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Topical Corticosteroid

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28301. Cutaneous lymphangiectasia associated with photoageing and topical corticosteroid application. (Abstract)

Cutaneous lymphangiectasia associated with photoageing and topical corticosteroid application. We report the case of a 69-year-old man with a history of multiple erythematous bullae on both forearms, which had been present for about 1 month. The lesions appeared after several years of topical corticosteroid application and photoageing. A biopsy revealed lymphangiectasia with solar elastosis and increase in the ratio of elastic to collagen fibres in the dermis. We suggest that this patient's

2008 Clinical & Experimental Dermatology

28302. Expression of Chloride Channel Protein CLC-3 in Patients With Allergic Rhinitis: Effect of Topical Corticosteroid Treatment. Full Text available with Trip Pro

Expression of Chloride Channel Protein CLC-3 in Patients With Allergic Rhinitis: Effect of Topical Corticosteroid Treatment. To determine whether the chloride channel protein CLC-3 is upregulated in patients with allergic rhinitis (AR) and whether topical corticosteroid treatment decreases the expression of CLC-3.Histologic study.Academic research.Eighteen patients with AR were included in the study.Expression of CLC-3 was detected by immunohistochemistry and by reverse transcription-polymerase (...) chain reaction before and at 4 weeks after treatment with the topical corticosteroid mometasone furoate.Strong CLC-3 expression was detected in epithelium and in submucosal glands. An increased presence of CLC-3 was demonstrated in nasal mucosa compared with that in normal nasal tissue. A statistically significant difference in CLC-3 gene expression level was found in nasal tissues before vs at 4 weeks after treatment with mometasone.CLC-3 may have a role in modulating the pathogenesis of AR

2008 Archives of Otolaryngology Head and Neck Surgery

28303. Expert consensus: time for a change in the way we advise our patients to use topical corticosteroids. Full Text available with Trip Pro

Expert consensus: time for a change in the way we advise our patients to use topical corticosteroids. Topical corticosteroids form the mainstay of treatment for many skin conditions. If used appropriately, they are safe and effective, and side-effects are generally uncommon. Current advice to patients to apply topical corticosteroid preparations 'sparingly' or 'thinly' contributes to 'steroid phobia', increasing the risk of poor clinical response and treatment failure. Such cautionary advice (...) also overlooks the fact that the vast majority of patients are prescribed topical corticosteroids of mild potency for which the evidence suggests that the risk of harm is minimal. In the patient's mind, the current advice groups all steroids together regardless of their potential for adverse effects. The advice also tends to reinforce an erroneous concern that the risks from topical corticosteroids may be similar to those from systemic corticosteroids. We propose a change to make the pharmacy

2008 British Journal of Dermatology

28304. Esophageal strictures in adult eosinophilic esophagitis: dilation is an effective and safe alternative after failure of topical corticosteroids. (Abstract)

Esophageal strictures in adult eosinophilic esophagitis: dilation is an effective and safe alternative after failure of topical corticosteroids. Strictures are a frequent complication of eosinophilic esophagitis. The efficacy and safety of topical corticosteroids and of dilation of eosinophilic esophagitis-associated strictures have not yet been thoroughly clarified. We present a retrospective analysis of 10 adult patients with eosinophilic esophagitis who had symptomatic esophageal stenosis (...) that was unresponsive to topical corticosteroids, and who were treated using bougienage. Eight patients had one single stricture, one patient had two, and another had three strictures; mean stricture length was 2.1 cm (range 1 - 6 cm). Bougienage led to prompt symptom relief. Apart from transient postprocedural odynophagia, no severe complications occurred. During the follow-up (mean 6 months; range 2 - 11 months), all patients enjoyed sustained treatment response.

2008 Endoscopy

28305. Fingertip dermatitis refractory to topical corticosteroids associated with nail-patella syndrome. (Abstract)

Fingertip dermatitis refractory to topical corticosteroids associated with nail-patella syndrome. A 14-year-old girl and her 47-year-old father presented with fingernails that were hypoplastic, spoon-shaped and ridged since birth. Fingertip dermatitis and paronychia were also observed in the daughter, which had been present since birth and had progressively worsened. The daughter denied trauma to her fingernails or chronic exposure to irritants and allergens. She had previously tried topical (...) corticosteroids for 18 months without any benefit. We put forward the possibility of chronic paronychia and fingertip dermatitis, refractory to topical corticosteroids, as associations of digital nail-patella syndrome.

2008 Australasian Journal of Dermatology

28306. Circadian and ultradian (12 h) variations of skin blood flow and barrier function in non-irritated and irritated skin-effect of topical corticosteroids. Full Text available with Trip Pro

Circadian and ultradian (12 h) variations of skin blood flow and barrier function in non-irritated and irritated skin-effect of topical corticosteroids. The skin is the organ that receives the greatest exposure to light and shows a high-amplitude circadian rhythm in epidermal cell proliferation. We have previously demonstrated that the skin barrier function has a significant circadian rhythm. Corticosteroids (CS) are the most commonly used topical treatment in dermatology. Time-dependent (...) differences in their efficacy and side-effects would be of considerable interest. The aims of the current study were to examine time-dependent cycles in the effect of topical CS application in healthy and irritated skin on skin blood flow and its relationship to barrier function. Twenty clinically healthy, diurnally active subjects were examined at eight and nine time points over a 24 or 28 h span respectively, using non-invasive skin bioengineering techniques of laser Doppler imaging, a transepidermal

2004 Journal of Investigative Dermatology

28307. Successful management of vulvar adhesions with potent topical corticosteroids: a case report. (Abstract)

Successful management of vulvar adhesions with potent topical corticosteroids: a case report. Vulvar adhesions are a rarely reported but clinically recognized complication of severe ulcerations following herpes genitalis. The condition is avoidable with adequate pharmacologic treatment, hygiene, separation of the labia and topical application of skin emollients.Vulvar agglutination was diagnosed in a 23-year-old woman following hospitalization for severe herpetic vulvar ulcerations. Manual (...) attempts to separate the labia under local anesthesia were unsuccessful. Topical application of a potent cortico- steroid led to separation with no residual effects.Preventive and proactive management of extensive herpetic vulvar ulcerations should be the first line of care. There will always be patients who will present at a later stage of the disease, with established vulvar agglutination; there potent topical corticosteriods could prove valuable. There is no literature on the use of topical

2004 Journal of Reproductive Medicine

28308. The role of topical corticosteroids in bullous pemphigoid in the elderly. (Abstract)

The role of topical corticosteroids in bullous pemphigoid in the elderly. Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease. Until recently the condition was treated with oral corticosteroids. However, high-dose corticosteroids are poorly tolerated in the elderly and their use has probably contributed to the high mortality rates observed in several cohorts. Accordingly, considerable effort has been directed at identifying corticosteroid-sparing agents (...) , such as immunosuppressant drugs, plasma exchange techniques, intravenous immunoglobulins and tetracycline, that can be used in this clinical setting. Many of these options have appeared to be useful in open series, but they have been found to be ineffective or only marginally effective when tested in randomised, controlled trials. An important breakthrough occurred with the demonstration in a large, randomised trial that a 'super-potent' topical corticosteroid (clobetasol propionate) was not only associated

2005 Drugs & Aging

28309. Evaluation of efficacy of topical corticosteroid for the clinical treatment of nasal polyposis: searching for clinical events that may predict response to treatment. (Abstract)

Evaluation of efficacy of topical corticosteroid for the clinical treatment of nasal polyposis: searching for clinical events that may predict response to treatment. The objective of the present study was to evaluate the clinical response to topical budesonide in patients with nasal polyposis (NP) and to evaluate if there is any clinical event that may predict the response to treatment. Twenty patients with NP were assessed by a clinical questionnaire, nasal endoscopy and sinusal computed

2007 Rhinology

28310. Vesiculo-erosive oral mucosal disease--management with topical corticosteroids: (2) Protocols, monitoring of effects and adverse reactions, and the future. (Abstract)

Vesiculo-erosive oral mucosal disease--management with topical corticosteroids: (2) Protocols, monitoring of effects and adverse reactions, and the future. Although topical corticosteroids (TCs) are the most widely used drugs in oral medicine, and specifically in the treatment of vesiculo-erosive oral mucosal disease, there are few evidence-based data for the correct use of these drugs. In this review, we outline the most widely used protocols, the most common reasons for treatment failure

2005 Journal of Dental Research

28311. Vesiculo-erosive oral mucosal disease--management with topical corticosteroids: (1) Fundamental principles and specific agents available. (Abstract)

Vesiculo-erosive oral mucosal disease--management with topical corticosteroids: (1) Fundamental principles and specific agents available. Vesiculo-erosive diseases of the oral mucosa pose a major challenge in oral medicine, because they are chronic, painful, and interfere with the daily activities and quality of life of the patients, including disturbing eating, drinking, talking, and personal relationships. Many are autoimmune diseases, and corticosteroid therapy is currently central (...) to their treatment. These diseases present with inflammation and alterations to epithelial integrity, through cell and/or humoral immunity-mediated attack on epithelial-connective tissue targets. Until recently, despite their serious adverse effects, it was necessary to prescribe systemic corticosteroids to control severe erosive oral diseases. Now, however, many of these diseases can be controlled by high-potency topical corticosteroids, which have proved to be highly efficacious and to cause fewer adverse

2005 Journal of Dental Research

28312. Hyperkeratosis lenticularis perstans (Flegel's disease) - successful treatment with topical corticosteroids. (Abstract)

Hyperkeratosis lenticularis perstans (Flegel's disease) - successful treatment with topical corticosteroids. Flegel's disease, also known as hyperkeratosis lenticularis perstans, is a rare skin disease characterized by small, red-brown, hyperkeratotic, papules that are usually located on the lower extremities. The diagnosis is based on the clinical appearance in association with the typical histologic features of orthohyperkeratosis and a subepidermal band-like infiltrate. Treatment (...) is difficult and rarely fully effective. We report on a woman with Flegel's disease who responded to a topical corticosteroid therapy with betamethasone dipropionate.

2008 International Journal of Dermatology

28313. 3-Yr-Follow-Up of Topical Corticosteroid Treatment for Eosinophilic Esophagitis in Adults. (Abstract)

3-Yr-Follow-Up of Topical Corticosteroid Treatment for Eosinophilic Esophagitis in Adults. Eosinophilic esophagitis (EE) is a clinicopathologic syndrome comprising isolated eosinophilic inflammation of the esophagus, with symptoms of dysphagia, and possibly, reflux. It was initially described in children, and in recent years, there is a heightened awareness in adults. The etiology is not completely understood. The treatments include dietary manipulation, topical corticosteroids, systemic (...) corticosteroids, Montelukast, and endoscopic dilation. In adults, there are no randomized trials demonstrating the efficacy of any particular treatment, and no prospective studies describing the natural history of the disease following treatment.We performed an interval follow-up of patients treated with a swallowed corticosteroid inhaler. We contacted 51 adult patients who were diagnosed with EE and treated with a swallowed corticosteroid inhaler between September 1, 1999, and May 31, 2003. All patients had

2008 American Journal of Gastroenterology

28314. Topical corticosteroid allergy in an urban Australian centre. (Abstract)

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

28315. Topical corticosteroid inhibits interleukin-4, -5 and -13 in nasal secretions following allergen challenge. (Abstract)

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

28316. How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis? (Abstract)

How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis? Therapy for rhinitis improves sleep quality and symptoms of daytime sleepiness. This improvement with therapy may be secondary to anti-inflammatory effects, leading to a reduction of inflammatory mediators, or to a mechanical reduction of congestion directly leading to improvement in sleep disturbance. We combined our data from 3 placebo-controlled studies of intranasal corticosteroids in patients (...) with perennial rhinitis to determine whether a correlation between the reduction of congestion and improved sleep and daytime somnolence existed. The pooled data of budesonide, flunisolide, and fluticasone demonstrated significantly decreased nasal congestion, sleep problems, and sleepiness in treated patients. The data demonstrated a correlation between a reduction in nasal congestion and an improvement of sleep (P < .01) and daytime somnolence (P = .01). Thus, topical intranasal corticosteroids should

2005 Journal of Allergy and Clinical Immunology

28317. Critical factors determining the potency of topical corticosteroids. (Abstract)

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

28318. Class I topical corticosteroid use by psoriasis patients in an academic practice. (Abstract)

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

28319. A novel foam vehicle for delivery of topical corticosteroids. (Abstract)

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

28320. Clinical studies of a new vehicle formulation for topical corticosteroids in the treatment of psoriasis. (Abstract)

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

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