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Topical Corticosteroid

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28161. A single-center, double-blind, randomized trial of the atrophogenic effects of fluocinonide cream 0.1% versus clobetasol propionate cream 0.05% in participants with corticosteroid-responsive dermatoses. (Abstract)

, -0.1825 mm; standard deviation, 0.0239; P<.0001). This reduction was significantly greater than results from sites treated with fluocinonide cream 0.1% (difference, -0.1507; standard deviation, 0.0131; P<.0001). Although topical corticosteroids often are the first-line treatment for patients with various dermatoses, a side effect of continuous use is cutaneous atrophy. Our study demonstrated that clobetasol propionate cream 0.05% caused a significantly greater reduction in epidermal thickness compared (...) A single-center, double-blind, randomized trial of the atrophogenic effects of fluocinonide cream 0.1% versus clobetasol propionate cream 0.05% in participants with corticosteroid-responsive dermatoses. To compare the atrophogenic effects of fluocinonide cream 0.1% versus clobetasol propionate cream 0.05%, 20 participants with corticosteroid-responsive dermatoses were randomly assigned to receive fluocinonide cream 0.1% on one arm and clobetasol propionate cream 0.05% on the other arm. Study

2008 Cutis; cutaneous medicine for the practitioner Controlled trial quality: uncertain

28162. Quantitative, highly sensitive liquid chromatography-tandem mass spectrometry method for detection of synthetic corticosteroids. Full Text available with Trip Pro

Quantitative, highly sensitive liquid chromatography-tandem mass spectrometry method for detection of synthetic corticosteroids. Measurements of serum or urine concentrations of synthetic glucocorticoids are useful for assessing suspected iatrogenic hypothalamic-pituitary-adrenal axis suppression and Cushing syndrome. We have developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for the simultaneous quantitative analysis of beclomethasone dipropionate, betamethasone (...) , and tablets. This provides a valuable tool for evaluating the clinical effects of topical and systemic synthetic corticosteroids.

2004 Clinical Chemistry

28163. A thyroid hormone analogue, triiodothyroacetic acid, corrects corticosteroid-downregulated collagen synthesis. (Abstract)

A thyroid hormone analogue, triiodothyroacetic acid, corrects corticosteroid-downregulated collagen synthesis. The aim of this study was to compare the change in collagen synthesis between topical treatments with two doses of triiodothyroacetic acid (TRIAC), a thyroid hormone analogue, and placebo, after pretreatment with topical betamethasone 17-valerate (BM). Eighteen healthy volunteers were pretreated with BM on abdominal skin for 3 days, and were then treated for 14 days with a cream (...) with anti-inflammatory topical treatment with potent glucocorticoids to prevent their suppressive activity on dermal collagen production.

2004 Thyroid Controlled trial quality: uncertain

28164. Effects of local corticosteroids on acute experimental urticaria. (Abstract)

Effects of local corticosteroids on acute experimental urticaria. Corticosteroids are often used in the treatment of acute or chronic urticaria. However, their effects on mastocyte activation as well as on the histamine-induced dermal oedema remain poorly investigated. The aim of the present study was to investigate the effects of corticosteroids (CS) on the development of acute experimental urticaria induced by prick-tests with histamine and codeine. This experimental model corresponds (...) to the common form of urticaria. CS were administered at the site of the histamine and codeine prick tests in order to test for a direct effect on the development of acute urticaria. Two types of experiments were performed: 1) after a 48-hour period of topical CS application on the forearm, 7 healthy volunteers were skin prick-tested with histamine and codeine simultaneously in duplicate, one series in the pretreated area and the other in a non-treated area. 2) six other volunteers were prick-tested

2004 European journal of dermatology : EJD Controlled trial quality: uncertain

28165. Corticosteroids but not pimecrolimus affect viability, maturation and immune function of murine epidermal Langerhans cells. Full Text available with Trip Pro

Corticosteroids but not pimecrolimus affect viability, maturation and immune function of murine epidermal Langerhans cells. Given the importance of dendritic cells in the immune response, we investigated the effect of corticosteroids (CS) on the integrity, survival, and function of murine Langerhans cells (LC) in comparison with pimecrolimus, a novel anti-inflammatory drug for the topical treatment of atopic dermatitis. BALB/c mice were treated twice on one day with ethanolic solutions

2004 Journal of Investigative Dermatology

28166. Evaluation of tests of hypothalamic-pituitary-adrenal axis function used to measure effects of inhaled corticosteroids. (Abstract)

Evaluation of tests of hypothalamic-pituitary-adrenal axis function used to measure effects of inhaled corticosteroids. To review the evidence supporting the evaluation of hypothalamic-pituitary-adrenal (HPA) axis function as a measure of systemic exposure and clinical adverse events, discuss factors that affect systemic exposure to inhaled corticosteroids (ICSs), and review the effects of various ICSs that are currently available or under development on HPA axis function from a therapeutic (...) perspective.Randomized published clinical trials and review articles on the topic of HPA axis suppression were retrieved in MEDLINE. Searches dating back to 1988 were restricted to human studies published in English.Studies that evaluated HPA axis function and the methods used to measure its activities and the effects of ICSs (fluticasone propionate, budesonide, beclomethasone dipropionate, mometasone furoate, and ciclesonide) were selected.Factors that influence adverse events caused by ICSs include pharmacokinetic

2007 Asthma & Immunology

28167. Effects of long-term low-dose corticosteroid therapy on humoral immunity. (Abstract)

of corticosteroid therapy. Published works on this topic in animal and human models are reviewed. The findings unique to this patient are highlighted.While undergoing long-term corticosteroid therapy, a patient developed a clinical and immunologic picture suggestive of common variable immunodeficiency, with predominantly qualitative and quantitative B-cell abnormalities. These abnormalities resolved within 2 years after tapering of corticosteroid therapy.Long-term low-dose corticosteroid use may reversibly (...) Effects of long-term low-dose corticosteroid therapy on humoral immunity. Corticosteroids are agents that suppress the immune system. Their suppressive activity is predominantly restricted to cell-mediated immunity, with a marginal inhibitory effect on humoral immunity.To describe an acquired reversible B-cell deficiency in a patient treated with low-dose corticosteroids for 36 years.A broad range of T- and B-cell parameters were studied over time, during and after discontinuation

2006 Asthma & Immunology

28168. Concerns about intranasal corticosteroids for over-the-counter use: position statement of the Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology. (Abstract)

use. We took the position that safety issues regarding this proposal would be our sole concern. We reviewed the literature to evaluate the frequency and severity of potential adverse events related to the administration of intranasal corticosteroids. We limited this review to 5 areas: (1) effects on growth, (2) ocular effects, (3) effects on bone, (4) effects on the hypothalamic-pituitary-adrenal axis, and (5) local adverse effects. After review of the available data, we concluded that intranasal (...) noted herein. Our conclusion was strengthened by the fact that these adverse effects can be insidious and therefore not evident for many years; there is the potential for overuse; patients could also have access to other forms of topically administered corticosteroids, thus increasing their total dose; and individuals vary in their susceptibility to corticosteroid-induced adverse effects. We were also influenced to take this position knowing that generally reassuring data regarding the use

2006 Asthma & Immunology

28169. Intercellular adhesion molecule-1 expression in nasal polyps treated with corticosteroid. (Abstract)

Intercellular adhesion molecule-1 expression in nasal polyps treated with corticosteroid. The aim of this study was to compare intracellular adhesion molecule-1 (ICAM-1) expression in nasal polyp cases who were administered topical corticosteroid and in middle turbinates.Twenty-four patients with nasal polyps were included in the study group. These patients were treated with 100 microg budesonide in each nostril twice daily for 2 months before the surgery. Twenty-one nonatopic patients (...) with concha bullosa were included in the control group. The specimens were taken from patients undergoing endoscopic surgery.In polyps, significantly higher mean ICAM-1 intensity scores were found by comparison with the control turbinates.Corticosteroid treatment in patients with nasal polyps does not diminish ICAM-1 to that of turbinate tissue. The initiating events in the formation of nasal polyps still occur in these patients despite treatment with the topical nasal steroid.

2004 American Journal of Otolaryngology

28170. Plasma-cell cheilitis: successful treatment with intralesional injections of corticosteroids. Full Text available with Trip Pro

Plasma-cell cheilitis: successful treatment with intralesional injections of corticosteroids. Plasma-cell cheilitis is a rare inflammatory disorder of the lip characterized histologically by a band-like infiltrate of plasma cells in the upper dermis. It is considered an oral counterpart of plasma-cell balanitis. Clinically, it presents as a circumscribed, flat to slightly raised, eroded area of the lip. The cause of plasma-cell cheilitis is unknown, and the treatment is often disappointing. We (...) describe a 55-year-old woman who had a long-lasting painful, swollen, and eroded area on her lips, which responded poorly to various topical treatments. Biopsy showed a band-like infiltrate composed mainly of mature plasma cells in the dermis. A diagnosis of plasma-cell cheilitis was made after excluding contact dermatitis, lichen planus, bacterial, fungal and spirochaete infections, and an extramedullary plasmacytoma. Dramatic improvements were observed after intralesional injections

2008 Clinical & Experimental Dermatology

28171. Targeting congestion in allergic rhinitis: The importance of intranasal corticosteroids. (Abstract)

intervention for nasal congestion and other nasal symptoms, with established superiority to antihistamines, decongestants, and leukotriene antagonists. In addition to symptom relief, INSs suppress numerous stages of the inflammatory cascade, inhibiting the influx of inflammatory cells and mediators. Topical nasal corticosteroids have a low incidence of local adverse effects, negligible systemic absorption, and excellent safety. Congestion is one of the most bothersome symptoms of AR. INS therapy improves (...) Targeting congestion in allergic rhinitis: The importance of intranasal corticosteroids. The cardinal nasal symptoms of allergic rhinitis (AR) are sustained by an underlying inflammatory process. Congestion is one of the most prominent and distressing symptoms for patients and is strongly associated with a broadly deteriorated quality of life and significant losses in productivity. The purpose of this study was to explore the role of intranasal corticosteroids (INSs) in down-regulating

2008 Allergy and Asthma Proceedings

28172. A case of hydrocortisone desensitization in a patient with radiocontrast-induced anaphylactoid reaction and corticosteroid allergy. (Abstract)

A case of hydrocortisone desensitization in a patient with radiocontrast-induced anaphylactoid reaction and corticosteroid allergy. Allergic reactions and systemic desensitization to corticosteroids have been documented rarely in English language literature. These reactions appear more often when the agent is applied topically and may lead to dangerous complications in patients if administered i.v. Therefore, the safety and efficacy of using an i.v. corticosteroid for desensitization (...) in a patient who has a history of allergy to corticosteroid must be weighed carefully, especially when the aim of its use is to prevent an allergic reaction from a second drug. We report a case of successful systemic hydrocortisone desensitization in a patient with radiocontrast-induced anaphylactoid reaction and corticosteroid allergy. Sensitization to corticosteroids was determined through skin testing. The patient was desensitized to hydrocortisone and premedicated with hydrocortisone

2006 Allergy and Asthma Proceedings

28173. New developments in inhaled corticosteroids. (Abstract)

New developments in inhaled corticosteroids. Inhaled corticosteroids (ICSs) are the foundation of pharmacotherapy in persistent asthma because they control airway inflammation. The anti-inflammatory effect of ICSs is primarily topical, at their site of deposition in the airways. Consequently, deposition characteristics of the ICS and its formulation and inhalation device, in addition to intrinsic properties of the corticosteroid, influence clinical efficacy. Small-particle formulations (...) , especially those developed in a metered-dose inhaler with the new hydrofluoroalkane propellant, may have improved lung deposition characteristics along with possibly improved clinical efficacy. Lipid conjugation of ICSs within the lungs may allow prolonged duration of effect, enabling once-daily dosing. Safety concerns of ICSs are related to systemic absorption and oropharyngeal deposition. An ICS with a longer serum half-life, especially one with a higher affinity for the corticosteroid receptor, may

2006 Allergy and Asthma Proceedings

28174. Salivary IgA and oral candidiasis in asthmatic patients treated with inhaled corticosteroid. (Abstract)

in topical immunity, such as salivary IgA.We evaluated differences in salivary IgA between asthmatics in whom Candida was detected or not detected from the pharynges, respectively.Saliva was collected from 18 healthy controls and 37 asthmatic patients treated with inhaled corticosteroids. The amounts of total IgA and the Candida-specific IgA of the saliva were measured. Fungal culture of the pharyngeal wall was also performed.There were no differences in salivary total IgA and Candida-specific IgA (...) Salivary IgA and oral candidiasis in asthmatic patients treated with inhaled corticosteroid. Inhaled corticosteroids are used for the treatment of bronchial asthma. Systemic side effects are rare, but local problems, such as oral candidiasis, can occur. Only a proportion of patients encounter this problem, and the mechanism of oral candidiasis induced by inhaled corticosteroids remains obscure. According to reports in immunodeficient patients, oral candidiasis is related to deficiencies

2005 Journal of Asthma

28175. Corticosteroids: options in the era of steroid-sparing therapy. (Abstract)

Corticosteroids: options in the era of steroid-sparing therapy. Topical corticosteroids remain the most commonly used topical treatments for inflammatory dermatoses, including psoriasis and atopic dermatitis. Topical corticosteroids are available in a variety of vehicles-creams, ointments, lotions, gels, and, more recently, foam. The vehicle used can substantially affect the individual agent's clinical action, potency, and acceptability to the patient. Moreover, some vehicles are better suited (...) for specific body areas. Selection of the appropriate product should be determined by area of usage, physician experience, cost, and patient preference, particularly regarding vehicle. Although topical corticosteroids are associated with several side effects, including skin atrophy, telangiectases, purpura, and striae formation, appropriate usage can minimize these occurrences. Judicious use includes short-term, appropriate application as initial monotherapy or in combination strategies with other

2005 Journal of American Academy of Dermatology

28176. Results of patch testing to a corticosteroid series: a retrospective review of 1188 patients during 6 years at Mayo Clinic. (Abstract)

Results of patch testing to a corticosteroid series: a retrospective review of 1188 patients during 6 years at Mayo Clinic. Allergy to topical corticosteroids is more common than previously realized. To detect this allergy, a corticosteroid series is used for patch testing in addition to corticosteroid screens on a standard series.We sought to review our experience with patch testing to corticosteroid series.We conducted a retrospective study of patch testing to our corticosteroid series over 6 (...) years (January 1, 2000-December 31, 2005).Of 1188 patients patch tested to corticosteroid series, 127 (10.69%) had allergic reaction to at least one corticosteroid; 56 reacted to multiple corticosteroids. Rates of allergic patch test reaction to 19,611 individual corticosteroids were 0.41% to 5.03%. Rates of reaction to corticosteroid groups were 1.10% to 5.72%; concomitant reactions between groups were noted. Present screens on our standard series identified 74% of those detected

2007 Journal of American Academy of Dermatology

28177. Effect of pimecrolimus vs. corticosteroids on murine bone marrow-derived dendritic cell differentiation, maturation and function. (Abstract)

Effect of pimecrolimus vs. corticosteroids on murine bone marrow-derived dendritic cell differentiation, maturation and function. Pimecrolimus (SDZ ASM981) is a non-steroid member of calcineurin inhibitors recently developed for the treatment of inflammatory skin diseases. In this study, we compared the effect of pimecrolimus and corticosteroids on the differentiation, maturation and function of murine bone marrow-derived dendritic cells (BM-DC). We added pimecrolimus at concentrations of 5-500 (...) of activation markers. The release of some inflammatory cytokines was reduced, but the stimulatory capacity in vivo was not affected. In contrast, mometasone furoate has pronounced effects on BM-DC at a concentration ten to 1000 times lower than those used with pimecrolimus. Furthermore, topical treatment of mice with clobetasole cream 0.05% resulted in almost complete depletion of splenic DC and a severe hyposplenia, while high-dose oral pimecrolimus treatment did not show any effects on the spleen

2006 Experimental Dermatology

28178. Pimecrolimus permeates less than tacrolimus through normal, inflamed, or corticosteroid-pretreated skin. (Abstract)

Pimecrolimus permeates less than tacrolimus through normal, inflamed, or corticosteroid-pretreated skin. The permeabilities of normal human and normal, inflamed, or corticosteroid (CS) pretreated skin of young domestic pigs for pimecrolimus and tacrolimus were compared in vitro, using Franz-type diffusion cells. The test articles were either used as 1.0% solutions or as the marketed formulations (Elidel 1% cream, Protopic 0.1%, and 0.03% ointment). In normal human skin, the permeation rate (...) suggest that in patients with acute skin inflammation or after therapy with topical CSs, percutaneous absorption and, as a consequence, systemic drug exposure will be lower with Elidel 1% cream as compared with Protopic 0.1% and 0.03% ointment.

2005 Experimental Dermatology

28179. Oral prednisolone induced acute generalized exanthematous pustulosis due to corticosteroids of group A confirmed by epicutaneous testing and lymphocyte transformation tests. (Abstract)

A, hydrocortisone type). The histological examination showing neutrophilic subcorneal spongiform pustules was consistent with the diagnosis of AGEP. In both cases the rash cleared within a week upon treatment with topical steroids (corticosteroid of group D1, betamethasonedipropionate type and corticosteroid of group D2, hydrocortisone-17-butyrate type). Three months after recovery, the sensitization to corticosteroids of group A was confirmed by epicutaneous testing and positive lymphocyte transformation (...) Oral prednisolone induced acute generalized exanthematous pustulosis due to corticosteroids of group A confirmed by epicutaneous testing and lymphocyte transformation tests. Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous eruption which is often provoked by drugs.We report 2 cases of AGEP which showed rapidly spreading pustular eruptions accompanied by malaise, fever and neutrophilia after the administration of systemic prednisolone (corticosteroid of group

2006 Dermatology

28180. Massive weight loss decreases corticosteroid-binding globulin levels and increases free cortisol in healthy obese patients: an adaptive phenomenon? Full Text available with Trip Pro

Massive weight loss decreases corticosteroid-binding globulin levels and increases free cortisol in healthy obese patients: an adaptive phenomenon? Obesity, insulin resistance, and weight loss have been associated with changes in hypothalamic-pituitary-adrenal (HPA) axis. So far, no conclusive data relating to this association are available. In this study, we aim to investigate the effects of massive weight loss on cortisol suppressibility, cortisol-binding globulin (CBG), and free cortisol (...) obese subjects, an increase of free cortisol was associated with a simultaneous decrease in CBG levels, which might be an adaptive phenomenon relating to environmental changes. This topic, not addressed before, adds new insight into the complex mechanisms linking HPA activity to obesity.

2007 Diabetes Care

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