clobetasol and Telangiectasis

Topics: Administration, Cutaneous; Adult; Atrophy; Betamethasone Valerate; Biopsy; Cell Count; Clobetasol; Drug Evaluation; Female; Glucocorticoids; Humans; Hydrocortisone; Keratinocytes; Male; Middle Aged; Occlusive Dressings; Pharmaceutical Vehicles; Prednisolone; Skin; Telangiectasis; Ultrasonography

Currently, there are no accurate and simple methods available to measure this risk of atrophy in patients treated with topical glucocorticosteroids. In the present clinical trial, we validated a new score (Dermaphot(®) score) to assess the atrophogenic potential of glucocorticosteroids. 36 healthy adult volunteers were included in an investigator-initiated, blinded, randomized, intra-individual comparison, vehicle controlled multi-centre study. Subjects were treated in a randomized manner for 3 weeks with pimecrolimus cream 1 %, mometasone furoate (1 mg/g), clobetasol propionate 0.05 % and vehicle. In addition, ultrasound examination for skin thickness was performed. Data demonstrated a direct correlation of the achieved Dermaphot(®) score and the ultrasound thickness measurements. Our study shows that the Dermaphot(®) score can be used as a simple method to evaluate the atrophogenic potential of glucocorticosteroids. Respectively, we showed that the new score is an easy, valid and sensitive new tool for early detecting and quantifying even subclinical glucocorticosteroid-induced skin damage. We demonstrated that the score is able to differentiate the extent of skin atrophy (damage) after 3 weeks of topical glucocorticosteroid application with different levels of skin transparency and levels of telangiectasia.

Topics: Adult; Atrophy; Clobetasol; Female; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Reproducibility of Results; Severity of Illness Index; Skin; Tacrolimus; Telangiectasis; Young Adult

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

Owing to its anti-inflammatory, antipruritic, vasoconstrictive, and immune-modulating properties, clobetasol propionate is used to treat psoriasis. This study was conducted to evaluate the efficacy, safety, and cosmetic acceptability of clobetasol propionate lotion compared with its vehicle and with clobetasol propionate cream in the treatment of moderate to severe plaque-type psoriasis. A total of 222 patients were treated. After 4 weeks of treatment, clobetasol propionate lotion was more efficient than vehicle lotion and of equivalent efficacy as clobetasol propionate cream. Cosmetic acceptability was significantly better with clobetasol propionate lotion than with clobetasol propionate cream. Clobetasol propionate lotion was efficient, safe, and well tolerated and offers a significantly higher cosmetic advantage in the treatment of moderate to severe plaque-type psoriasis compared with clobetasol propionate cream.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Clobetasol; Female; Humans; Male; Middle Aged; Psoriasis; Skin; Telangiectasis; Treatment Outcome

Topics: Administration, Cutaneous; Adolescent; Adult; Anti-Inflammatory Agents; Atrophy; Child; Child, Preschool; Clobetasol; Female; Follow-Up Studies; Glucocorticoids; Humans; Male; Ointments; Skin; Skin Diseases, Vesiculobullous; Skin Pigmentation; Telangiectasis; Treatment Outcome; Vitiligo

Topics: Administration, Cutaneous; Betamethasone Valerate; Clobetasol; Double-Blind Method; Drug Eruptions; Emulsions; Glucocorticoids; Humans; Pharmaceutical Vehicles; Prednisolone; Silicone Elastomers; Skin; Skin Diseases, Eczematous; Surface Properties; Telangiectasis; Triamcinolone Acetonide

Five corticosteroid ointments and placebo were compared in 17 volunteers with regard to their influence on normal skin under occlusive conditions. Each volunteer had six simultaneous applications on the forearms and six on the back. The trial was double-blind and lasted 4 weeks. The ointments were placed in randomized order. The treatments were 0.1 and 0.03% domoprednate, 0.1% hydrocortisone butyrate, 0.1% betamethasone valerate, 0.05% clobetasole propionate and placebo. Skin thickness was measured on days 0, 7, 14, 21 and 28, transepidermal water loss on days 0, 14 and 28, while blood flow and telangiectasias were evaluated only on day 28 at termination of the trial. The skin thickness became significantly reduced on all corticosteroids, but not on placebo; 0.03% domoprednate, however, tended to have an intermediate position between placebo and the other ointments. The transepidermal water loss did not change. Rating of telangiectasia under stereomicroscope showed a significantly lower score after 0.03% domoprednate and placebo as compared to the other ointments. Assessment of telangiectasia by laser-Doppler flowmetry showed a similar tendency. It is concluded that 0.1% domoprednate is comparable to other topical corticosteroids with respect to atrophogeneity and formation of telangiectasia, but the 0.03% concentration seems to result in fewer side effects.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Atrophy; Betamethasone; Betamethasone Valerate; Clinical Trials as Topic; Clobetasol; Dermatologic Agents; Double-Blind Method; Female; Humans; Hydrocortisone; Male; Pregnadienes; Random Allocation; Skin; Telangiectasis; Ultrasonography

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Candidiasis, Vulvovaginal; Clobetasol; Diflucortolone; Female; Herpes Genitalis; Humans; Middle Aged; Papillomavirus Infections; Telangiectasis; Time Factors; Vulvar Lichen Sclerosus; Young Adult

A case of lichen sclerosus that developed in a pattern corresponding to the lines of Blaschko is described. This pattern of extragenital lichen sclerosus has not, to our knowledge, previously been reported and could result from an epidermal clone with altered androgen sensitivity supporting a hormonal pathogenesis for this disease.

Topics: Abdomen; Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Atrophy; Clobetasol; Clone Cells; Dehydroepiandrosterone Sulfate; Epidermis; Female; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Purpura; Skin; Telangiectasis; Testosterone

The effects of hydrocortisone, dexamethasone, betamethasone 17-valerate and clobetasol propionate at concentrations of 10(-5)-10(-12) M on the proliferation of human dermal microvascular endothelial cells (HDMEC) were studied in vitro. In addition, confluent HDMEC were treated with TNF (1000 U/ml) or IL-1 beta (1000 U/ml) alone or in combination with the corticosteroids (10(-5) M, 10(-6) M) for 24 h, and cytokine-induced expression of intercellular adhesion molecule-1 (ICAM-1) was assessed by immunocytochemistry. Controls were treated either with growth medium or with the corticosteroids alone. All tested corticosteroids stimulated HDMEC growth after 4 and 6 days of treatment in a dose-dependent manner, as assessed by 3H-thymidine incorporation and the 4-methyl-umbelliferyl heptanoate (MUH) assay. The minimal effective concentration was 10(-9) M for hydrocortisone, 10(-10) M for dexamethasone and betamethasone, and 10(-12) M for clobetasol. In untreated and in corticosteroid-treated cultures, less than 5% of the cells expressed ICAM-1. TNF and IL-1 beta were strong inducers of ICAM-1 expression on 74% and 82% of the cells, respectively. None of the tested corticosteroids significantly influenced cytokine-induced ICAM-1 expression, suggesting that the anti-inflammatory effects of corticosteroids are not related to ICAM-1 modulation on HDMEC.

Topics: Adrenal Cortex Hormones; Betamethasone Valerate; Cell Adhesion Molecules; Cell Division; Cells, Cultured; Clobetasol; Dexamethasone; Endothelium, Vascular; Humans; Hydrocortisone; Intercellular Adhesion Molecule-1; Interleukin-1; Recombinant Proteins; Skin; Telangiectasis; Tumor Necrosis Factor-alpha