Structure-Activity Relationship

Topics: Administration, Topical; Adrenal Insufficiency; Anti-Inflammatory Agents; Betamethasone; Clinical Trials as Topic; Clobetasol; Costs and Cost Analysis; Glucocorticoids; Humans; Psoriasis; Skin Diseases

Forty patients with skin diseases of various origins were treated with a combination of three creams, the respective bases of which were clobetasone butyrate, sodium fusidate and ketoconazole. Satisfactory results were obtained in 97.5% of cases, with remission of symptoms and good healing of lesions. Tolerance was excellent in 97.5% of cases, with only one patient complaining of burning sensations after the applications.

Topics: Administration, Topical; Adolescent; Adult; Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Drug Therapy, Combination; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases

A double-blind, randomized, placebo-controlled trial was carried out comparing the effects of clobetasol propionate ointment and the ointment base on the inflammation induced by cryotherapy of basal cell carcinomata and warts. A single application of the steroid was shown to be significantly better at reducing erythema, pain and swelling than the ointment base.

Topics: Adolescent; Adult; Aged; Betamethasone; Carcinoma, Basal Cell; Clinical Trials as Topic; Clobetasol; Cryosurgery; Dermatitis; Double-Blind Method; Erythema; Humans; Middle Aged; Ointments; Skin Diseases; Skin Neoplasms; Warts

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clinical Trials as Topic; Clobetasol; Female; Humans; Infant; Male; Ointments; Skin Diseases; Switzerland

32 adult hospitalized patients with common skin disorders were controlled in a double-blind comparison study with clobetasol propionate (Dermovat) and betamethasone-17,21-dipropionate (Diproderm) with regard to adrenal suppression. The latter, when assessed by plasma cortisol, was significantly greater in the dermovat-treated groups after the 1st and 2nd week with daily treatment with both 25 g and 15 g ointment. Daily treatment of skin areas greater than 25% with 25 g Diproderm also showed clear adrenal suppression, whereas no such effect was obtained with daily treatment with 10 g Diproderm of skin areas greater than 15%. In all cases, plasma cortisol levels were normal 1--2 weeks after the end of topical treatment.

Topics: Administration, Topical; Adrenal Cortex; Adult; Betamethasone; Clobetasol; Double-Blind Method; Drug Evaluation; Evaluation Studies as Topic; Humans; Hydrocortisone; Skin Diseases

Topics: Adolescent; Adult; Aged; Betamethasone; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Female; Humans; Male; Middle Aged; Ointments; Psoriasis; Skin Diseases; Solutions; Triamcinolone Acetonide

Dear Editor, cutaneous chronic graft versus host disease (cGVHD) is a pathological process consisting of donor-derived T-cells aimed at the antigens of the recipient. It exhibits a large range of clinical presentations resembling morphea and deep sclerosis/fasciitis, all characterized by both inflammation and progressive dermal and hypodermic fibrosis (1). Although classic scleroderma-like lesions in cGVHD are nummular or irregular plaques and linear bundles associated with hypo- or hyperpigmentation (2), we report an atypical case with ulcerative presentation. No other case-reports of morphea-like or scleroderma-like cGVHD with an ulcerated appearance after liver transplantation (LT) and magnetic resonance imaging (MRI) correlation have been found in the literature. CASE REPORT Ten months after LT due to an end-stage cirrhosis associated with multifocal hepatocarcinoma (HCC), a 61-year-old man on immunosuppressive therapy with Tacrolimus (1 mg) and Everolimus (10 mg) presented to our clinic for a skin lesion in the right scapular region. We observed a flat ulcerated plaque with areas of sclerosis, minimal necrosis, and well-defined slightly erythematous margins (Figure 1, a). On palpation, the plaque had a hard consistency and was slightly painful. The skin lesion had been preceded by subjective discomfort with stinging sensation for seven months before its onset. Gradually lesion developed starting from a small, flat, oval purplish plaque associated with a progressive increase in pain. Patient denied dysphagia, retrosternal heartburn, Raynaud's phenomenon, arthralgia, and dyspnea. A previous MRI (Figure 2, a,b) showed subcutaneous and muscle edema. Blood tests showed abnormal liver function indexes due to extrahepatic cholestasis, while C-reactive protein, erythrocyte sedimentation rate, and leukocytes were within normal ranges. Self-reactive antibodies were negative. Histological examination (Figure 1, b) identified rare dyskeratotic keratinocytes and basal lymphocyte infiltrate, a dermal dense fibrosis with the disappearance of the skin appendages, and large fibrous septa in the adipose panniculus. It led to the diagnosis of scleroderma/morphea, based on the patient's clinical history. The diagnosis of graft versus host disease scleroderma-like post liver transplant was established. The lesion was treated by topical application of 0.05% clobetasol once a day. We did not use systemic immunosuppressive therapy in order to prevent HCC recurrence. The pat

Topics: C-Reactive Protein; Clobetasol; Everolimus; Fibrosis; Graft vs Host Disease; Humans; Inflammation; Liver Transplantation; Magnetic Resonance Imaging; Male; Middle Aged; Scleroderma, Localized; Sclerosis; Skin Diseases; Tacrolimus; Ulcer

Topics: Administration, Topical; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Biopsy; ChAdOx1 nCoV-19; Clobetasol; Combined Modality Therapy; Compression Bandages; COVID-19; Diagnosis, Differential; Humans; Male; Necrosis; Neomycin; Nystatin; SARS-CoV-2; Skin; Skin Diseases; Thrombosis; Treatment Outcome

Granuloma inframammary adultorum represents a variant of erosive papulonodular dermatosis; we report a case of a patient with bilateral erosive plaques and nodules predominantly located under the breast.

Topics: Administration, Cutaneous; Breast; Clobetasol; Dermoscopy; Female; Glucocorticoids; Granuloma; Humans; Middle Aged; Skin Diseases

Topics: Administration, Topical; Clobetasol; Desmoglein 3; Exanthema; Female; Fluorescent Antibody Technique; Glucocorticoids; Humans; Injections, Intralesional; Keratosis; Middle Aged; Pemphigus; Scalp; Skin Diseases; Treatment Outcome; Triamcinolone

Topics: Adult; Anticonvulsants; Clobetasol; Dermatitis; Drug Eruptions; Eating; Female; Glucocorticoids; Granuloma; Humans; Migraine Disorders; Skin; Skin Diseases; Topiramate; Treatment Outcome

Clobetasol propionate (CP) is a high-potency corticosteroid, representing the standard of care for the symptomatic treatment of different skin disorders as well as oral mucosal diseases. Several topical delivery systems are available for treating oral lesions, but the ideal one is still lacking. In this work, we propose a novel class of chitosan (CS) patches, loaded with CP, for the topical treatment of inflammatory chronic oral diseases. Chitosan patches have been fabricated via electrophoretic deposition (EPD), by using a one-pot approach in order to load controlled quantity of CP. Optimized structures showed a water uptake in the range of 200-360% and mechanical properties that allow the design of flexible patches in wet state (E = 0.6 MPa and σ

Topics: Administration, Topical; Chitosan; Clobetasol; Delayed-Action Preparations; Drug Carriers; Drug Compounding; Drug Delivery Systems; Drug Liberation; Electrophoresis; Equipment Design; Ethanol; Humans; Skin; Skin Diseases; Transdermal Patch; Water; Wettability

Topics: Administration, Topical; Aged; Clobetasol; Diagnosis, Differential; Female; Glucocorticoids; Granuloma, Giant Cell; Herpes Zoster; Humans; Psoriasis; Skin Diseases

Wells syndrome (WS) or eosinophilic cellulitis is a rare, idiopathic, inflammatory dermatosis. The typical clinical presentation is urticarial plaque without preferential location that usually heals without scarring. We present a 62-year-old man with history of lung cancer that had undergone a right superior lobectomy 12 months previously. The patient had a relapsing dermatosis beginning about 6 months before the diagnosis of the lung cancer, characterised by pruritic, erythematous plaques located on the trunk and arms. These lesions spontaneously resolved within a few weeks without scarring. A skin biopsy revealed findings compatible with WS. Several diseases have been associated with WS. These include haematological diseases, fungal, parasitic and viral infections, drug reactions and rarely non-haematological malignancies. We present a case of this rare syndrome in a patient with history of lung cancer that we believe acted as a triggering event. To our knowledge, this is the second case reporting this association.

Topics: Administration, Topical; Biopsy; Cellulitis; Clobetasol; Dermatologic Agents; Eosinophilia; Humans; Loratadine; Lung Neoplasms; Male; Middle Aged; Recurrence; Skin Diseases; Tacrolimus; Treatment Outcome

The inflammatory process plays an important role in sulfur mustard (HD) injury and HD pathogenesis, suggesting that anti-inflammatory treatments applied as soon as possible following HD injury may reduce tissue damage and accelerate healing. This study used the HD dermal weanling swine model to investigate the efficacy of two non-steroidal anti-inflammatory drugs, capsaicin and diclofenac, when applied in combination with the steroid, clobetasol. The therapeutic regimen was also investigated with respect to initiation of treatment post-exposure, frequency and duration. Yorkshire-cross pigs were randomly assigned to experimental groups, corresponding to all combinations of treatment (capsaicin with clobetasol or diclofenac with clobetasol), onset time (1, 2 or 4 h post-exposure), treatment duration (1, 3 or 5 days) and frequency of applications (2, 3 or 4 per day). For each animal, two sites on the ventral abdomen were exposed to 400 μL of neat HD for 8 min to achieve superficial dermal (SD) lesions and two sites were exposed to 400 μL neat HD for 30 min to achieve deep dermal (DD) lesions. Each treatment regimen was tested against a SD and a DD injury. Untreated SD and DD lesion sites served as within-animal controls. Assessments, up to one week post-challenge, included digital photographs, clinical assessments (lesion size measurements and modified Draize scoring), transepidermal water loss (TEWL), reflectance colorimetry and histopathologic evaluations that included an estimate for depth of injury and wound healing parameters. Diclofenac plus clobetasol treatment resulted in significant reductions in lesion contracture and modified Draize scores, increased barrier function (decreased TEWL), and increased healing as determined by histopathology for both SD and DD injury when compared with untreated sites and sites treated with capsaicin plus clobetasol. An increased duration of treatment from 1 to 5 days was most commonly associated with decreased clinical assessment and histopathological severity scores. Therefore, a combination of diclofenac and clobetasol application, when administered for at least five days, shows promise in ameliorating HD-induced lesions.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Capsaicin; Chemical Warfare Agents; Clobetasol; Diclofenac; Drug Therapy, Combination; Female; Mustard Gas; Skin; Skin Diseases; Swine

Topics: Antibodies, Monoclonal; Antineoplastic Agents; Biopsy; Choroid Neoplasms; Clobetasol; Female; Glucocorticoids; Humans; Ipilimumab; Melanoma; Middle Aged; Sarcoidosis; Skin; Skin Diseases; Treatment Outcome

Topics: Clobetasol; Dermatologic Agents; Diagnosis, Differential; Erythema; Hepatitis C, Chronic; Humans; Male; Middle Aged; Necrosis; Skin; Skin Diseases; Trace Elements; Treatment Outcome; Zinc

Topics: Acitretin; Administration, Cutaneous; Aged; Anti-Inflammatory Agents; Breast Diseases; Clobetasol; Dermatologic Agents; Female; Histiocytosis, Sinus; Humans; Immunosuppressive Agents; Keratolytic Agents; Methotrexate; Retreatment; Skin Diseases; Thalidomide; Treatment Failure

Sarcoidosis is a multisystem disease characterized by non-caseating granulomas present in the involved organ systems. The disease is believed to result from an interaction among genetic factors, antigens, and the immune response. Environmental exposures and infectious agents have been implicated as potential causes. Cutaneous sarcoidosis presents clinically in many forms and the lesions are classified as either specific or non-specific. Non-specific lesions show a nondescript inflammatory process whereas specific lesions display typical, non-caseating granulomas. There are many different forms of specific lesions with some being more common than others. Psoriasiform lesions are uncommon. The literature suggests that as few as 0.9% of patients display this type of cutaneous sarcoidosis. Some of these patients present solely with cutaneous sarcoidosis, but others have systemic involvement with pulmonary involvement being the most common concomitant presentation. Plaques appear as round or oval, brownish, red infiltrated lesions, frequently involving the extensor surface of the extremities, face, scalp, back, and buttocks. Multiple configurations, including discrete, confluent, annular, and polycyclic, have been reported. Despite the clinical resemblance to psoriasis, on histological examination, only non-caseating granulomas are seen in the dermis. In rare cases both psoriasiform sarcoidosis and psoriasis were present.

Topics: Administration, Cutaneous; Clobetasol; Dermatologic Agents; Diagnosis, Differential; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Infliximab; Middle Aged; Psoriasis; Rituximab; Sarcoidosis; Skin Diseases

Topics: Adalimumab; Adult; Antirheumatic Agents; Clobetasol; Female; Humans; Inflammatory Bowel Diseases; Infliximab; Male; Methylprednisolone; Skin; Skin Diseases; Tumor Necrosis Factor-alpha

Topics: Adult; Clobetasol; Epidermis; Glucocorticoids; Humans; Hyperplasia; Lasers, Gas; Male; Skin Diseases; Tattooing

Cutaneous reactive angiomatoses (CRA) encompass a distinct group of rare benign reactive vascular proliferations that include reactive angioendotheliomatosis, diffuse dermal angiomatosis and reactive intralymphatic histiocytosis. The etiology of these conditions, often associated with either localized or systemic diseases, is poorly understood. We report a 72-year-old woman who presented giant diffuse cellulitis-like plaques on the right lower limb and the pelvis and a reduction of her general condition with fever. Light microscopy studies revealed combined features of reactive angioendotheliomatosis, diffuse dermal angiomatosis and reactive intralymphatic histiocytosis. A small arteriovenous fistula of the right lower leg was thought to act as trigger. Systemic corticosteroids resulted in the clinical remission of the skin lesions. Our observation provides strong evidence that reactive angioendotheliomatosis, diffuse dermal angiomatosis and reactive intralymphatic histiocytosis, previously regarded as distinct forms of CRA, may show overlapping histopathological features and most likely represent facets of the same disease.

Topics: Aged; Angiomatosis; Anti-Inflammatory Agents; Arteriovenous Fistula; Cellulitis; Clobetasol; Diagnosis, Differential; Female; Fever; Humans; Prednisolone; Skin Diseases

Topics: Aged; Biopsy; Clobetasol; Ear, External; Epidermal Cyst; Eyelids; Glucocorticoids; Humans; Neck; Skin; Skin Diseases; Treatment Failure

Cutaneous sarcoidosis is challenging to diagnose due to its many nonspecific manifestations. In this report we describe a case of cutaneous sarcoidosis in a patient presenting with multiple lesions. Diagnosis of the disease involves not only clinical and pathologic findings but also multiple exclusions.

Topics: Anti-Inflammatory Agents; Black or African American; Clobetasol; Desonide; Female; Glucocorticoids; Humans; Middle Aged; Sarcoidosis; Skin Diseases; United States

Erosive pustular dermatosis (EPD) is a rarely reported condition that primarily involves the actinically damaged scalp of elderly women. Although the condition is well recognized in the United Kingdom and Europe, no US cases have heretofore been reported.. We sought to document the presence, and determine the clinical characteristics, of EPD in the US population.. Patients were recruited from the dermatology clinic at a university in California and from the private practices of dermatologists in the Northern California region.. Eleven patients with EPD were identified. Eight were women and 3 were men. The scalp was involved in 9 patients and the extremities in two patients. The involved skin was actinically damaged in 9 patients. The patients were elderly (66-90 years) but one patient was a 15-year-old boy. All lesions resolved or greatly improved with the application of high-potency steroids or tacrolimus.. Not all patients were examined personally by the authors of this article. The length of follow-up was relatively short.. EPD is a fairly common disease and is the most likely diagnosis in instances where chronic, nonhealing, shallow erosions occur on actinically damaged, or otherwise atrophic, skin. In spite of the name, intact pustules are rarely present. The histology is that of moderate to marked, nonspecific chronic inflammation. EPD responds well to high-potency topical steroids.

Topics: Administration, Topical; Adolescent; Aged; Aged, 80 and over; Atrophy; Calcineurin Inhibitors; Clobetasol; Extremities; Female; Follow-Up Studies; Glucocorticoids; Humans; Male; Photosensitivity Disorders; Scalp Dermatoses; Skin Diseases; Skin Diseases, Vesiculobullous; Steroids; Tacrolimus; Treatment Outcome

We report a case of a 53-year-old African American woman with an unusual example of striae caused by topical steroid usage and discuss the widespread usage of these products.

Topics: Administration, Topical; Clobetasol; Cosmetics; Elastic Tissue; Female; Glucocorticoids; Humans; Middle Aged; Skin Diseases

Skin atrophy is one of the most frequent side-effects of the topical glucocorticoid. Skin barrier impairment has also been reported as a steroid-induced side effect. Although there have been various studies on preventing or minimizing this atrophogenic effect, little has been reported about preventing barrier impairment. This study was performed to determine the effects of a multilamellar emulsion (MLE) that had a well-ordered lamellar structure on the steroid-induced barrier impairment and epidermal atrophy. To confirm these effects of MLE, 0.05% clobetasol-17-propionate (CP) and 0.05% clobetasol-17-propionate in MLE (MLE/CP) were topically applied to both flanks of hairless mice for 9 days. The topically applied CP induced a significant impairment of the epidermal permeability barrier, and MLE/CP also did not have a preventive effect on this change. However, skinfold thickness studies and histological studies showed that MLE/CP significantly reduced the steroid-induced atrophy. The topical application of MLE/CP was also shown to have a preventive effect on the steroid-induced increase of the stratum corneum (SC) surface pH. In addition, the electron microscopic findings showed relatively well-conserved lamellar bilayers in the skin treated with MLE, as compared to CP only. The results showed that the topical application of MLE immediately after CP treatment prevented the glucocorticoid-induced transepidermal water loss values increase. Light microscopy measurements showed that the skin treated with MLE immediately after CP treatment for 1 week had a slightly lower decline of skin thickness than did the CP-treated skin. These results suggest that MLE should be effective for preventing glucocorticoid-induced epidermal atrophy and for repairing the barrier impairment.

Topics: Administration, Topical; Animals; Atrophy; Biopsy, Needle; Clobetasol; Disease Models, Animal; Emulsions; Epidermis; Female; Glucocorticoids; Immunochemistry; Male; Mice; Mice, Hairless; Permeability; Probability; Reference Values; Risk Factors; Sensitivity and Specificity; Skin Absorption; Skin Diseases

Easily applicable water-specific instruments measuring local oedema in skin are not available. The aim of this study is to demonstrate quantitative assessment of skin oedema with the dielectric technique by measuring increase of skin water content related to sodium lauryl sulphate (SLS)-induced irritant contact dermatitis.. Irritant skin reaction and resulting oedema were induced by an irritant patch test on volar forearms in 12 healthy volunteers with the application of 1% SLS for 6 h. After occlusion the volunteers were divided into two groups: the patch test site of group I (six volunteers) received no treatment other than a base cream for the skin reaction, while for group II (six volunteers) a strong corticosteroid (clobetasol propionate) was applied on the irritant skin. During a follow-up of 72 h, erythema was scored visually, and irritant-induced oedema was measured with a novel water-specific instrument MoistureMeter-D.. In the untreated irritant skin, a maximum increase of 45% in skin water content was found at 10 h postocclusion and water content was still elevated at 72 h. With these persons, the degree of oedema agreed well with the ultrasound-measured skin thickness (P=0.053). In the corticosteroid-treated skin, an increase of 8% in water content was measured during 72 h but there was no correlation between oedema and skin thickness. There was no correlation between erythema and oedema in untreated or corticosteroid-treated skin.. The new instrument can easily be applied for noninvasive quantitative evaluation of local oedema and fluid retention in irritant-exposed skin.

Topics: Adult; Anti-Inflammatory Agents; Body Water; Clobetasol; Dermatitis, Irritant; Edema; Electrochemistry; Erythema; Humans; Skin; Skin Diseases; Sodium Dodecyl Sulfate; Surface-Active Agents; Ultrasonography

Complications caused by skin lightening practices have not been systematically studied in Europe.. Our aim was to assess the complications of skin lightening among people of African descent living in Paris.. This was a descriptive study. All patients presenting with complications from skin lightening procedures underwent a complete clinical examination and were questioned about their practice.. Forty-six patients from various African countries (39 women, 7 men) presented with skin changes suggestive of side effects from skin lightening practices. The complications seemed mainly related to the use of clobetasol and hydroquinone.. The selection bias does not allow assessment of uncomplicated skin lightening.. Complications arising from skin lightening practices represent a significant health problem for people of African descent living in Paris.

Topics: Adrenal Insufficiency; Adult; Africa; Black People; Clobetasol; Cosmetics; Female; Glucocorticoids; Humans; Hydroquinones; Male; Middle Aged; Paris; Skin Diseases; Skin Pigmentation

Topical steroids became available, without prescription, in the U.K. in 1987, with hydrocortisone 1% cream first being licensed for irritant contact dermatitis and reactions to insect bites. Since then the number of indications for nonprescription hydrocortisone use has increased and clobetasone has also become available as an over-the-counter (OTC) medicine. Little has been reported about how OTC steroids are used by community pharmacy clients.. We determined how OTC topical steroids are applied by patients, their demographic profile, the products used and the conditions treated, how frequently products were applied and how regularly purchased. The extent to which off-label use takes place was explored.. A patient-completed questionnaire study was used in 100 branches of a national pharmacy in Great Britain.. Questionnaires were completed and returned by 315 clients (16%). Eczema (192 cases, 61%) and dermatitis (66 cases, 21%) were the conditions most frequently treated. Nottingham Eczema Severity Scores calculated for 228 eczema and dermatitis sufferers shows that 164 patients (72%) had mild eczema. Those with more severe eczema were more likely to use clobetasone than hydrocortisone. The use of topical steroids outside OTC marketing authorization guidelines was widespread; however, no patient reported any adverse effects or deterioration in condition following steroid use.. OTC topical steroids are used mainly to treat eczema and dermatitis. Almost 50% of users treating these conditions exceed the limits of the rather restrictive OTC marketing authorization. Clinicians should be aware of the potential for adverse effects as a result of patients self-medicating with hydrocortisone or clobetasone for an extended period.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Child; Child, Preschool; Clobetasol; Contraindications; Dermatitis; Drug Administration Schedule; Eczema; Female; Glucocorticoids; Humans; Hydrocortisone; Infant; Male; Middle Aged; Nonprescription Drugs; Patient Satisfaction; Self Administration; Skin Diseases; Surveys and Questionnaires; United Kingdom

Pseudo-inflammatory tumours are a poorly defined group of tumours, with indeterminate malignant potential, which can occur at almost any site of the body. The optimal treatment of inflammatory pseudo-tumours is yet to be elucidated. Surgical excision has been the most frequently reported treatment in the literature. We report a case of solitary cutaneous inflammatory pseudo-tumour.

Topics: Adult; Clobetasol; Glucocorticoids; Granuloma, Plasma Cell; Humans; Male; Shoulder; Skin Diseases

Previous studies have shown the antidotal efficacy of topical iodine at 15 and 30 min post-exposure to sulfur mustard (SM). Here we demonstrate efficacy at longer intervals (20, 30, 45, and 60 min, respectively, for data) using an improved topical povidone-iodine preparation termed N66, which contains steroidal and non-steroidal anti-inflammatory agents. In the mouse, N66 reduced severity of ear edema by 43, 47, 44, and 36%; ear epidermal ulceration by 74, 58, 45, and 58%; and epidermal necrosis by 54, 34, 26, and 31% at the respective time points. A similar effect was observed with encrustation. The healing marker, grade of acanthotic area, showed dramatic increases of 39.6-, 25.3-, 20.9-, and 22-fold. Severity of the dermal parameters, acute inflammation and dermal necrosis, was reduced by 63, 34, 34, and 38% and 80, 54, 54, and 59%, respectively. In guinea pig skin, topical treatment with N66 45 min post-exposure reduced the SM-induced ulceration area by 75%. The histological parameters subepidermal microblister formation, epidermal ulceration, epidermal necrosis, and encrustation were reduced by 63, 61, 41, and 41%, respectively. The healing marker, grade of acanthotic area, was elevated by 73%. N66 induced a statistically significant reduction in two dermal markers for tissue damage: acute inflammation (33%) and dermal necrosis (48%). Reduced skin damage was also observed in areas adjacent the treated sites. The pharmacologically active components of N66 showed additive effect. These findings suggest that the povidone-iodine preparation combined with anti-inflammatory agents functions as a potent antidote against skin lesions induced by SM at relatively long intervals between exposure and treatment.

Topics: Administration, Topical; Animals; Anti-Inflammatory Agents; Chemical Warfare Agents; Clobetasol; Disease Models, Animal; Drug Combinations; Ear Diseases; Edema; Guinea Pigs; Male; Mice; Mice, Inbred ICR; Mustard Gas; Piroxicam; Povidone-Iodine; Protective Agents; Skin; Skin Diseases; Skin Irritancy Tests; Time Factors

Atrophic plaques with white borders are occasionally seen on sun-exposed areas of the skin. These patients are usually elderly and have solar elastosis. This condition is referred to as annular atrophic plaques of skin and we describe a typical case.

Topics: Aged; Atrophy; Biopsy; Chronic Disease; Clobetasol; Diagnosis, Differential; Epidermis; Humans; Keratosis; Male; Sclerosis; Skin Diseases

Topics: Administration, Cutaneous; Adult; Clobetasol; Eyelid Diseases; Facial Dermatoses; Female; Humans; Nose Diseases; Sarcoidosis; Skin Diseases

The lesions of 141 patients with chronic skin diseases unresponsive to therapy were treated once a week with clobetasol propionate lotion left under the completely occlusive patch Duoderm. In 131 patients the lesions resolved completely, while partial remission was observed in the remaining 10. The mean interval to complete remission was: for chronic plaque psoriasis, 12 days; psoriasis on palms and soles, 2.5 weeks; palmoplantar pustulosis, 2.2 weeks; skin lesions of Reiter's syndrome, 3 weeks; chronic lichenified eczema, 2.0 weeks; neurodermatitis, 3.1 weeks; breast eczema, 9 days; discoid lupus erythematosus, 3.7 weeks; lichen planus, 2.8 weeks; sarcoidosis, 4 weeks; and lichen sclerosus et atrophicus, 2 weeks. Other conditions benefitting from the treatment were pompholyx, necrobiosis lipoidica, granuloma annulare and pretibial myxedema. The amount of topical corticosteroids needed was reduced to at most 1/20 and to as little as 1/100, compared with common topical steroid preparations.

Topics: Adult; Bandages, Hydrocolloid; Chronic Disease; Clobetasol; Colloids; Humans; Occlusive Dressings; Skin Diseases; Treatment Outcome

The lesions of 161 patients with chronic skin diseases that were unresponsive to therapy were treated once a week with clobetasol propionate lotion left under the completely occlusive patch Duoderm. The lesions completely resolved after a period of nine days to four weeks in 148 patients, while partial remission was observed in the remaining 13. The following diseases responded favourably: chronic plaque psoriasis, psoriasis on palms and soles, palmoplantar pustulosis, skin lesions related to Reiter's syndrome, chronic lichenified eczema, neurodermatitis, breast eczema, discoid lupus erythematosus, lichen planus, sarcoidosis, lichen sclerosus et atrophicus and lymphocytic infiltrate of Jessner. Relapses were infrequent when complete histological remission had been achieved. Other diseases which improved with this treatment were pompholyx, necrobiosis lipoidica, granuloma annulare and pretibial myxoedema.

Topics: Administration, Cutaneous; Adult; Bandages, Hydrocolloid; Chronic Disease; Clobetasol; Colloids; Humans; Occlusive Dressings; Skin Diseases

Topics: Clobetasol; Humans; Skin Diseases; Vasoconstrictor Agents

Topics: Administration, Topical; Adult; Clobetasol; Female; Gingival Hypertrophy; Humans; Sarcoidosis; Skin Diseases

The clinical and histological response to 12 weeks of treatment with a very potent topical fluorinated steroid was studied in 15 patients with vulval lichen sclerosus (LS) who were treated with twice daily applications of clobetasol propionate 0.05% cream (Dermovate, Glaxo U.K.). Thirteen patients completed the study and all showed a marked clinical improvement. Histological measurements of skin biopsies taken before and after treatment showed a significant reduction in the characteristic features of LS. One patient developed contact sensitivity to clobetasol propionate. There was no evidence of infection or skin atrophy during the study. Patients completing the study have been followed up for up to 22 months and have been maintained in remission with moderately potent topical steroids which had previously been ineffective.

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Clobetasol; Female; Follow-Up Studies; Humans; Middle Aged; Skin; Skin Diseases; Vulvar Diseases

The treatment of granuloma annulare is still unsatisfactory. A number of topical and systemic therapies have been tried, some of which can improve the condition, but serious side effects are possible with those reported so far. We treated a patient with disseminated granuloma annulare by local application of a vitamin E emulsion and achieved a marked improvement within as little as 12 days.

Topics: Administration, Oral; Administration, Topical; Aged; Aged, 80 and over; Breast Neoplasms; Clobetasol; Drug Therapy, Combination; Female; Granuloma; Humans; Paraneoplastic Syndromes; Skin Diseases; Vitamin E

Superpotent topical steroids used to treat psoriasis and steroid-responsive dermatoses may produce local cutaneous side effects, including atrophy, steroid acne, perioral dermatitis, hypopigmentation, hypertrichosis and superinfections. Suppression of the hypothalamic-pituitary-adrenal axis may be one of the systemic side effects. Superpotent topical steroids should not be used under occlusion, in flexural areas, on the face and in children. The total amount used per week and the duration of treatment should be carefully monitored.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Glucocorticoids; Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Skin Diseases

Milia developed in two patients with different chronic dermatoses after 2 weeks of treatment with clobetasol propionate ointment. Routine histologic and immunohistochemical analysis showed the cysts to be of eccrine gland origin.

Topics: Administration, Topical; Aged; Betamethasone; Clobetasol; Epidermal Cyst; Female; Humans; Male; Middle Aged; Skin Diseases

It is now well established that epidermis, like many other tissues, contains a phospholipase A2 that is responsible for the initiation of the arachidonic acid cascade. Here we report that human epidermis also contains a second, quite distinct enzyme of the phospholipase A2 group, which is unique in its extreme activity against phospholipids in true solution. It also differs from the classic cutaneous enzyme in that (a) its activity is not reduced by pretreatment of the skin with corticosteroids in vivo nor by treatment of the epidermal homogenate with alkaline phosphatase in vitro, and (b) its activity is reduced, rather than increased, in the lesions of inflammatory diseases such as psoriasis. The enzyme seems to occur mainly in fully differentiated keratinocytes, its level being low in the basal cell layer of epidermis and in keratinocytes cultured in vitro. On the basis of these observations, we suggest that this new phospholipase A2 is responsible for the degradation of phospholipids that accompanies the terminal keratinization process.

Topics: Alkaline Phosphatase; Cells, Cultured; Clobetasol; Eczema; Epidermis; Humans; Keratins; Lichen Planus; Phospholipases; Phospholipases A; Phospholipases A2; Psoriasis; Skin Diseases; Trypsin

In conclusion, there can be no doubt that CP is a remarkable local steroid with potency greater than anything previously available to the dermatologist. It may be useful for short-term (less than 2 weeks) and intermittent treatment of widespread inflammatory dermatoses. It is excellent for treating some stubborn localized inflammatory dermatoses before moving on to more dilute preparations. When prescribing CP, it is important to warn the patient of common side effects, such as atrophy and striae, and to instruct the patient carefully in its use, mentioning body areas that should be spared its application. CP should not be applied to flexural, scrotal, or, with a few exceptions such as discoid lupus erythematosus and actinic reticuloid, facial skin. Its use is contraindicated in infants, toddlers, and children under 12 years of age. In addition, adult patients must be told never to use more than 50 gm per week (the manufacturer's recommendation). The prescribing physician must monitor and regularly review the amount used per unit time. Treatment with CP beyond 2 weeks is not recommended in the product information on CP listed in the Physicians' Desk Reference (1988). Those few patients taking CP for a long period should be managed as though they are on systemic steroids. Episodes of acute stress, such as surgery and intercurrent infection, should be managed with supplemental, if necessary parenteral, glucocorticoid administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Topical; Betamethasone; Clobetasol; Eczema; Humans; Psoriasis; Skin Diseases

The effect of topical clobetasol propionate and a 1% topical indomethacin gel which could inhibit UV erythema was measured on anthralin inflammation by change in skin-fold thickness and erythema. The time course of the inflammatory oedema and erythema were different, as was their response to the drugs studied. The oedema of anthralin inflammation was completely inhibited by clobetasol propionate but the erythemal response showed a small and non-significant reduction. Indomethacin had no effect on anthralin oedema but produced a small but significant reduction in erythema in the first 24 h after anthralin application. These results suggest that either anthralin inflammation is not due to production of prostenoids, or that if it is, it occurs by other than the classical enzymic pathway.

Topics: Adult; Aged; Anthracenes; Anthralin; Betamethasone; Clobetasol; Dermatitis, Contact; Edema; Erythema; Female; Humans; Indomethacin; Male; Middle Aged; Skin Diseases; Ultraviolet Rays

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Female; Glucocorticoids; Humans; Male; Skin Diseases

Thirty-eight patients suffering from dermatological conditions of various natures were treated by means of the simultaneous application of a combination of three creams, the bases of which were sodium fusidate, ketoconazole and clobetasone butyrate respectively. Positive results, in the form of remission of symptoms, were obtained in 86.7% of the cases. Local tolerance was excellent in all cases and no adverse reactions were observed.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clobetasol; Dermatologic Agents; Drug Therapy, Combination; Female; Fusidic Acid; Humans; Infant; Ketoconazole; Male; Middle Aged; Skin Diseases

Topics: Administration, Topical; Anti-Inflammatory Agents; Clobetasol; Glucocorticoids; Humans; Skin Diseases

Forty out-patients suffering from a variety of skin diseases were treated over a period of 7 to 14 days (mean 9.6 days) with twice-daily applications of an extempore combination of sodium fusidate, clobetasone butyrate and ketoconazole creams. The severity of symptoms was assessed before, after 5 days and at the end of treatment and an overall evaluation made of response to therapy. The findings indicated that there was clinical cure or significant improvement in 37 (92.5%) of the patients, with excellent tolerance and no reports of any adverse reactions.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Antifungal Agents; Child; Child, Preschool; Clobetasol; Drug Combinations; Female; Fusidic Acid; Humans; Ketoconazole; Male; Middle Aged; Skin Diseases

Topics: Adolescent; Adult; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clobetasol; Eczema; Female; Humans; Male; Middle Aged; Ointments; Psoriasis; Skin Diseases

Topics: Betamethasone; Clobetasol; Humans; Skin Diseases

Topics: Adult; Aged; Betamethasone; Child; Clobetasol; Female; Humans; Male; Middle Aged; Ointments; Skin Diseases

Topics: Betamethasone; Clobetasol; Double-Blind Method; Drug Evaluation; Evaluation Studies as Topic; Humans; Ointments; Skin Diseases

Topics: Adolescent; Adult; Aged; Betamethasone; Clobetasol; Female; Humans; Male; Middle Aged; Skin; Skin Diseases; Vasoconstriction

Topics: Administration, Topical; Betamethasone; Clobetasol; Female; Humans; Male; Skin Diseases

Topics: Administration, Topical; Adult; Betamethasone; Child; Clobetasol; Female; Humans; Psoriasis; Skin Diseases