fluticasone and Skin-Diseases

Topical corticosteroids are the most widely used agents for the treatment of inflammatory skin disease, particularly atopic dermatitis and psoriasis. In selecting the most appropriate steroid preparation to use-among the vast array currently available-the clinician must consider the severity and localization of the disease, the risk of drug-induced adverse reactions, the age of the patient, and the potency of the various agents. Due to differences in bioavailability, the vehicle and application technique of corticosteroids must also be evaluated. Numerous clinical trials have demonstrated that fluticasone propionate-a fluorinated corticosteroid-is effective, safe, well tolerated, and offers the advantage of a low potential for systemic and local side effects.

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

Fluticasone propionate (FP) is generally considered to have twice the efficacy of beclomethasone dipropionate (BDP) on a weight-to-weight basis for the control of asthma, and may have lesser effects on adrenal function. However, the effects of FP and BDP on skin integrity and bone metabolism markers require further examination. Sixty-nine asthmatic subjects were enrolled in a double-blind crossover study in which, after a baseline period, they received BDP or FP (at half the dose of BDP) for two 4-month periods each. A questionnaire on skin bruising, a skin examination, tests of adrenal function and of markers of bone metabolism were performed after 2 months of each period. The number of asthma exacerbations was not significantly different for the two treatment periods (eight for BDP and nine for FP), nor were various indices of asthma control. Whereas the frequency of bruising reported by the questionnaire was not different, there were more bruises on examination for BDP (1.6+/-2.5) than for FP (1.2+/-2.3) (p=0.04). Although baseline serum cortisol was not significantly different for the two drugs, the increase in cortisol after cortrosyn was lower for BDP (357+/-158 micromol x dL(-1)) than for FP (422+/-144 micromol x dL(-1)) (p<0.01). Serum osteocalcin levels were significantly lower in subject on BDP (2.8+/-1.7 microg x mL(-1)) than on FP (3.5+/-1.9 ng x mL(-1)) (p=0.003). Other markers of bone metabolism were not significantly altered. The three major side-effects were loosely, but significantly correlated with the periods on BDP and FP. However, skin bruises, increase in cortisol after Cortrosyn and osteocalcin were not significantly correlated for the period on either BDP or FP. In conclusion, whereas fluticasone propionate used at half the dose of beclomethasone dipropionate has a comparable effect on the control of asthma, fluticasone propionate demonstrated fewer side-effects in terms of skin bruising, adrenal suppression and bone metabolism.

Topics: Administration, Inhalation; Administration, Topical; Androstadienes; Anti-Asthmatic Agents; Anti-Inflammatory Agents; Asthma; Beclomethasone; Contusions; Cross-Over Studies; Double-Blind Method; Female; Fluticasone; Humans; Hydrocortisone; Male; Middle Aged; Osteocalcin; Prospective Studies; Skin Diseases

The aim of this study was to evaluate the usefulness of fluticasone propionate in various dermatoses and to present the data to non-dermatologists. The study was performed at the Department of Dermatology, University School of Medicine in Poznań. The studied group consisted of 40 cases of various types of eczema, psoriasis vulgaris, DLE, photodermatoses and morphea. Fluticasone propionate cream or ointment was applied to lesional skin twice daily for 7-19 days. Acute eczematous skin lesions significantly improved after the first seven days of treatment, whereas in patients with chronic eczema the good therapeutic results were observed after 14-19 days. Fluticasone propionate was also effective in the treatment of DLE and photodermatoses.

Topics: Administration, Topical; Adolescent; Adult; Aged; Androstadienes; Anti-Inflammatory Agents; Drug Administration Schedule; Eczema; Female; Fluticasone; Glucocorticoids; Humans; Male; Middle Aged; Photosensitivity Disorders; Proteus Infections; Proteus vulgaris; Psoriasis; Scleroderma, Localized; Skin Diseases

Use of a continuous glucose-monitoring system (CGMS) in the management of type 1 diabetes (T1D) may cause local skin irritation.. To examine the effects of fluticasone propionate aqueous nasal solution (nsFP), sprayed topically prior to CGMS insertion among youth with T1D.. This is a case series observational report, including real-life 6-month follow-up data from one pediatric diabetes center. All patients suffering from local skin irritation due to CGMS adhesives were offered prevention form skin irritation by spraying 2 puffs of nsFP on the skin area prior to adhesion of CGMS. Data were collected from their charts after 6 months. Outcome measures included the difference in degree of skin irritation, number of days of CGMS use, BMI SDS, mean glucose, and HbA1c, prior to use and during 6 months after use.. Twelve patients used nsFP prior to CGMS insertion, mean age 8.6 ± 4.9 years and 66.7% males. Ten patients, median age 6.1 years (5.3-9.5) and 56% males, continued using nsFP for a mean of 0.56 ± 0.11 years, with no recurrence of local irritation nor dermatitis to same adhesive material. No differences were found before and after use of nsFP in CGMS mean glucose 180 mg/dl (153-202) versus 165 mg/dl (150-192). BMI SDS was slightly higher 0.44 (- 0.9-1.2) versus 0.25 (- 0.47-1.06), P = 0.05.. This small-scale, single-site description of a simple intervention by nsFP and favorable outcome provides valuable insight for a simple solution for skin irritation and dermatitis in the pediatric population with T1D.

Topics: Administration, Topical; Adolescent; Aerosol Propellants; Blood Glucose; Blood Glucose Self-Monitoring; Child; Child, Preschool; Diabetes Mellitus, Type 1; Equipment and Supplies; Female; Fluticasone; Follow-Up Studies; Humans; Infant; Male; Skin Diseases; Treatment Outcome; Young Adult

Topics: Adrenal Gland Diseases; Adult; Androstadienes; Betamethasone; Black People; Bleaching Agents; Dermatologic Agents; Female; Fluticasone; Humans; Hydroquinones; Ointments; Skin Diseases; Sudan