hoe-777 and Dermatitis--Contact

In this study, we investigated the effect of calcipotriol, prednicarbate and clobetasol 17-propionate on skin thickness over a treatment period of 6 weeks. The study was conducted as a controlled, randomized, double-blind comparison. The influence of these drugs on normal skin under occlusive conditions was assessed visually and by measuring skin thickness using 20 MHz B mode ultrasound. Both topically applied glucocorticosteroids lead to a significant decrease in skin thickness. In contrast to the glucocorticosteroid-induced atrophy, calcipotriol application on normal skin leads to an increase in skin thickness in all volunteers. The effect remains constant for the duration of treatment. The cause of this increase seems to be an irritative reaction of the skin which was histologically investigated in one volunteer. The histological features of this reaction are characteristic for a subacute dermatitis. The implications of these findings for the therapeutic mechanism of calcipotriol are discussed.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Atrophy; Calcitriol; Clobetasol; Dermatitis, Contact; Dermatologic Agents; Double-Blind Method; Female; Glucocorticoids; Humans; Male; Middle Aged; Prednisolone; Skin; Ultrasonography

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Child; Dermatitis, Contact; Glucocorticoids; Humans; Neurodermatitis; Prednisolone; Psoriasis

Capsaicin applied to human skin provokes a response known as neurogenic inflammation. Neuropeptides (substance P, CGRP), released from afferent C-fiber terminals and histamine, secondarily released from mast cells, are supposed to participate in this reaction. We investigated the contribution of arachidonic acid and metabolic products to neurogenic inflammation, using a potent topically applied glucocorticoid and the corresponding vehicle. Arachidonic acid is liberated from membrane phospholipids by phospholipase A2, an enzyme that can be blocked by glucocorticoids. In 12 healthy volunteers, neurogenic inflammation was induced by capsaicin 1% on both upper forearms after 16 h of topical pretreatment with either prednicarbate or vehicle. Neurogenic inflammation was assessed by laser Doppler flowmetry and by planimetry of flare sizes. Prednicarbate significantly reduced the laser Doppler flow values inside the flare responses, as well as the flare sizes themselves. These results show that to some extent glucocorticoids reduce capsaicin-induced neurogenic inflammation.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Capsaicin; Dermatitis, Contact; Forearm; Humans; Ointments; Pharmaceutical Vehicles; Prednisolone; Regional Blood Flow; Skin

Two female patients developed an allergic contact dermatitis after using Dermatop cream and -ointment for several weeks. Patch tests were positive with the reagent prednicarbate itself. No cross reactions to other glucocorticosteroids were observed. Type-IV-sensitization to glucocorticosteroids should be considered if chronic dermatitis does not improve, or even becomes worse, in spite of adequate therapy. With regard to possible cross reactions or multiple sensitization, epicutaneous tests with other glucocorticosteroids are necessary.

Topics: Adolescent; Aged; Anti-Inflammatory Agents; Dermatitis, Contact; Eczema; Female; Humans; Prednisolone; Skin Tests

Topics: Aged; Anti-Inflammatory Agents; Dermatitis, Contact; Female; Humans; Leg Ulcer; Prednisolone; Recurrence

Prednicarbate (Dermatop) was topically applied in 50 children suffering from inflammatory dermatoses. In 12 children, the courses of therapy were documented by photographs. Its rapid onset of action, its lacking suppression of the endogenic biosynthesis of cortisol, as well as its small antiproliferative effect on cutaneous fibroblasts suggest that prednicarbate bears only minor risks especially for children's skin.

Topics: Administration, Topical; Anti-Inflammatory Agents; Child; Child, Preschool; Dermatitis; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Seborrheic; Eczema; Female; Humans; Male; Prednisolone

In 20 patients suffering from acute or chronic inflammatory dermatoses, topical treatment with prednicarbate (Dermatop) was photographically documented and evaluated. Because of the rapid and pronounced anti-inflammatory and anti-edematous effect of prednisolone-17-ethyl carbonic ester without halogenic groups, therapy took only 7 to 21 days. Since there was practically no suppression of the endogenic biosynthesis of cortisol and no atrophogenic potency, we expected a minimum of side effects along with a maximum of therapeutic results.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Dermatitis; Dermatitis, Atopic; Dermatitis, Contact; Eczema; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prednisolone; Psoriasis

We report on the clinical efficacy of the local corticoid prednicarbate (chemical name: prednisolone-17-ethyl carbonate-21-propionate). In a concentration of 0.25%, it can be assigned to corticoid force class III. We think it's remarkable that even extensive application of 20 g daily in patients with affected skin and 30 g daily in healthy persons does not cause any suppression of plasma cortisol. Extreme long-term application (12 months) in 4 test persons did not result in any clinical, histological, or electron microscopical signs of topical atrophy; only one case showed slight hypertrichosis. These studies show that we may regard the original opinion as disproved that efficacy and side effects of corticoids are always inseparably linked together. To our minds, this preparation constitutes an essential step towards solving the problem of long-term application of a topical corticoid wherever it may be necessary from the dermatologic point of view, e.g. especially in atopic dermatitis and psoriasis.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone Valerate; Child; Cortisone; Dermatitis; Dermatitis, Atopic; Dermatitis, Contact; Desoximetasone; Double-Blind Method; Drug Evaluation; Female; Humans; Male; Middle Aged; Prednisolone; Psoriasis