pulmicort and Psoriasis

Contact allergy to corticosteroids has recently gained increased attention.. Five cases of contact dermatitis due to budesonide, a nonhalogenated steroid, are described. The Japanese literature was reviewed for reports on this allergy, and the occurrence due to budesonide was compared with that of other dermocorticosteroids.. Budesonide use can cause contact dermatitis.. Although budesonide may be beneficial because of its anti-inflammatory effects, clinicians should be alert to its potential for causing contact dermatitis.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Budesonide; Chronic Disease; Dermatitis; Dermatitis, Allergic Contact; Dermatitis, Seborrheic; Drug Eruptions; Eczema; Erythema; Female; Glucocorticoids; Humans; Japan; Leg Dermatoses; Male; Pregnenediones; Psoriasis

This pilot randomized intra-patient side to side trial was designed to assess the antipsoriatic efficacy, safety and tolerability of once daily versus the separate application of a vitamin D3 analogue and a powerful corticosteroid.. Twenty patients with plaque type psoriasis were enrolled. Two similar symmetrical lesions were randomized to be treated with an application of an ointment containing calcipotriol 50 µg/g plus betamethasone dipropionate 0.5 mg/g once daily or the application of budesonide 0.25 mg/g cream in the morning and tacalcitol 4 µg/g ointment in the evening.. Eighteen patients completed the study. Both treatments proved to be effective but budesonide cream and tacalcitol ointment gave a faster improvement of lesions and itching relief at t1 and were better tolerated.. The separate daily regimen may represent a suitable treatment option for patients who need a faster improvement and a better moisturizing activity. Further studies which compare the efficacy and safety of these regimens need to be developed.

Topics: Administration, Cutaneous; Adult; Aged; Betamethasone; Budesonide; Calcitriol; Dermatologic Agents; Dihydroxycholecalciferols; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Ointments; Pruritus; Psoriasis; Time Factors; Young Adult

Corticosteroids are important in the treatment of inflammatory dermatoses, such as psoriasis. They have anti-inflammatory, anti-proliferative and immunosuppressive effects. In this study, the effect of budesonide on proliferation, inflammatory cells and cytokines in psoriasis was investigated. In order to elucidate the time course of the different effects of corticosteroid treatment in psoriasis, six patients were treated for 3 weeks with budesonide 0.025% ointment (Preferid), and biopsies were studied immunohistochemically, before treatment and after 1 and 3 weeks of treatment. Clinical scores together with staining with antibodies indicating proliferation, keratin 16, keratin 10, T-lymphocytes, monocytes, polymorphonuclear leukocytes, Langerhans cells, interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha), and intercellular adhesion molecule-1 (ICAM-1) were performed. 'Psoriasis area' and 'severity index' (PASI) scores were significantly reduced after 1 week and 3 weeks of treatment. Epidermal hyperproliferation (Ki-67 binding) and suprabasal keratin 16 (Ks8.12) expression decreased within 1 week, while keratin 10 (RKSE60) expression did not change. Five out of 6 patients showed cytokine levels (IL-1alpha, IL-6, IL-8, and TNF-alpha; detected immunohistochemically) in the normal range, while 1 patient had highly increased cytokine levels. In this patient, cytokine levels decreased during treatment. In 4 patients, showing high dermal ICAM-1 expression before treatment, a consistent reduction of ICAM-1 on endothelial cells was observed. The inflammatory infiltrate (T-lymphocytes (T11), monocytes/macrophages (WT14), polymorphonuclear leukocytes (PMN, anti-elastase)) was reduced to some extent after 3 weeks. The number of Langerhans cells (OKT6) did not change. These results indicate that the psoriatic lesions, although clinically comparable, show interindividual differences in cytokine expression. Corticosteroid treatment for 1-3 weeks improves clinical scores and hyperproliferation. Cytokine levels are reduced during steroid treatment in the patient who showed high levels before treatment. To suppress the infiltrate entirely, longer steroid treatment is probably necessary. This may explain the relapse seen after short term corticosteroid therapy.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Biomarkers; Budesonide; Cell Division; Cytokines; Female; Glucocorticoids; Humans; Immunohistochemistry; Inflammation; Inflammation Mediators; Keratins; Male; Middle Aged; Pregnenediones; Psoriasis; Time Factors

Two clinical trials were carried out in order to study adrenal suppression in 6 patients with psoriatic erythroderma and in 28 patients with psoriasis treated with topical glucocorticosteroids. Betamethasone-17-valerate (0.1%), betamethasone-17,21-dipropionate (0.05%) and budesonide (0.025%) ointments were studied in erythroderma; betamethasone-17,21-dipropionate and budesonide in psoriasis. The erythroderma study was an open, crossover experiment; the psoriasis study was a double-blind, group-comparative study. Adrenal suppression was measured as plasma cortisol concentrations with and without ACTH stimulation. The depressive activity on the HPA-axis in increasing order was budesonide, betamethasone-17-valerate and betamethasone-17,21-dipropionate. The differences, however, did not reach statistically significant levels.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Betamethasone; Betamethasone Valerate; Budesonide; Clinical Trials as Topic; Dermatitis, Exfoliative; Female; Glucocorticoids; Humans; Male; Middle Aged; Pregnenediones; Psoriasis

Topics: Adolescent; Adult; Aged; Budesonide; Child; Clinical Trials as Topic; Desonide; Double-Blind Method; Female; Humans; Male; Middle Aged; Ointments; Pregnadienetriols; Pregnenediones; Psoriasis

A double-blind trial was carried out to compare the effectiveness of budesonide, a non-halogenated steroid, and betamethasone-17,21-dipropionate in the treatment of psoriasis. One group of 40 hospitalized patients was treated with both preparations under occlusive dressings. The evaluation was done as a left-right comparison within each patient. These patients were treated for 1 week, with evaluations on Days 3 and 7. Another series of 79 out-patients was divided into two groups, either group being treated with one of the two preparations. These were treated for 2 weeks, with evaluations after 1 and 2 weeks. Itching, scaling, erythema and induration were recorded on a 5-point scale. A preference was stated for the best result. Statistically significant results favouring the budesonide ointment were obtained, both with and without occlusion.

Topics: Adolescent; Adult; Aged; Betamethasone; Budesonide; Child; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Occlusive Dressings; Pregnenediones; Psoriasis

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Clinical Trials as Topic; Double-Blind Method; Female; Glucocorticoids; Humans; Hydrocortisone; Male; Middle Aged; Pregnenediones; Psoriasis

Topics: Administration, Topical; Anti-Inflammatory Agents; Budesonide; Chemical Phenomena; Chemistry; Clinical Trials as Topic; Double-Blind Method; Glucocorticoids; Humans; Pregnenediones; Psoriasis; Random Allocation

In a double-blind, randomized multi-centre study, 116 patients with psoriasis have been treated for 1-3 weeks with budesonide ointment (Preferid, Draco/Tika; a subsidiary of AB ASTRA), a new non-halogenated topical steroid. In a series of 11 patients a 0.025% budesonide ointment was significantly superior to placebo. In a second series, of 54 patients, a 0.025% fluocinolone acetonide ointment (Synalar, ICI). In a third series, of 51 patients, a 0.010% budesonide ointment was compared with 0.025% fluocinolone acetonide ointment. No statistically significant difference between these two preparations was found to exist. No adverse reactions were observed.

Topics: Administration, Topical; Budesonide; Clinical Trials as Topic; Double-Blind Method; Humans; Pregnenediones; Psoriasis; Random Allocation

In a double-blind within-patient clinical trial in psoriasis, budesonide 0.025% ointment has been shown to be at least as efficient as betamethasone-17-valerate 0.1% ointment. A lower concentration of budesonide ointment, 0.01%, was used for 4 weeks of maintenance treatment. This concentration controlled residual symptoms well in a majority of the patients, thirty-two in number.

Topics: Adolescent; Adult; Aged; Betamethasone; Betamethasone Valerate; Budesonide; Child; Clinical Trials as Topic; Double-Blind Method; Female; Glucocorticoids; Humans; Male; Middle Aged; Ointments; Pregnenediones; Psoriasis

Observations made in a controlled double-blind investigation of two non-halogenated topical steroids, hydrocortisone-17-butyrate (HCB) and budesonide in thirty-six patients with psoriasis revealed a clear difference in therapeutic effect between the two ointments, indicating that they belong to different groups of topical steroids according to a classification accepted in the Nordic countries. Budesonide had a good therapeutic effect in all the patients studied, while, as a rule, HCB was clearly less effective.

Topics: Administration, Topical; Anti-Inflammatory Agents; Budesonide; Clinical Trials as Topic; Dermatologic Agents; Double-Blind Method; Female; Glucocorticoids; Humans; Hydrocortisone; Male; Middle Aged; Ointments; Pregnenediones; Psoriasis

Lymphocytic colitis which is more common in women than in men has been associated with autoimmune conditions, and hormones are thought to play a role. The effect of pregnancy on the clinical course of women with lymphocytic colitis has not yet been reported. We describe a case of chronic watery diarrhea in a woman with psoriasis and lymphocytic colitis that has relapsed after successful treatment with budesonide had been stopped before undergoing modern assisted reproductive care. Elevated stool frequencies diminished after in vitro fertilization and remained normal throughout pregnancy when no systemic immunosuppressive therapy was administered and plaque psoriasis slightly worsened under local symptomatic treatment. After preterm birth and early breastfeeding cessation, chronic watery diarrhea, however, recurred. This clinical observation suggests that pregnancy influences the overall course of chronic watery diarrhea of autoimmune-associated microscopic colitis.

Topics: Anti-Inflammatory Agents; Breast Feeding; Budesonide; Cesarean Section; Colitis, Lymphocytic; Diarrhea; Drug Therapy, Combination; Embryo Transfer; Etanercept; Female; Fertilization in Vitro; Humans; Immunoglobulin G; Infant, Newborn; Methylprednisolone; Middle Aged; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Psoriasis; Receptors, Tumor Necrosis Factor; Recurrence; Remission, Spontaneous

Topics: Adult; Anti-Inflammatory Agents; Budesonide; Colitis, Lymphocytic; Female; Glucocorticoids; Humans; Psoriasis

Topics: Androstadienes; Anti-Asthmatic Agents; Bronchodilator Agents; Budesonide; Female; Fluticasone; Humans; Nebulizers and Vaporizers; Pregnenediones; Psoriasis; Recurrence

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Dermatitis, Allergic Contact; Drug Eruptions; Female; Glucocorticoids; Humans; Pregnenediones; Psoriasis

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Aged; Aged, 80 and over; Betamethasone; Betamethasone Valerate; Budesonide; Dermatitis, Exfoliative; Female; Histamine; Humans; Leukocyte Count; Male; Middle Aged; Ointments; Pregnenediones; Psoriasis

Topics: Administration, Oral; Administration, Topical; Adrenal Cortex; Adult; Anti-Inflammatory Agents; Betamethasone; Budesonide; Clobetasol; Diflucortolone; Dose-Response Relationship, Drug; Eczema; Female; Humans; Hydrocortisone; Male; Middle Aged; Ointments; Pregnenediones; Psoriasis

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Budesonide; Dermatitis, Contact; Female; Glucocorticoids; Humans; Methylprednisolone; Pregnenediones; Psoriasis; Triamcinolone Acetonide