mometasone-furoate and Psoriasis

Sweet's syndrome was initially described as a reactive dermatosis characterized by sudden onset of fever, leucocytosis, and raised erythematous plaques infiltrated with neutrophils, and therefore called acute febrile neutrophilic dermatosis. However, later it became obvious that fever and neutrophilia are variable features, and a number of other characteristics have been described. Although the dorsa of the hands are frequently affected, the palmoplantar involvement mimicking pustulosis observed in our case appears to be unusual.

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Biopsy; Dapsone; Diagnosis, Differential; Drug Therapy, Combination; Fatal Outcome; Female; Glucocorticoids; Humans; Mometasone Furoate; Prednisolone; Pregnadienediols; Psoriasis; Skin; Sweet Syndrome

Mometasone, a synthetic 16 alpha-methyl analogue of beclomethasone, is classified as a 'potent' glucocorticoid for dermatological use. It is available as 0.1% cream, ointment and lotion formulations for the treatment of patients with inflammatory glucocorticoid-responsive dermatoses. In patients with atopic dermatitis, the effect of mometasone 0.1% applied once daily over 2 to 3 weeks were similar to those of other glucocorticoids of similar potency, such as betamethasone dipropionate 0.05% twice daily and methylprednisolone aceponate 0.1% once daily. Mometasone 0.1% was significantly superior to twice-daily application of less potent glucocorticoids such as clobetasone 0.05%, hydrocortisone 1.0%, hydrocortisone butyrate and hydrocortisone valerate 0.2%. In patients with seborrhoeic dermatitis, mometasone 0.1% was more effective than ketoconazole 2.0% and hydrocortisone 1.0% in trials lasting 4 or 6 weeks. In the management of scalp psoriasis and psoriasis vulgaris, mometasone 0.1% applied once daily for 2 to 8 weeks was generally more effective than other glucocorticoids of similar or weaker potency such as betamethasone valerate 0.1%, fluocinolone acetonide 0.025%, fluticasone propionate 0.005%, triamcinolone acetonide 0.1% and hydrocortisone 1.0% and as effective as diflucortolone valerate 0.1%. Alternate day application of mometasone 0.1% for 2 weeks was as effective as once-daily application in maintaining symptom control in a small number of patients with psoriasis vulgaris. Although mometasone demonstrates greater anti-inflammatory activity and a longer duration of action than betamethasone, it has low potential to cause adverse systemic effects such as suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Moreover, its atrophogenic potential is low and no greater than that of other glucocorticoids in its class, such as betamethasone valerate. Transient, mild to moderate, local adverse effects such as burning, stinging, folliculitis, dryness, acneiform eruptions and signs of skin atrophy have been reported with mometasone. Mometasone has shown a low risk of primary sensitisation and cross-reactions in preliminary patch test studies. Mometasone is a well tolerated topical glucocorticoid effective in the management of patients with atopic dermatitis, seborrhoeic dermatitis, scalp psoriasis and psoriasis vulgaris. In addition to its low potential for causing primary sensitisation and cross-reactions with other topical glucocorticoids, mometaso

Topics: Administration, Topical; Anti-Inflammatory Agents; Clinical Trials as Topic; Dermatitis; Glucocorticoids; Humans; Mometasone Furoate; Pregnadienediols; Psoriasis

Topical glucocorticoids are still among the dermatologicals most frequently used. This is due to their undebatable potency in inflammatory skin disease. Their use is limited by the fear of side effects both systemic and topical, especially skin atrophy. Hence, congeners with an increased benefit-risk ratio are urgently needed and research on new drugs no longer focuses on more active drugs but safer ones. Only recently, evidence has been forwarded that the goal is realistic. Some new glucocorticoids, especially the nonfluorinated double-ester type such as prednicarbate, appear promising. In fact, they seem to affect fibroblast growth in vitro as well as skin thickness in vivo less than equipotent conventional glucocorticoids. Pertinent findings in humans have been obtained with the use of ultrasound equipment. The relevant aspects of chemistry, pharmacology, clinical benefits, and toxicology of the various glucocorticoids old and new are reviewed, as are potential future alternatives.

Topics: Administration, Topical; Anti-Inflammatory Agents; Atrophy; Betamethasone Valerate; Dermatitis, Atopic; Glucocorticoids; Humans; Mometasone Furoate; Odds Ratio; Prednisolone; Pregnadienediols; Psoriasis; Skin

Further formulations of mometasone furoate are needed for treatment of patients with plaque psoriasis to meet individual patient preferences. This has motivated the development of Ovixan(®) (Galencia, Malmoe, Sweden), a formulation of mometasone furoate with different cosmetic properties than the commonly used formulation, Elocon(®) (Merck [Schering Plough], Whitehouse Station, New Jersey, USA). This novel formulation of mometasone furoate was examined in a vasoconstrictor assay comparing its efficacy with that of Elocon. Subsequently, the new formulation was tested in a multicenter, randomized, double-blind clinical study in patients with plaque psoriasis.. Healthy volunteers were included in the vasoconstrictor study. The treatments were randomly assigned to test fields on the forearms. The test fields were gently cleaned after treatment for 6 h. Skin color was measured during the following 24 h and area under the time curve was calculated. The clinical efficacy and tolerance of Ovixan was as compared to that of Elocon and their vehicles in a double-blind study in patients with plaque psoriasis. Patients with four symmetrically placed lesions on the arms or the legs were treated for 6 weeks. Primary endpoint was the change from baseline of the Total Severity Sign score for each treated lesion. The cosmetic characteristics of the two test preparations were assessed by an independent cosmetological institute.. Ovixan was shown to have skin blanching potency almost identical to the vasoconstrictor potency of Elocon. Clinical equivalence of Ovixan to Elocon was demonstrated in the clinical study of the efficacy in patients with plaque psoriasis. A professional testing team clearly documented the cosmetic superiority of Ovixan as compared to Elocon.. The results of the investigations show that Ovixan is equipotent to the commonly used formulation Elocon. However, the cosmetic properties are in favor of Ovixan. The effect of the cosmetic differences on patient preferences and patient adherence to prescribed treatment has to be investigated in further studies.

Topics: Administration, Cutaneous; Adult; Anti-Inflammatory Agents; Chemistry, Pharmaceutical; Double-Blind Method; Female; Humans; Male; Middle Aged; Mometasone Furoate; Patient Satisfaction; Pharmaceutical Vehicles; Pregnadienediols; Psoriasis; Treatment Outcome; Young Adult

Mometasone furoate, a potent glucocorticoid (class III) with a favorable benefit/risk ratio, has emerged as a standard medication for the treatment of inflammatory skin disorders. The purpose of the investigation presented here was to determine the noninferiority of a topical mometasone formulation, a light cream (O/W 60/40 emulsion) with mometasone furoate 0.1% (water content of 33%) versus marketed comparators. Using the vasoconstrictor assay, a strong blanching effect of the new cream (called Mometasone cream) comparable to that of a mometasone comparator, a fatty cream with mometasone furoate 0.1%, could be demonstrated. Thus, the topical bioavailability of the active ingredient mometasone furoate (0.1%) was regarded to be similar for Mometasone cream and the mometasone comparator. Using the psoriasis plaque test, a strong antipsoriatic effect comparable to that of the mometasone comparator was found for Mometasone cream after 12 days of occlusive treatment. A nearly identical reduction in the mean infiltrate thickness and similar mean AUC values were noted with both formulations confirmed by clinical assessment data. The noninferiority of Mometasone cream to its active comparator with respect to the AUC of change to baseline in infiltrate thickness was demonstrated. Both medications were well tolerated. Overall, Mometasone cream and the mometasone comparator showed similar efficacy and tolerability. Mometasone cream, in addition to its high potency and good tolerability, provides the properties of a light cream, which might make this new medication particularly suitable for application on acutely inflamed and sensitive skin.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Area Under Curve; Biological Availability; Chemistry, Pharmaceutical; Dermatologic Agents; Double-Blind Method; Female; Germany; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Ointments; Pregnadienediols; Psoriasis; Skin; Skin Absorption; Vasoconstriction; Young Adult

Emollients are considered important adjunctive tools for the therapeutic management of psoriasis patients. In spite of the widespread use, the actual impact of emollients on psoriasis is far to be completely elucidated. The objective of this study was to evaluate the effect of a new emollient cream containing milk proteins and Glycyrrhiza glabra extracts in patients with palmar and/or plantar psoriasis treated with topical corticotherapy. This pilot open parallel-group trial was carried out in 40 patients with palmar and/or plantar psoriasis. Patients were randomized to receive monotherapy with mometasone furoate ointment, applied once daily to the palmoplantar lesions until remission and for a maximum of 4 weeks (N=20), or the same topical corticotherapy in combination with the emollient cream (N=20). The emollient was applied twice a day for 4 weeks. Clinical assessments were performed at baseline and 2 and 4 weeks after the start of treatment. All patients completed the study and showed a progressive improvement of their palmo-plantar psoriasis over the treatment period, achieving at week 4 a statistical significant reduction in the severity of all clinical signs (erythema, desquamation and infiltration) and in the surface area affected. The comparison between the two groups showed no differences in the mean average duration of corticosteroid therapy, whereas a significantly greater improvement of desquamation, surface area affected, and subjective symptoms was observed at week 4 in the group treated with the corticotherapy combined with the emollient as compared to patients who received the corticotherapy alone. This pilot experience suggests the importance of the adjuvant role of particular emollients in the management of psoriasis.

Topics: Anti-Inflammatory Agents; Emollients; Female; Humans; Male; Middle Aged; Mometasone Furoate; Ointments; Pilot Projects; Pregnadienediols; Psoriasis

Treatment in psoriasis vulgaris continues to unmet needs in terms of efficacy, quality of life and costs. Patients with moderate forms of psoriasis are using topical corticosteroids as first-line therapy and patients with severe forms also use this therapy. Optimization of this treatment is made by the use of combination drugs or by the sequential or rotational therapies. A multicentric clinical study was performed to measure the efficiency of mometasone furoate 0.1% and salicylic acid 5% and mometasone furoate 0.1% as sequential local therapy in psoriasis.. This was a randomized, multicentre trial with two patient groups receiving active treatment. The study group (N = 184) received mometasone furoate 0.1% and salicylic acid 5% for the first 7 days of treatment, and in the following 14 days, the patients used mometasone furoate 0.1%. The second group (N = 176) was treated with mometasone furoate 0.1% for 21 consecutive days. Psoriasis Area Severity Index (PASI) score and Dermatology Life Quality Index (DLQI) were calculated.. After the first week of treatment in the study group, the reduction of PASI score was 44%, statistically significant greater than the reduction of PASI score in the second group (37%). Quality of life estimated by DLQI indicated significant lower values in the first (study) group.. The sequential treatment mometasone furoate 0.1% and salicylic acid 5% followed by mometasone furoate 0.1% proves to be efficient, safe and an excellent option for the following sequence: in-patient and out-patient.

Topics: Administration, Topical; Adult; Anti-Infective Agents, Local; Drug Therapy, Combination; Female; Humans; Keratolytic Agents; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Psoriasis; Quality of Life; Romania; Salicylic Acid; Severity of Illness Index; Treatment Outcome

Retinoids like tazarotene are approved for the treatment of chronic plaque psoriasis. In the beginning of topical retinoid therapy, 15-20% of the patients suffer from mild to moderate adverse reactions with burning and erythema. The aim of the study was to find predicative parameters of the individual irritative potential and to suggest options to reduce these initial irritations.. Twenty in-patients with different skin types (1 + 2: 11, 3 + 4: 9), with chronic plaque psoriasis were included in this open study. In each patient, 7 randomized plaques on the forearm were treated for 14 days on different ways: test area 1: morning (m) and evening (e) placebo, test area 2: placebo (m) and tazarotene 0.05% (e), test area 3: placebo (m) and tazarotene 0.1% (e), test area 4: calcipotriol (m) and calcípotriol (e), test area 5: mometasone furoate (m) and tazarotene 0.05% (e), test area 6: mometasone furoate (m) and tazarotene 0,1% (e), test area 7: placebo (m) and tazarotene in increasing concentrations (e), test area 8: healthy skin for control. Before and after therapy, skin barrier function, blood flow and plaque thickness in 20-MHz sonography were assessed in different test areas intraindividually by non- invasive biophysical measurements.. After 14 days of therapy, tazarotene 0.05% and 0.1% produced a stronger increase of laser Doppler flow in patients with skin type 1 and 2 than in patients with skin type 3 and 4. When using the combination therapy of tazarotene and mometasone, the laser Doppler flow was significantly lower than in tazarotene as monotherapy. 20-MHz-ultrasound showed a significant decrease in the thickness of the echo-poor band in all topical therapy regimens compared to placebo. Patients of skin type 1 and 2 reached a higher density of the dermis than patients of skin type 3 and 4, meaning a stronger decrease of inflammatory infiltration and acanthosis.. Adapting retinoid therapy to the patient's skin type can reduce the initial irritative side-effects. During the first days, patients with skin type 1 or 2 should add a medium potency corticosteroid. Stronger skin irritation caused by tazarotene therapy increases therapy effects.

Topics: Administration, Cutaneous; Adult; Calcitriol; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Forearm; Humans; Irritants; Male; Mometasone Furoate; Nicotinic Acids; Pregnadienediols; Psoriasis; Reproducibility of Results; Retinoids; Sensitivity and Specificity; Skin; Water Loss, Insensible

Topics: Adult; Aged; Anti-Inflammatory Agents; Dermatologic Agents; Drug Eruptions; Drug Therapy, Combination; Female; Follow-Up Studies; Gels; Humans; Male; Middle Aged; Mometasone Furoate; Nicotinic Acids; Ointments; Pregnadienediols; Pruritus; Psoriasis; Skin; Treatment Outcome

Both tazarotene (a retinoid prodrug) and calcipotriene (a synthetic analog of vitamin D3) are effective in the treatment of plaque psoriasis, but no reports in the literature directly compare the efficacy and tolerability of these 2 drugs. Tazarotene is commonly used in conjunction with a topical corticosteroid. In this study, tazarotene was used with mometasone furoate (a synthetic corticosteroid), and the 2-drug regimen was compared with calcipotriene monotherapy.. This study was conducted to compare the efficacy and tolerability of tazarotene 0.1% gel once daily plus mometasone furoate 0.1% cream once daily with those of calcipotriene 0.005% ointment twice daily in the treatment of plaque psoriasis.. In this multicenter, investigator-blinded, parallel-group study, adult patients with chronic, stable plaque psoriasis affecting 5% to 20% of their body surface area were randomly allocated to receive up to 8 weeks of treatment with either tazarotene 0.1% gel once daily (in the evening) plus mometasone furoate 0.1% cream once daily (in the morning) or calcipotriene 0.005% ointment twice daily. Patients were assessed at baseline and at weeks 2, 4, and 8 of treatment. Patients who demonstrated complete clearance of plaque psoriasis after 2 or 4 weeks of treatment and those whose psoriasis had improved > or = 50% after 8 weeks of treatment entered a 12-week posttreatment follow-up phase during which they applied only moisturizer. Patients were reassessed after 4, 8, and 12 weeks of posttreatment follow-up. Physician-rated measures of efficacy included global improvement, plaque elevation, scaling, erythema, and percentage of body surface area involvement. Patient-rated assessments included efficacy of study treatment compared with previous therapies, comfort of treated skin, outlook for long-term control of psoriasis, and overall impression of treatment.. Of 120 patients with moderate to severe psoriasis enrolled from 3 centers, 106 (88%) completed the study. No significant differences in baseline clinical variables were observed between the 2 groups. Twenty-seven patients (45%) in the tazarotene plus cortico-steroid group achieved marked improvement (> or = 75% global improvement) after 2 weeks of treatment compared with 15 patients (26%) in the calcipotriene group (P < or = 0.05). Between-group comparisons of the percentage of patients achieving complete or almost complete clearance (> or = 90% global improvement) did not reach statistical significance at any time point. When compared with the calcipotriene regimen, the tazarotene plus corticosteroid regimen resulted in significantly greater efficacy on trunk lesions in reducing plaque elevation (at the end of treatment and at week 4 of the posttreatment phase, P < or = 0.05), scaling (week 4 of treatment and week 4 of the posttreatment phase, P < or = 0.05), erythema (week 4 of treatment and at the end of treatment, P < or = 0.05), and percentage of body surface area involvement (weeks 2 and 4 of treatment, P < or = 0.01). In addition, the tazarotene plus corticosteroid regimen was significantly more effective in reducing the percentage of body surface area involvement in upper limb lesions (weeks 2 [P < or = 0.05] and 4 [P < or = 0.01] of treatment). Forty-two of 55 patients (76%) in the tazarotene plus corticosteroid group rated their medication as more or much more effective than previous therapies compared with 30 of 52 patients (58%) in the calcipotriene group (P < or = 0.05). Although adverse events (burning, pruritus, irritation, and erythema) occurred in a significantly greater proportion of patients who received tazarotene plus corticosteroid than in those who received calcipotriene (P < or = 0.05), 47 of 55 patients (85%) in both groups rated the comfort of their treated skin as "somewhat comfortable" or better and both groups had similar discontinuation rates due to treatment-related adverse events (3% and 5%, respectively). CONCL

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Calcitriol; Dermatologic Agents; Drug Administration Schedule; Drug Therapy, Combination; Female; Gels; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Nicotinic Acids; Ointments; Pregnadienediols; Psoriasis; Treatment Outcome

A photographic tracking study was performed to facilitate a visual evaluation of the effect of treating psoriatic lesions in a clinical setting with tazarotene 0.05% gel, tazarotene 0.1% gel, tazarotene 0.1% gel plus mometasone furoate as needed for irritation, or tazarotene 0.1% gel plus mometasone furoate. Tazarotene was administered once daily in the evening, and mometasone furoate was administered once daily in the morning, for 12 weeks or until clearance if this occurred first. A total of twenty patients were enrolled in this open-label study. Rates of treatment success (50% or greater improvement in psoriasis) were higher with tazarotene 0.1% monotherapy compared with tazarotene 0.05% monotherapy, and were higher still when tazarotene was used in combination with mometasone furoate. Concurrent use of this steroid also enhanced speed of efficacy, patient satisfaction, and tolerability. Furthermore, long periods of remission were achieved in patients treated with combination tazarotene plus corticosteroid therapy. These findings suggest that tazarotene plus a mid-potency topical corticosteroid is a valuable first-line treatment option for stable plaque psoriasis.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Dermatologic Agents; Drug Therapy, Combination; Female; Gels; Glucocorticoids; Humans; Keratolytic Agents; Male; Middle Aged; Mometasone Furoate; Nicotinic Acids; Patient Satisfaction; Photography; Pregnadienediols; Psoriasis; Remission Induction; Retinoids; Time Factors; Treatment Outcome

Enkephalins are opioid peptides that can modulate immune responses and inflammatory processes. Furthermore, they inhibit keratinocyte proliferation/differentiation in vitro. Previously, we have shown that enkephalins are present in increased amounts in lesional psoriasis.. To determine the effect of topical treatment with the vitamin D analogue calcipotriol and the corticosteroid mometasone furoate on the level of methionine-enkephalin (enk) in psoriatic lesions.. Twelve psoriatic patients were treated with calcipotriol and mometasone furoate for 14 days without or with hydrocolloid occlusion. Keratome biopsies were obtained from treated and untreated skin, and the extracted enk was quantified by radioimmunoassay. Furthermore, punch biopsies were obtained for immunohistochemical analysis.. Clinically, both calcipotriol and mometasone furoate improved psoriasis to the same degree, the effects being more pronounced after occlusion. Histologically, treatment with mometasone furoate without occlusion decreased both the epidermal thickness/parakeratosis and the number of dermal immunocompetent cells (CD3- and CD68-positive cells). In contrast, treatment with calcipotriol without occlusion reduced the epidermal thickness and the degree of parakeratosis but decreased the number of CD3- and CD68-positive cells only slightly. The mean enk level was decreased by 26 and 86% by calcipotriol without and with occlusion and by 16 and 63% by mometasone furoate without and with occlusion, respectively. The decreases in the enk levels corresponded to the degree of clinical improvement but not to the histological changes.. The increased levels of enk in psoriatic lesions are reduced in parallel with the clinical improvement induced by a topical vitamin D analogue and a corticosteroid. Because enkephalins can modulate epidermal differentiation and inflammatory processes, the findings indicate that enkephalins may play a role in the pathogenesis of psoriasis.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Antigens, CD; Antigens, CD20; Antigens, Differentiation, Myelomonocytic; Calcitriol; CD3 Complex; Dermatologic Agents; Enkephalins; Glucocorticoids; Humans; Immunohistochemistry; Middle Aged; Mometasone Furoate; Occlusive Dressings; Pregnadienediols; Psoriasis; Skin; Treatment Outcome

In a randomized study 30 patients with chronic stationary psoriasis were treated with 3 different topical schemes. Group 1 (n = 10) received monotherapy (dithranol (D) twice a day, D/D), group 2 (n = 10) calcipotriol mornings/dithranol evenings (calcipotriol (C)/dithranol (D) C/D) and 3 (mometasone (M) mornings/dithranol (D) evenings, M/D). During the therapy period of 4 weeks we documented the PASI-Score as well as infiltration, erythema and desquamation weekly. The M/D group revealed in the first week a significantly faster reduction of the PASI-score (5.3) than in the D/D group (PASI 13.22). The C/D group (PASI 10.5) show a not significantly faster reduction. After 4 weeks of treatment and after a follow period of 6 weeks there were similar PASI-Scores in all groups. There were less side-effects in the M/D group than in the others. The beginning, more anti-psoriatic effectiveness was achieved by the mometasone/dithranol combination than the other schemes. In the long term, the effects were similar.

Topics: Administration, Topical; Adult; Aged; Anthralin; Anti-Inflammatory Agents; Calcitriol; Dermatologic Agents; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Prospective Studies; Psoriasis; Recurrence

The topical corticosteroids are widely used in the treatment of moderate psoriasis, because of their usefulness for reducing inflammation and controlling itching. The therapeutic effect of corticosteroids in different cutaneous inflammatory diseases may be partially explained by their varying ability to block in vitro the synthesis of different cytokines, which play a pivotal role in epidermal hyperproliferation and leukocyte recruitment into the skin. The purpose of the present investigation was to further elucidate the mode of action of mometasone furoate, a medium-high potency, topical corticosteroid, on adhesion molecules, cytokines and cytokine receptor expression in psoriatic skin. Using an immunohistochemical assessment, we examined lesional skin biopsies from ten psoriatic patients before treatment and after 1 and 3 weeks of therapy. The overexpression of alpha 2, alpha 3, alpha 6, and beta 1 integrins detected in the spinous layer of untreated psoriatic skin was significantly decreased after therapy in 8 out of 10 cases, characterized by only partial clinical remission. In the remaining patients, a disappearance of the above integrin reactivity paralleling the disappearance of psoriatic lesions was induced by the treatment. With the exception of GM-CSF, no or only marginal effects of mometasone furoate on the cytokine and cytokine receptor system were observed. A significant reduction of the positive immunostaining with anti-ICAM-1 and ICAM-2 monoclonal antibodies on dermal vascular endothelial cells was also seen. Thus, our findings indicate that the therapeutic effects of mometasone furoate in psoriasis are mediated principally by decreasing adhesion molecule expression and to a lesser degree by inhibiting cytokine synthesis.

Topics: Administration, Cutaneous; Adult; Aged; Anti-Inflammatory Agents; Antigens, CD; Biopsy, Needle; Cell Adhesion Molecules; Culture Techniques; Female; Glucocorticoids; Humans; Immunohistochemistry; Intercellular Adhesion Molecule-1; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Psoriasis; Skin; Statistics, Nonparametric

Topics: Administration, Topical; Anti-Inflammatory Agents; Clinical Trials as Topic; Drug Administration Schedule; Glucocorticoids; Humans; Mometasone Furoate; Ointments; Pregnadienediols; Psoriasis; Random Allocation; Scalp Dermatoses; Triamcinolone Acetonide

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Atrophy; Female; Humans; Hydrocortisone; Male; Middle Aged; Mometasone Furoate; Ointments; Pregnadienediols; Psoriasis; Skin

Mometasone furoate (Elocon) is a newly formulated and unique medium-potency synthetic 17-heterocyclic corticosteroid. The efficacy and safety of the ointment and cream formulations (0.1 percent) of the corticosteroid, administered once daily, were compared with those of the ointment and cream formulations of fluocinolone acetonide 0.025 percent administered three times daily and triamcinolone acetonide 0.1 percent administered twice daily in four multicenter clinical studies. They were conducted involving psoriasis patients with chronic and moderate to severe disease. Evaluation of change in disease sign scores indicated that mometasone ointment, applied once daily, was significantly more effective (P less than 0.01) than fluocinolone ointment, applied three times daily, and triamcinolone ointment, applied twice daily. The cream formulation of mometasone was significantly more effective (p less than 0.001) than fluocinolone cream, applied three times daily, and equivalent to triamcinolone cream, applied twice daily. The incidence of local adverse experiences following treatment with the ointment or cream formulations of mometasone was minimal. Mometasone ointment and cream provide a highly effective once-a-day treatment for moderate to severe psoriasis with minimal risk of side effects.

Topics: Administration, Topical; Anti-Inflammatory Agents; Drug Administration Schedule; Female; Fluocinolone Acetonide; Glucocorticoids; Humans; Male; Mometasone Furoate; Multicenter Studies as Topic; Ointments; Pregnadienediols; Psoriasis; Random Allocation; Triamcinolone Acetonide

Present investigation was aimed to develop aspasomal gel of Mometasone Furoate for the treatment of Psoriasis that are biologically active and deliver drug at controlled rate and decrease dosing frequency.. The vesicles were fabricated using film hydration method and optimized using 32 factorial Design. Prepared formulations were evaluated for percent drug loading, vesicle size, Zeta potential, polydispersity index and morphological studies. Gel was prepared using carbopol by loading optimized drug loaded asposomes and was evaluated for drug content, pH, viscosity and spreadability. The drug release study from the gel was done using dialysis membrane and goat skin. Anti- oxidant potency of the prepared aspasomal gel was determined by Ferric Reducing Assay whereas, in-vivo performance for inflammation and skin irritation was carried out using Wistar rats.. Optimized aspasomes demonstrated desired properties for entrapment efficiency (74.72 ± 1.8), vesicle size (282.9 ± 1.7), polydispersity index (0.2), zeta potential (-20.2 mV) with spherical shape. The results recorded for drug release from the optimized aspasomal gel exhibited sustained release (24h) compared to the marketed cream (5h). Depot formation of Mometasone furoate loaded aspasomal gel in the epidermis was confirmed by ex vivo skin penetration study by using fluorescent marker. In-vivo study revealed no any irritation and inflammation to the skin promoting drug delivery system to treat psoriasis.. In conclusion, Mometasone furoate loaded aspasomal gel releases the drug for longer duration of time and reduce dosing frequency, providing the new dimension for the treatment of psoriasis.

Topics: Administration, Topical; Animals; Gels; Humans; Mometasone Furoate; Psoriasis; Rats; Rats, Wistar; Skin Absorption

Topics: Adrenal Cortex Hormones; Humans; Mometasone Furoate; Psoriasis; Ultraviolet Therapy; Vitiligo

Palmoplantar pustular psoriasis, also termed palmoplantar pustulosis (PPP), is a rare disease affecting the palmoplantar regions characterized by sterile, yellow to brown pustules mostly on erythematous skin. PPP is related to a high burden due to painful, impaired and stigmatizing character. Several isoforms of interleukin (IL) have been implicated in its pathophysiology. Here, we report on four patients with PPP treated with the novel IL-17 receptor A blocker brodalumab, in whom this therapy was not successful or showed moderate improvement combined with adverse events.

Topics: Adult; Aged; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Dermatologic Agents; Disease Progression; Drug Therapy, Combination; Female; Humans; Middle Aged; Mometasone Furoate; Psoriasis; Receptors, Interleukin-17; Recurrence; Severity of Illness Index; Treatment Outcome; Withholding Treatment

The aim of the present study was to develop and evaluate nanostructured lipid carrier based topical hydrogel of mometasone furoate for the treatment of psoriasis.. Drug loaded NLCs were successfully developed by microemulsion technique. Pseudo ternary phase diagrams were constructed using different combinations of surfactant and co-surfactants to study the microemulsion existence range. Different compositions were selected from the phase diagram showing maximum microemulsion region and were converted into NLCs by dilution in water (1:20). The optimized formulation was characterised for droplet size, zeta potential, entrapment efficiency and morphology was studied using Transmission Electron Microscopy. Ex vivo permeation studies were carried out using Wistar rat skin. The potential of this formulation in treating psoriatic inflammation was studied using imiquimod induced skin inflammation animal model.. The optimized formulation (F4) has droplet size of 163.2±0.522 nm, zeta potential - 0.086±0.099 mV and entrapment efficiency of 60.0±0.187%. Transmission electron microscopy confirmed spherical shape of nanostructured lipid carrier. Carbopol 940 was used to convert NLC dispersion into NLC based hydrogel to improve its viscosity for topical administration. Drug permeation studies showed prolonged drug release from the NLC based gel as compared to marketed formulation following Higuchi release kinetics. The skin deposition of MF loaded NLC based hydrogel was found to 2.5 fold higher than marketed formulation with primary skin irritation index of 0.20. In vivo studies showed complete clearance of parakeratosis by treatment with the prepared NLC formulation. Accelerated stability studies signify high robustness scale of optimized formulation under one month storage period.. The prepared NLC based formulation has proved to be a promising carrier system for the treatment of psoriasis.

Topics: Acrylic Resins; Administration, Topical; Animals; Anti-Inflammatory Agents; Drug Carriers; Drug Liberation; Female; Hydrogels; Mice, Inbred BALB C; Mometasone Furoate; Oleic Acid; Psoriasis; Rats, Wistar; Skin; Skin Absorption; Stearic Acids

We describe the case of a 15-month-old boy with Kawasaki disease who developed varicella 7 days after the beginning of the disease and diffuse plaque psoriasis after 43 days. Associations between Kawasaki disease and psoriasis, between Kawasaki disease and varicella and between varicella and psoriasis have all been reported in the literature. The triple association of Kawasaki disease, varicella and psoriasis is very rare. Neither the double nor the triple associations are well known among a diverse group of practitioners.

Topics: Aspirin; Chickenpox; Humans; Immunoglobulins, Intravenous; Infant; Male; Mometasone Furoate; Mucocutaneous Lymph Node Syndrome; Psoriasis

To evaluate patients' assessment of therapy, efficacy, quality of life and treatment adherence in patients with scalp psoriasis treated with non-alcoholic mometasone emulsion or calcipotriol/betamethasone gel.. Prospective, open-label, multicentre, non-interventional study. Patients with non-severe scalp psoriasis were treated with mometasone emulsion or calcipotriol/betamethasone gel. Evaluations included patient's global assessment of treatment, physician's global assessment of disease severity, quality of life (Dermatology Life Quality Index), physician's subjective evaluation of therapy, treatment adherence and adverse events.. Ninety-five patients treated with mometasone emulsion and 88 treated with calcipotriol/betamethasone gel were included in the intention-to-treat analysis. Patients' global assessment of treatment favoured mometasone emulsion over calcipotriol/betamethasone gel (p = 0.008), with treatment rated as good/very good by 91% versus 82.5%. Patients were less likely to report irritation of fingers' skin with mometasone than with calcipotriol/betamethasone (p = 0.0015). Severity of scalp psoriasis and quality of life improved in both groups. Adherence to treatment was similar in both groups. Physicians' perception of efficacy, tolerability and compliance was better for mometasone emulsion.. Non-alcoholic mometasone emulsion achieved greater acceptability to patients and physicians than calcipotriol/betamethasone gel for the treatment of scalp psoriasis. Both topical treatments were similarly effective in terms of disease severity and quality of life.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Betamethasone; Calcitriol; Dermatologic Agents; Drug Combinations; Emulsions; Female; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Patient Acceptance of Health Care; Patient Compliance; Patient Preference; Prospective Studies; Psoriasis; Quality of Life; Scalp Dermatoses

Immunomodulatory agents that target PD-1 and its ligand (PD-L1) are being increasingly used in the management of lung cancer. Potential immune-related adverse events include dermatological complications which mostly are of low grade severity. The use of immune checkpoint inhibitors may lead to the exacerbation of autoimmune conditions. We report a case of a documented psoriasis flare with anti-PD-1 treatment for lung cancer.

Topics: Adenocarcinoma; Aged; Antibodies, Monoclonal; Antineoplastic Agents; B7-H1 Antigen; Calcitriol; Carcinoma, Non-Small-Cell Lung; Cigarette Smoking; Disease Progression; ErbB Receptors; Exons; Humans; Male; Mometasone Furoate; Neoplasm Metastasis; Phototherapy; Psoriasis; Sequence Deletion

Topics: Adalimumab; Anti-Inflammatory Agents; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Female; Humans; Hypercholesterolemia; Hyperglycemia; Keratolytic Agents; Middle Aged; Mometasone Furoate; Ointment Bases; Petrolatum; Pregnadienediols; Psoriasis; Salicylic Acid

In patients with psoriasis, videocapillaroscopy has been used to visualize the typical modifications in the microcirculatory architecture.. To evaluate the modifications of the superficial capillary bed in a psoriatic plaque and healthy perilesional skin during treatment with a topical steroid.. In total, 24 patients affected with psoriasis vulgaris were enrolled. Each patient was instructed to apply mometasone furoate cream 0.1% once daily to a selected psoriatic lesion for 12 weeks. At baseline (T0) and after 4 (T1), 8 (T2) and 12 (T3) weeks, clinical and capillaroscopic examination was made of the psoriatic plaque and the surrounding skin.. At the end of the study, the diameters of dilated and convoluted capillaries in the psoriatic plaque were significantly reduced (baseline, 69.2 microm; after 12 weeks, 29.3 microm; P < 0.0001) in all subjects. A marked clinical improvement was also noted (plaque score: baseline, 7.4; after 12 weeks, 0.5; P < 0.0001). The perilesional skin also showed improvement in capillaroscopic alterations, even if the drug had not been applied to those areas. Of the 24 patients, 12 were clinically healed at the end of the treatment period, although the capillaroscopic picture returned to normal in only 2 of them.. Mometasone furoate cream proved to be effective in reducing the clinical and capillaroscopic alterations of the psoriatic plaque, but there was no association between clinical improvement and microcirculatory alterations noted. The action of mometasone furoate action on the microcirculation was not limited only to the area of application, but also extended to the surrounding areas.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Capillaries; Female; Humans; Male; Microcirculation; Microscopic Angioscopy; Middle Aged; Mometasone Furoate; Pregnadienediols; Psoriasis; Treatment Outcome; Young Adult

Topics: Alkynes; Anti-HIV Agents; Anti-Inflammatory Agents; Anti-Retroviral Agents; Antiviral Agents; Benzoxazines; Cyclopropanes; Deoxycytidine; Emtricitabine; HIV Infections; Humans; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Psoriasis; Risk Factors; Treatment Refusal

Topics: Adult; Androstadienes; Female; Fluticasone; Humans; Lip Diseases; Mometasone Furoate; Ointments; Prednisolone; Pregnadienediols; Psoriasis; Treatment Outcome

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Diagnosis, Differential; Emollients; Female; Humans; Lip; Mometasone Furoate; Mouth Diseases; Pregnadienediols; Psoriasis; Recurrence; Treatment Outcome

Psoriasis is a common skin disorder that may be triggered by hormonal disturbances, among other factors. Some studies have demonstrated an elevation of serum parathyroid hormone (PTH) levels in psoriasis and several other diseases of keratinization of unknown aetiology. PTH-related peptide (PTH-rp), on the other hand, is a potent inhibitor of epidermal cell growth factor and is not expressed in psoriatic skin. Serum levels of this peptide have not been reported in psoriasis. Immunoassay was used to measure serum PTH and PTH-rp in 22 patients with plaque-type psoriasis before and after treatment with mometasone furoate. Results were compared with a group of 20 healthy, non-psoriatic volunteers. Serum PTH levels were significantly elevated in the psoriatic group compared with the control group (p=0.001) and were significantly reduced after treatment (p=0.01). A correlation was found between pretreatment serum PTH levels and psoriasis area and severity scores (PASI) (r=0.42; p=0.01). In contrast, serum PTH-rp levels were not different between psoriatics and controls and were not affected by treatment. These findings indicate that serum PTH concentrations reflect disease activity in patients with psoriasis.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Female; Humans; Male; Middle Aged; Mometasone Furoate; Parathyroid Hormone; Parathyroid Hormone-Related Protein; Pregnadienediols; Psoriasis

Raised intraocular pressure and glaucoma have rarely been associated with use of periorbital corticosteroids for dermatological conditions such as blepharitis and eczema. Three cases are described in which periorbital topical corticosteroids appear to have resulted in raised intraocular pressure or glaucoma. Topical corticosteroids used for dermatological conditions around the face and eyes are often regarded as being fairly innocuous with regard to ocular side-effects. This case series demonstrates that secondary open-angle glaucoma can be a sight-threatening consequence, and periorbital steroids should therefore be used cautiously and sparingly, particularly in those with a family history of glaucoma. Intraocular pressure may not always return to normal upon cessation of the drug.

Topics: Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Blepharitis; Dermatitis, Allergic Contact; Eyelids; Glaucoma; Glucocorticoids; Humans; Hydrocortisone; Intraocular Pressure; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Psoriasis

Topics: Age of Onset; Anti-Inflammatory Agents; Child; Combined Modality Therapy; Diseases in Twins; Genetic Predisposition to Disease; Haplotypes; Histocompatibility Testing; Humans; Male; Mometasone Furoate; Pedigree; Pregnadienediols; Psoriasis; Treatment Outcome; Twins, Monozygotic; Ultraviolet Therapy

Tazarotene is the first receptor-selective retinoid indicated for the topical treatment of plaque psoriasis. It is being used clinically in combination with other topical antipsoriatic treatments, although its stability in the presence of these products has not been examined extensively. This study examines the compatibility of tazarotene 0.05% gel with 17 other topical products used in the treatment of psoriasis, assessed over a 2-week period. Tazarotene showed minimal degradation (<10%) at 0, 8, 24, and 48 hours after compounding with each of the 17 products. In addition, after 1 and 2 weeks, degradation of tazarotene remained less than 10% for 15 of the 17 products tested. Tazarotene appeared to have minimal impact on the stability of the other products. These results suggest that tazarotene gel can be successfully coprescribed with a range of commonly used topical psoriasis treatments without adversely affecting the chemical stability of either agent.

Topics: Administration, Topical; Betamethasone; Calcitriol; Clobetasol; Dermatologic Agents; Drug Evaluation, Preclinical; Drug Incompatibility; Fluocinonide; In Vitro Techniques; Mometasone Furoate; Nicotinic Acids; Pregnadienediols; Psoriasis

Topical steroid treatment is a common therapy for psoriasis. Steroids are known to bind to specific cytoplasmic receptors and to influence gene expression. We investigated the effects of the novel steroid derivative mometasone furoate on the expression of putative target genes in normal human epidermal cells (KC). Gene expression was measured by semiquantitative mRNA-PCR. In addition, cytokine receptor characteristics were assessed by ligand binding studies. We found a dose-dependent downregulation of proinflammatory mediators (IL-8, TNF alpha). Genes involved in growth regulation (HER-2, p53) were also modulated. IL-8 binding to KC was inhibited. We conclude that modulation of the expression of cytokine, cytokine receptor and growth factor genes may contribute to the antipsoriatic action of steroids.

Topics: Administration, Topical; Anti-Inflammatory Agents; Betamethasone; Cells, Cultured; Cytokines; Gene Expression; Humans; Hydrocortisone; Mometasone Furoate; Polymerase Chain Reaction; Pregnadienediols; Psoriasis; Receptors, Cytokine; RNA, Messenger; Steroids

Topics: Administration, Cutaneous; Anti-Inflammatory Agents; Dermatitis, Atopic; Facial Dermatoses; Follow-Up Studies; Glucocorticoids; Humans; Intertrigo; Mometasone Furoate; Ointments; Pregnadienediols; Psoriasis; Safety; Time Factors

Topics: Administration, Topical; Anti-Inflammatory Agents; Glucocorticoids; Humans; Mometasone Furoate; Pregnadienediols; Psoriasis