desonide and Dermatitis--Atopic

Desonide foam is a newly approved topical corticosteroid preparation of 0.05% desonide. It has been shown effective compared with vehicle placebo in the treatment of mild-to-moderate atopic dermatitis in both pediatric and adult populations. Given the favorable safety profile of all other desonide preparations and their utility as a low potency corticosteroid, desonide foam promises to be a useful addition to the armamentarium, when other desonide vehicles might be less acceptable.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Child; Dermatitis, Atopic; Desonide; Humans; Pharmaceutical Vehicles

Atopic dermatitis (AD) is a chronic cyclical inflammatory skin disease that is increasing in incidence. Twenty percent of those affected with AD are infants and young children. Despite the development of newer nonsteroidal topical therapies, such as calcineurin inhibitors, topical corticosteroids remain the gold standard for the treatment of active eczematous disease and management of exacerbation due to established efficacy and safety with appropriate use. The xerotic, sensitive skin of AD patients mandates the use of nonirritating and nondrying topical vehicles. Recently, phase III clinical studies have demonstrated the safety and efficacy of a novel aqueous hydrogel vehicle for desonide delivery in mild to moderate AD, which is free of fragrances and surfactants. Corneometry and transepidermal water loss studies have demonstrated that this patented hydrogel vehicle alone offers advantages including moisturization and skin barrier enhancement, both of which are significant when treating eczematous and xerotic skin. Patient and physician preference surveys suggest that the novel properties of this vehicle may aid in patient compliance with AD therapy.

Topics: Anti-Inflammatory Agents; Clinical Trials, Phase III as Topic; Dermatitis, Atopic; Desonide; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Skin; Treatment Outcome; Water Loss, Insensible

Topics: Administration, Topical; Anti-Infective Agents, Local; Bacterial Adhesion; Dermatitis, Atopic; Desonide; Humans; Staphylococcal Skin Infections; Staphylococcus aureus; Virginiamycin

To observe and analyze the clinical efficacy of mucopolysaccharide polysulfate (MPS) ointment combined with desonide ointment in treatment of infantile eczema. A total of 180 infants who had been treated for eczema at our hospital were enrolled. The patients were divided into control group accepting desonide ointment only and research group accepting mucopolysaccharide polysulfate ointment and desonide ointment. The therapeutic efficacies of two groups were compared. Results: By comparing the total therapeutic efficacy, results showed that the total efficacy of the research group was 96.67%, while that value of the control group was 82.22%, making the total efficacy of the research group significantly higher (p<0.05). And the improvement of the Eczema Area and Severity Index (EASI) score in the research group after drug administration was significantly better than that of the control group (p<0.05). Moreover, there was a greater decrease in the recurrence rate of the research group than that of the control group (p<0.05). Combined application of mucopolysaccharide polysulfate ointment and desonide ointment can achieve better therapeutic effect in treatment of infantile eczema.

Topics: Anti-Inflammatory Agents; Child, Preschool; Dermatitis, Atopic; Desonide; Drug Therapy, Combination; Female; Glycosaminoglycans; Humans; Infant; Male; Ointments; Treatment Outcome

Itch is a common and troubling symptom of atopic dermatitis. It is not mediated by histamine, and standard anti-itch therapies, therefore, have limited benefit for most AD patients. Instead, anti-inflammatory agents are used to reduce inflammation and therefore improve associated itch. Studies confirm that long-term use of corticosteroids can lead to a reduction in pruritus. A pilot study was designed to assess the effects of one week of twice-daily application of desonide hydrogel 0.05% for the treatment of atopic dermatitis. Active treatment was associated with significant improvements in IGA scores at day 3 and day 7 (mean score 0.55, 75.83% improvement from Baseline; P <.0001) and pruritus VAS scores at day 3 and day 7 (mean 6.35-point, 86.61% reduction in VAS scores; P <.0001). Treatment with the convenient, hydrating hydrogel formulation is effective and associated with an improvement in subjects' quality of life.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Child; Dermatitis, Atopic; Desonide; Female; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Male; Middle Aged; Pilot Projects; Pruritus; Quality of Life; Treatment Outcome; Young Adult

Topical steroids are used for the treatment of primary atopic dermatitis (AD); however, their associated risk of serious complications is great due to the presence of vulnerable lesions in young children with AD. Topical calcineurin inhibitors (TCIs) are steroid-free, anti-inflammatory agents used for topical AD therapy. However, their use is prohibited in infants <2 years of age because of their carcinogenic potential. We conducted a randomized, double-blind trial to evaluate the efficacy of TCIs as a secondary AD treatment for children <2 years of age by comparing 1% pimecrolimus cream with 0.05% desonide cream. We performed urinary metabolomics to predict long-term side effects. The 1% pimecrolimus cream displayed similar efficacy and exceptional safety compared with the 0.05% desonide cream. Metabolomics-based long-term toxicity tests effectively predicted long-term side effects using short-term clinical models. This applicable method for the functional interpretation of metabolomics data sets the foundation for future studies involving the prediction of the toxicity and systemic reactions caused by long-term medication administration.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Dermatitis, Atopic; Desonide; Double-Blind Method; Female; Humans; Infant; Male; Metabolomics; Predictive Value of Tests; Skin Cream; Tacrolimus; Time Factors

The stratum corneum typically is compromised in patients with atopic dermatitis (AD). Beneficial AD treatments should provide moisture to the skin as well as restore impaired barrier function. Traditional treatments involve ointments or creams. A clinical study was conducted to determine if desonide in a hydrogel vehicle (HGV) could improve the moisture content and barrier function of the stratum corneum in adults with mild to moderate AD. Participants applied desonide hydrogel 0.05% twice daily for 4 weeks to areas of both lesional and nonlesional skin. Corneometry and transepidermal water loss (TEWL) were measured at baseline and weeks 1, 2, and 4. Statistically significant improvements in corneometry and TEWL measurements on lesional skin were observed at all study visits compared with baseline (all P < or = .002 and P < or = .04, respectively).

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Dermatitis, Atopic; Desonide; Female; Humans; Hydrogels; Male; Middle Aged; Severity of Illness Index; Skin; Treatment Outcome; Water Loss, Insensible; Young Adult

The properties of vehicle formulations may influence drug delivery, efficacy, and tolerance profiles of topical medications. Patient preferences vary and the importance of certain aesthetic attributes depend on the disease state, the site of application, and the length and extent of treatment, among other factors. Formulations that offer aesthetic advantages over traditional vehicles may improve patients' willingness to apply therapy as directed and therefore may affect the outcome of treatment. A participant preference study was conducted to determine if an aqueous gel (hydrogel) formulation of desonide would appeal to patients with atopic dermatitis (AD). Before treatment adult participants with AD completed a questionnaire to assess their AD history and prior topical treatments and to rate the importance of topical vehicle attributes. Each participant then applied desonide hydrogel 0.05% to affected areas twice daily for 4 weeks. At the end of the treatment, participants were queried on the attributes of desonide hydrogel and how it compared with other vehicles previously used. Twenty-two participants with mild to moderate AD completed the study; 100% (22/22) of participants found desonide hydrogel to be easy to apply/use/spread, easy to use on hair-bearing skin, comfortable to use under makeup and/or cosmetics, suitable for use on multiple body areas, and stain free. Most participants reported that the product was soothing (82% [18/22]), did not dry the skin (96% [21/22]), disappeared quickly (82% [18/22]), was comfortable to wear under clothes (91% [20/22]), and was not greasy or shiny on skin (96% [21/22]).

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Dermatitis, Atopic; Desonide; Female; Humans; Hydrogels; Male; Middle Aged; Patient Preference; Pharmaceutical Vehicles; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome; Young Adult

Desonide 0.05% was recently developed in an emulsion foam formulation.. The safety of desonide foam 0.05% in children aged 3 months to 17 years was evaluated in two phase II studies and one phase III study.. A phase II open-label study of the effect of desonide foam 0.05% on the hypothalamic-pituitary-adrenal axis was evaluated in pediatric and adolescent participants with mild-to-moderate atopic dermatitis. The phase II and III clinical efficacy studies evaluated adverse events.. At the end of the 4-week treatment in the phase II study, 4% (3 of 75) of participants experienced mild, reversible hypothalamic-pituitary-adrenal-axis suppression. The combined safety data from the phase II and III studies revealed 6% of participants in the desonide foam group and 14% in the vehicle foam group reported adverse events (P = .0002), with application site burning as the most commonly reported adverse event (3% in the desonide foam group vs 7% in the vehicle foam group; P = .004).. The studies evaluated short-term use only.. Desonide foam was safe and well tolerated in participants as young as 3 months.

Topics: Administration, Cutaneous; Adolescent; Anti-Inflammatory Agents; Child; Child, Preschool; Dermatitis, Atopic; Desonide; Drug Administration Schedule; Female; Humans; Hypothalamo-Hypophyseal System; Infant; Male; Pituitary-Adrenal System; Treatment Outcome; United States

Low to mid potency corticosteroids remain a cornerstone of therapy for atopic dermatitis (AD). Since AD is most prevalent in the younger pediatric population and is chronic in nature, safety is of particular concern especially for children under 2 years of age. A novel desonide (0.05%) formulation was developed in a nonirritating and moisturizing aqueous gel (hydrogel) that is free of alcohol and surfactants. The safety and efficacy of this new class VI low potency topical steroid was substantiated in 2 phase III clinical trials in mild to moderate AD subjects aged 3 months to 18 years (mean age 6.7 years and 30% under 3 years). A total of 425 subjects were treated with desonide hydrogel and 157 subjects with the hydrogel vehicle. Desonide hydrogel 0.05% was extremely well-tolerated and provided statistically significant improvements in all primary (P < .001) and secondary (P < .006) efficacy endpoints in both studies. This novel desonide formulation represents an advancement in the treatment of AD.

Topics: Adolescent; Anti-Inflammatory Agents; Child; Child, Preschool; Dermatitis, Atopic; Desonide; Double-Blind Method; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Hydrogels; Infant; Male; Steroids; Treatment Outcome

The differences between topical corticosteroids are based mainly on their potency, safety and patient acceptability. The aim of this study was to evaluate a mild- to mid-potent topical corticosteroid, desonide 0.05%, on these three parameters in an Australian cohort of patients with facial seborrhoeic or atopic dermatitis. Eighty-one adult patients were randomized to receive desonide 0.05% lotion or its vehicle, applied twice daily for 3 weeks under double-blind conditions. In the active treatment group, 88% of patients had their skin condition cleared or almost cleared and only two patients experienced cutaneous adverse events (rash and pruritus). The acceptability of the lotion was high; 95% of patients stated they would use this topical corticosteroid again. These data support the short-term use of desonide 0.05% lotion as a suitable agent for the short-term treatment of facial dermatitis.

Topics: Administration, Topical; Adolescent; Adult; Anti-Inflammatory Agents; Australia; Dermatitis, Atopic; Dermatitis, Seborrheic; Desonide; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Emulsions; Esthetics; Facial Dermatoses; Female; Follow-Up Studies; Glucocorticoids; Humans; Male; Middle Aged; Probability; Reference Values; Treatment Outcome

Desonide ointment has demonstrated a good safety and efficacy profile during the many years it has been used in treating dermatoses. However, there have been no controlled clinical trials to evaluate its systemic safety when used in treating children. Suppression of the hypothalamic-pituitary-adrenal (HPA) axis can occur after repeated application of topical corticosteroids. In general, the degree of suppression of the HPA axis function is related to the daily dosage of steroid given, the duration of its administration, the extent of body surface covered, and the potency of the corticosteroid. This study sought to determine the comparative effects of 0.05 percent desonide and 2.5 percent hydrocortisone ointments on the HPA axis of children with atopic dermatitis. There was no suppression of early morning cortisol in either treatment group. The ACTH-stimulated mean cortisol values after four weeks of treatment were not significantly different from the baseline values for either treatment group. We conclude that neither 0.05 percent desonide ointment nor 2.5 percent hydrocortisone ointment compromised the HPA axis of children with atopic dermatitis treated topically for four weeks.

Topics: Administration, Topical; Adrenocorticotropic Hormone; Anti-Inflammatory Agents; Child; Child, Preschool; Dermatitis, Atopic; Desonide; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Infant; Male; Ointments; Pituitary-Adrenal System

Desonide, a class 6 nonfluorinated topical corticosteroid, has been available for more than two decades. Hydrocortisone is widely used in the treatment of dermatoses in children.. Our purpose was to compare the safety and efficacy of desonide ointment and 1.0% hydrocortisone ointment in children with atopic dermatitis.. One hundred thirteen children (mean age, 4.8 years) with mild to moderate atopic dermatitis were enrolled in a multicenter, randomized, investigator-masked, parallel-group study. Treatments were applied twice daily for 5 weeks and extended to 6 months in 36 of the patients. Signs of atrophy were evaluated. Efficacy was determined by measuring global improvement, erythema, lichenification, excoriations, oozing or crusting, pruritus, and induration.. No differences in safety were observed between hydrocortisone and desonide. The investigator's global assessment of improvement significantly favored desonide over hydrocortisone during 3 months of treatment (p < 0.05).. Desonide ointment showed greater efficacy, produced more rapid improvement, and demonstrated an equivalent cutaneous safety profile when compared with 1% hydrocortisone ointment for up to 6 months.

Topics: Child; Child, Preschool; Dermatitis, Atopic; Desonide; Female; Humans; Hydrocortisone; Infant; Male; Ointments; Single-Blind Method; Time Factors

A double-blind, randomized trial was conducted to determine the influence of topical steroid therapy on atopic skin flora. The bacteriological and clinical effects of desonide (Locapred), compared with those of its excipient, were studied in 40 children. Clinical scoring and bacteriological sampling were performed before the start of the trial and after 7 days of once-daily topical treatment. Before treatment, no differences in clinical score or Staphylococcus aureus colonization were noted between the two groups. After treatment, the clinical score improved (P < 0.001) in the desonide group, and S. aureus density decreased dramatically (P < 0.001). In the excipient group, no significant differences in clinical score or S. aureus density were noted. A comparison of the two groups demonstrated statistically significant differences with regard to clinical score (P < 0.001) and S. aureus density (P < 0.05). These results show the efficacy of topical corticosteroid treatment alone on S. aureus colonization in atopic skin, and confirm the critical role of inflammation in bacterial colonization.

Topics: Adolescent; Child; Child, Preschool; Colony Count, Microbial; Dermatitis, Atopic; Desonide; Double-Blind Method; Excipients; Female; Humans; Infant; Male; Skin; Staphylococcus aureus

A randomized, double-blind, left-right study to compare the therapeutic efficacy and the cosmetic acceptability of the new hydrocortisone 17-butyrate (Locoid) 0.1% fatty cream application form with desonide (Apolar) 0.1% ointment was performed in thirty patients suffering from moderate to severe atopic dermatitis. The medications were applied to symmetrical, bilateral skin lesions twice daily for 4 weeks. Both treatments effected highly significant reductions of the score values for the severity of all clinical skin parameters assessed. Score reductions were, however, more pronounced on Locoid-treated sides than on Apolar-treated sides both after 2 and 4 weeks of therapy. It appeared further that clinical efficacy of treatment at completion of the study was also in favour of Locoid-treated sides, indicating that Locoid fatty cream is more effective than Apolar ointment. No serious side-effects were reported during the study. The expressed patient preferences with respect to cosmetic acceptability of treatments were significantly in favour of Locoid fatty cream, indicating that patients preferred the use of this new galenic formulation over an ointment formulation. It is concluded that the new application form of Locoid, a fatty cream, is a useful and beneficial addition to topical corticosteroid therapy, which will promote patient compliance in a wide range of corticosteroid-responsive skin diseases.

Topics: Administration, Topical; Adolescent; Adult; Anti-Inflammatory Agents; Clinical Trials as Topic; Dermatitis, Atopic; Dermatologic Agents; Desonide; Double-Blind Method; Female; Humans; Hydrocortisone; Male; Middle Aged; Ointments; Pregnadienetriols; Random Allocation; Time Factors

Six groups of children suffering from widespread atopic dermatitis were treated once daily with six topical steroids of different potency. Systemic effects were measured by the morning estimation of plasma cortisol. A clear relationship was demonstrated between clinical efficacy of the steroid treatment and degree of reduced adrenal function. This study demonstrated that a rapid and marked therapeutic effect can be obtained with potent topical steroids applied once daily without occlusion, but in children is accompanied by a fall in plasma cortisol.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Child; Child, Preschool; Clobetasol; Dermatitis, Atopic; Desonide; Diflucortolone; Drug Administration Schedule; Female; Fluocortolone; Halcinonide; Humans; Hydrocortisone; Infant; Male; Ointments

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Child; Child, Preschool; Clinical Trials as Topic; Dermatitis, Atopic; Dermatitis, Contact; Desonide; Double-Blind Method; Drug Evaluation; Female; Humans; Hydrocortisone; Male; Middle Aged; Pregnadienetriols

We report two pediatric patients with a history of chronic lichenified atopic dermatitis (AD) who subsequently developed eruptive lentigines at sites of resolved AD. The occurrence of this phenomenon in eczematous dermatoses in the absence of topical calcineurin inhibitor (TCI) use is rarely reported in the literature.

Topics: Anti-Inflammatory Agents; Child; Chronic Disease; Dermatitis, Atopic; Desonide; Female; Fluocinolone Acetonide; Glucocorticoids; Humans; Lentigo; Male

Atopic dermatitis affects up to 20% of children and continues to increase in prevalence. Effective disease control is aimed at decreasing symptoms and reducing the frequency of flares, which may be complicated by secondary bacterial infections. Although recent advances have produced a number of non-systemic treatment options, topical corticosteroids remain a fundamental component of treatment algorithms. J Drugs Dermatol. 2019;18(2 Suppl):s112-116.

Topics: Administration, Cutaneous; Anti-Bacterial Agents; Clinical Trials as Topic; Coinfection; Critical Pathways; Dermatitis, Atopic; Dermatology; Desonide; Glucocorticoids; Humans; Treatment Outcome

Topics: Administration, Cutaneous; Anti-Inflammatory Agents; Dermatitis, Atopic; Desonide; Humans; Hydrogels; Medication Adherence; United States

The objective of this study was to evaluate patients' real-world experiences with desonide hydrogel for the treatment of mild to moderate atopic dermatitis (AD). Physicians who participated in this patient-experience program identified eligible participants (age range, < 3 months to 91 years) for treatment with desonide hydrogel 0.05%. The medication was prescribed by each participant's physician according to his/her practice guidelines and was provided to the participant at no charge. Patients (or their parents/guardians) voluntarily participated by providing consent and completing 2 surveys: one at baseline (pretreatment) and the other approximately 3 weeks after initiation of desonide hydrogel treatment (posttreatment). The pretreatment survey included questions about prior topical medication use for AD and satisfaction with prior treatments. The second survey assessed compliance with desonide hydrogel, satisfaction with treatment, characteristics of desonide hydrogel, intent to continue treatment, and willingness to recommend desonide hydrogel to others. A total of 1185 participants completed both the pretreatment and posttreatment surveys. Participant satisfaction with desonide hydrogel was 95% greater than satisfaction with prior topical medications for AD (P < .01). Adherence to treatment with desonide hydrogel was more than 80% based on reports from participants. Eighty-nine percent of participants reported that they would continue to use the medication for their condition if needed and 85% would recommend desonide hydrogel to others. Prescribing physicians received individual summaries of survey responses reported by each of his/her participating patients, which provided valuable feedback regarding participants' perceptions of treatment. Participants reported favorable experiences after treatment with desonide hydrogel compared with prior topical therapies. Desonide is widely prescribed for the treatment of AD.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Data Collection; Dermatitis, Atopic; Desonide; Female; Humans; Hydrogels; Male; Medication Adherence; Middle Aged; Patient Satisfaction; Practice Guidelines as Topic; Practice Patterns, Physicians'; Severity of Illness Index; Young Adult

Patients with atopic dermatitis (AD) may have poor adherence for several reasons, including fear of side effects or dislike of messy topical therapies.. To assess adherence to and efficacy of a multifaceted program for atopic dermatitis using a lightweight, easy-to-apply medication and more frequent return visits.. Forty-one subjects with mild-to-moderate atopic dermatitis were instructed to use desonide hydrogel 0.05% twice daily. Disease severity was measured at baseline and weeks 1, 2 and 4. Subjects also received a follow-up phone call on day 3. Adherence was assessed using electronic monitors. At the end of the study, subjects sampled and rated the vehicle attributes of six different topical corticosteroid formulations.. Mean adherence to twice-daily application slowly declined over time, from 81% on day 1 to 50% by day 27. An improvement in pruritus was observed as early as day 3, and by week 4, mean pruritus and EASI scores improved from baseline by 60% and 61%, respectively. Mean SGA scores also improved to marked improvement/almost clear by week 4. In vehicle attribute surveys, the hydrogel was consistently rated higher than the other vehicles in all categories.. Subjects responded very well to treatment, and adherence to desonide hydrogel 0.05% was much better than previously reported with ointments. The early efficacy, favorable attributes of the hydrogel vehicle and judicious follow up likely increased adherence to topical therapy. The use of ointments or more potent topical steroids as a first choice may be counterproductive in the treatment of atopic dermatitis.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dermatitis, Atopic; Desonide; Female; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Infant; Male; Medication Adherence; Middle Aged