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Topical Corticosteroid

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27761. Class I topical corticosteroid use by psoriasis patients in an academic practice. (PubMed)

Class I topical corticosteroid use by psoriasis patients in an academic practice. Psoriasis is a chronic skin disorder that can have a profound impact on the quality of life of patients. The treatment of psoriasis is complicated by the availability of numerous topical agents, systemic agents, and phototherapy. Of the topical preparations available, the ultra-high potency, or Class I steroids, have an important role in treating psoriasis. Their use is most appropriate for the treatment (...) of plaques in regions excluding the face, axilla, groin and genitals.The purpose of this study was to examine the prescribing patterns of Class I topical corticosteroids within a large academic dermatology practice for patients with all types of psoriasis.A retrospective chart review of 650 patients with psoriasis from an academic dermatology practice was performed. Class I steroid use was defined as those patients who were observed to be currently using clobetasol propionate, halobetasol propionate

2004 Journal of Dermatological Treatment

27762. Critical factors determining the potency of topical corticosteroids. (PubMed)

Critical factors determining the potency of topical corticosteroids. The vasoconstrictor assay is a highly reliable method used to determine the bioequivalence of topical corticosteroid preparations. By assessing skin blanching, the assay describes the delivery of the active agent through the skin barrier, intrinsic activity at the receptor, and the rate of clearance from the site of application. Vasoconstrictor rankings are generally good predictors of efficacy in clinical trials (...) . Vasoconstrictor assays are not as predictive of outcomes in clinical practice because these assays do not account for a critical factor: how well patients use the medication. Patient compliance plays a vital role in corticosteroid potency.

2006 Journal of Dermatological Treatment

27763. Cost-effectiveness analysis of tacrolimus ointment versus high-potency topical corticosteroids in adults with moderate to severe atopic dermatitis. (PubMed)

Cost-effectiveness analysis of tacrolimus ointment versus high-potency topical corticosteroids in adults with moderate to severe atopic dermatitis. Few cost-effectiveness analyses have been conducted on topical therapies for atopic dermatitis.We sought to compare cost-effectiveness of high-potency topical corticosteroids (HPTCs) and tacrolimus ointment for the treatment of moderate to severe atopic dermatitis for patients who are not responsive to or not well controlled with mid-potency topical (...) corticosteroids.A Markov model represented the cyclic nature of atopic dermatitis. Clinical outcomes were derived from published literature. "Efficacy" was defined as disease-controlled days on which patients experienced a greater than 75% improvement in their disease. Resource use and changes in management were on the basis of opinions of a physician panel; secondary treatment was an oral antibiotic with topical corticosteroids. Sensitivity analyses were conducted for all variables.The model was sensitive

2003 Journal of American Academy of Dermatology

27764. A novel foam vehicle for delivery of topical corticosteroids. (PubMed)

A novel foam vehicle for delivery of topical corticosteroids. Skin, particularly the uppermost layer--the stratum corneum--presents a formidable, largely impassable barrier to the entry of most compounds. Recently, a novel thermolabile, low-residue foam vehicle, VersaFoam (Connetics Corp, Palo Alto, Calif), has emerged that offers a number of clinical and cosmetic advantages for the delivery of therapeutic agents through the skin. Two corticosteroids--mid-potency betamethasone valerate (...) (probably the alcohols) act as penetration enhancers, and reversibly alter the barrier properties of the outer stratum corneum, thus driving the delivered drug across the skin membrane via the intracellular route. This is in contrast to traditional topical delivery vehicles, which must first rely on hydration of the intercellular spaces in the stratum corneum to achieve drug delivery. The latter mechanism reflects a hydration-dependent process, which may result in comparatively slower drug permeation.

2005 Journal of American Academy of Dermatology

27765. Clinical studies of a new vehicle formulation for topical corticosteroids in the treatment of psoriasis. (PubMed)

Clinical studies of a new vehicle formulation for topical corticosteroids in the treatment of psoriasis. Topical corticosteroids have been the mainstay of topical anti-inflammatory therapy of psoriasis and are available in different treatment strengths or doses and various formulations or vehicles. Traditional formulations have included ointments, creams, and lotions. More recently, the mid-potency corticosteroid betamethasone valerate (BMV) and the ultra-high-potency corticosteroid clobetasol (...) propionate (CP) have become available in a novel, thermolabile, low-residue foam vehicle for topical application. This review examines recent clinical studies on efficacy and safety of these two new formulations, BMV 0.12% foam (Luxiq; Connetics Corp, Palo Alto, Calif) and CP 0.05% foam (OLUX, Connetics Corp), as treatments for scalp and nonscalp psoriasis. The studies demonstrated that BMV foam and CP foam are safe and effective treatments for psoriasis affecting scalp and nonscalp regions of the body

2005 Journal of American Academy of Dermatology

27766. Ultrapotent topical corticosteroid treatment of hemangiomas of infancy. (PubMed)

Ultrapotent topical corticosteroid treatment of hemangiomas of infancy. Superficial cutaneous hemangiomas of infancy represent a therapeutic challenge. Two small case series using ultrapotent topical corticosteroids for periocular hemangiomas were reported in the ophthalmologic literature. The use of this therapy for hemangiomas of infancy at other sites on the body has not been reported.We sought to assess the clinical effects of short-term application of ultrapotent topical corticosteroids (...) , 35% demonstrated good response, 38% partial response, and 27% no response.Hemangiomas in 74% of the infants demonstrated either good or partial response to treatment with ultrapotent topical corticosteroids. Of the responders, the majority reported cessation of growth before what would have been expected for their age. Improvement varied, with thinner superficial hemangiomas demonstrating better cosmetic improvement than thicker lesions.

2005 Journal of American Academy of Dermatology

27767. Decreased in vitro cellular response to tetanus toxoid and tuberculin in patients using topical corticosteroids. (Full text)

Decreased in vitro cellular response to tetanus toxoid and tuberculin in patients using topical corticosteroids. Topical corticosteroids are the mainstay of treatment in inflammatory skin diseases. Corticosteroids penetrate human skin, especially when the penetration barrier is damaged. Whether long-term application of topical corticosteroids can lead to alteration of immune responses is not clear. We sought to examine the impact of topical corticosteroids on immune responses in patients using (...) long-term topical corticosteroids. Peripheral blood mononuclear cell proliferation in response to tetanus toxoid and tuberculin stimulation was studied, and tetanus toxoid-specific antibodies were examined with ELISA. The results showed that, compared with the control group, the stimulation indices of patients' peripheral blood mononuclear cell to tetanus toxoid and tuberculin stimulations were lowered, which was especially significant in the tetanus toxoid group. No significant decrease was found

2005 Acta Dermato-Venereologica

27768. Effect of topical corticosteroid application frequency on histamine-induced wheals. (PubMed)

Effect of topical corticosteroid application frequency on histamine-induced wheals. Very few studies have been conducted to assess the effect of corticosteroid application frequency to attain maximum benefit with minimum side-effects.Compare the efficacy of twice-daily, once-daily and alternate-day applications of clobetasol propionate (0.05%) and compare whether an initial once-daily application followed by a subsequent alternate-day application is as effective as a once-daily application.The (...) ability of corticosteroids to suppress histamine-induced wheals on human skin was used as a human bioassay model. Of the 26 subjects included, 21 completed the 1st phase. In the 2nd phase, 11 subjects were included and all completed the study. Four sites were chosen on the left forearm. Clobetasol propionate (0.05%) was applied twice daily, once daily, and on alternate days, and on the control site a color, texture and odour-matched vehicle was applied. Prick test with histamine was carried out after

2005 International Journal of Dermatology

27769. Topical corticosteroids for atopic eczema: clinical and cost effectiveness of once-daily vs. more frequent use. (PubMed)

Topical corticosteroids for atopic eczema: clinical and cost effectiveness of once-daily vs. more frequent use. Topical corticosteroids remain the mainstay of treatment for atopic eczema, yet there is uncertainty over the frequency of their use in terms of clinical and cost effectiveness.To assess the clinical and cost effectiveness of once-daily vs. more frequent use of same-potency topical corticosteroids in atopic eczema.A systematic review of the clinical and cost-effectiveness literature (...) was undertaken, together with a cost-minimization analysis.The review identified a sparse literature, comprising one previous systematic review and 10 randomized controlled trials (RCTs). No published cost-effectiveness studies were identified. RCTs were focused on potent topical corticosteroids (eight RCTs), with no trials (RCTs/controlled clinical trials) identified on mild potency products. There was broad heterogeneity in trial methods, and therefore we considered outcomes according to: (i) at least

2005 British Journal of Dermatology

27770. Determining the relative importance of patient motivations for nonadherence to topical corticosteroid therapy in psoriasis. (PubMed)

Determining the relative importance of patient motivations for nonadherence to topical corticosteroid therapy in psoriasis. Medication nonadherence is a significant problem in psoriasis. Although previous research has aimed to quantify the prevalence of nonadherence in topical medication users, patient motivations for intentional nonadherence are not fully understood.Our purpose was to determine the relative importance of factors contributing to nonadherence in topical corticosteroid users (...) with psoriasis.A survey was distributed to psoriasis patients visiting an outpatient clinic.Among the 53 persons surveyed, medication nonadherence was 40%. Frustration with medication efficacy, inconvenience, and fear of side effects were the most important reasons patients deviated from usage instructions. Subjects who did not receive instructions on topical treatment duration used corticosteroids longer (>8 weeks) than subjects who were instructed (P < .05).A relatively small sample size prevented trends

2006 Journal of American Academy of Dermatology

27771. Blinded side-to-side comparison of topical corticosteroid and tacrolimus ointment in children with moderate to severe atopic dermatitis. (PubMed)

Blinded side-to-side comparison of topical corticosteroid and tacrolimus ointment in children with moderate to severe atopic dermatitis. There is little information on the relative efficacy of topical tacrolimus and corticosteroids in the treatment of atopic dermatitis (AD) in children. In a single-centre, prospective, observer-blinded, side-to-side comparative study (ISRCTN65507338), 96 children with moderately severe AD were enrolled. The study aimed to compare the relative effectiveness (...) of the child's usual topical corticosteroid with 0.03% tacrolimus ointment applied for 1 week, and if there was no difference, 0.1% tacrolimus ointment applied for a further week. Topical tacrolimus was found to be more effective than topical corticosteroid in 72 of the 93 children (77%) who completed the study. Using multiple-regression analysis with age, gender, pretreatment surface area affected and pretreatment corticosteroid potency as covariants, the only factor that reduced the chance of observing

2007 Clinical & Experimental Dermatology

27772. Allergic contact dermatitis to methylprednisolone aceponate in a topical corticosteroid. (PubMed)

Allergic contact dermatitis to methylprednisolone aceponate in a topical corticosteroid. A 42-year-old registered nurse presented with a recurrent history of multifactorial hand dermatitis, which had ceased to respond to the topical corticosteroid that she was using. Patch testing revealed strong reactions to both Advantan Fatty Ointment (Commonwealth Serum Laboratories, Melbourne, Australia), and its active ingredient, methylprednisolone aceponate. Methylprednisolone aceponate is one (...) of the more sensitizing topical corticosteroids and is becoming increasingly recognized as a significant allergen.

2004 Australasian Journal of Dermatology

27773. Intertriginous granular parakeratosis responsive to potent topical corticosteroids. (PubMed)

Intertriginous granular parakeratosis responsive to potent topical corticosteroids. Granular parakeratosis is a recently recognized disorder of keratinization that is confined to intertriginous body sites. The histological features are distinctive. Aetiology is unclear at present but factors such as friction, perspiration and chemical irritation may be relevant. We describe three cases of granular parakeratosis that were notable for their rapid response to potent topical corticosteroids.

2003 Clinical & Experimental Dermatology

27774. Low basal serum cortisol in patients with severe atopic dermatitis: potent topical corticosteroids wrongfully accused. (Full text)

Low basal serum cortisol in patients with severe atopic dermatitis: potent topical corticosteroids wrongfully accused. Topical corticosteroids are used extensively to treat inflammatory skin disorders including atopic dermatitis (AD). Several studies have described temporary reversible suppression of hypothalamic-pituitary-adrenal function. However, sound evidence of permanent disturbance of adrenal gland function is lacking.To relate basal cortisol levels to prior use of topical (...) corticosteroids and disease activity in patients with moderate to severe AD and to investigate the effect on basal serum cortisol levels of topical corticosteroid treatment during hospitalization.Two groups of patients with AD were evaluated: 25 inpatients with severe AD who required hospitalization (group 1) and 28 outpatients with moderate to severe AD (group 2). In group 1, morning basal serum cortisol levels were measured twice, at admission and at discharge; in group 2, morning basal serum cortisol

2007 British Journal of Dermatology

27775. A cost-utility analysis of pimecrolimus vs. topical corticosteroids and emollients for the treatment of mild and moderate atopic eczema. (PubMed)

A cost-utility analysis of pimecrolimus vs. topical corticosteroids and emollients for the treatment of mild and moderate atopic eczema. Conventional treatments for atopic eczema include topical corticosteroids (TCS) and emollients. Pimecrolimus, an immunosuppressant, was licensed in the U.K. in 2003 as an alternative treatment of mild to moderate atopic eczema.To assess the cost-utility of pimecrolimus as a treatment for mild and moderate atopic eczema when compared with conventional

2006 British Journal of Dermatology

27776. Antimicrobial silk clothing in the treatment of atopic dermatitis proves comparable to topical corticosteroid treatment. (PubMed)

Antimicrobial silk clothing in the treatment of atopic dermatitis proves comparable to topical corticosteroid treatment. Atopic dermatitis (AD) is aggravated by mechanical irritation and bacterial colonization.This study compared the efficacy of an antimicrobial silk fabric (DermaSilk) with that of a topical corticosteroid in the treatment of AD.Fifteen children were enrolled and wore a dress, where the left side was made of DermaSilk and the right side was made of cotton. The right arm and leg (...) were treated daily with the corticosteroid mometasone for 7 days. The treatment efficacy was measured with a modified EASI (Eczema Area and Severity Index) and with an assessment by the patients/parents and by a physician. All patients were evaluated at baseline, as well as 7 and 21 days after the initial examination.All parameters showed that, irrespective of the treatment, there was a significant decrease of eczema after 7 days. No significant difference between DermaSilk-treated

2006 Dermatology

27777. Treatment of early-stage mycosis fungoides with twice-weekly applications of mechlorethamine and topical corticosteroids: a prospective study. (Full text)

Treatment of early-stage mycosis fungoides with twice-weekly applications of mechlorethamine and topical corticosteroids: a prospective study. To determine if a therapeutic regimen of twice-weekly applications of mechlorethamine hydrochloride and betamethasone dipropionate cream is effective in the treatment of early-stage mycosis fungoides while increasing cutaneous tolerance.Prospective nonrandomized study conducted from November 1999 to November 2002.Eleven university or hospital dermatology

2005 Archives of Dermatology

27778. Presence of formaldehyde in topical corticosteroid preparations available on the Swedish market. (PubMed)

Presence of formaldehyde in topical corticosteroid preparations available on the Swedish market. The aim of this study was to investigate the formaldehyde content of topical corticosteroid preparations available on the Swedish market. 73 samples were analysed with the chromotropic acid (CA) method for semi-quantitative formaldehyde determination and 30 samples with a high-performance liquid chromatographic method. These included 24 ointments, 28 creams, 1 lotion, 6 liniments, 2 gels, 9

2003 Contact Dermatitis

27779. Topical corticosteroid allergy in an urban Australian centre. (PubMed)

Topical corticosteroid allergy in an urban Australian centre. The reported prevalence of allergic contact dermatitis from topical corticosteroids in clinical populations, in the period 1993-2002, varied from 0.55 to 5.98%. This study is a retrospective analysis of 1153 individuals undergoing routine patch testing in an Occupational Dermatology Clinic in Melbourne, Australia. We report a rate of 0.52% for positive patch test reactions to 5 corticosteroids. Corticosteroids tested were (...) availability of corticosteroids. We conclude that the low rate of topical corticosteroid contact allergy reported by our clinic is associated with regional availability and prescribing practices and the scarcity of stasis dermatitis and leg ulcers in our clinic population.

2004 Contact Dermatitis

27780. Topical corticosteroid inhibits interleukin-4, -5 and -13 in nasal secretions following allergen challenge. (PubMed)

Topical corticosteroid inhibits interleukin-4, -5 and -13 in nasal secretions following allergen challenge. Cytokines and chemokines produced by allergen-reactive T-helper type 2 (Th2) cells may be pivotal to the pathophysiology of allergic disorders.This study was performed to assess the effect of 7 days of topical corticosteroid on nasal allergen challenge (NAC) in terms of eosinophils, cytokines and chemokines obtained by nasal lavage and filter paper methods.Patients with grass pollen

2005 Clinical and Experimental Allergy

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