A comparative study to evaluate the efficacy of clobetasol and curcumin in patients with oral submucous fibrosis

Background: Oral submucous fibrosis (OSMF) was considered primarily as a disease prevalent in Southern Asia and southern Asian immigrants. However, it has been associated with an increased risk of malignant transformation and beginning to garner considerable attention world-wide. The main aim in management of OSMF is to relieve burning sensation and improve mouth opening. Aim and Objective: This study aimed to compare efficacy of curcumin (2 g) and topical clobetasol propionate (0.05%) cream in management of OSMF. Materials and Methods: This prospective and randomized study was conducted among sixty clinically diagnosed patients between age group of 18 and 50 years of age. They were randomly divided into two groups. Group A patients were instructed to apply topical clobetasol propionate cream (0.05%) thrice daily for 6 weeks. Group B patients were prescribed oral curcumin lozenges for 6 weeks. Recalls were done every week for up to 6 weeks for both groups for which burning sensation and mouth opening parameters were recorded. Results: The prevalence of OSMF was more in the younger age group which was due to increase in the chewing habit. Reduction in burning sensation was seen among patients in both groups but a significant reduction of 6.67 was seen with clobetasol group when compared with curcumin group with mean reduction of 2.53. Marked improvement in mouth opening was seen with Clobetasol ointment group when compared to curcumin group with a mean increase in mouth opening of 3.57 mm in the former and only 0.47 mm improvement in the latter. Conclusion: In the present study, both treatments were beneficial in reducing burning sensation significantly with clobetasol group showing better improvement as compared to curcumin group. There was a significant improvement in mouth opening with clobetasol group and nonsignificant results were obtained with curcumin group. Therefore, clobetasol can be opted as a drug of choice in improving mouth opening in OSMF patients.

Topical therapy of various dermatoses with ImpoyzTM(clobetasol propionate) cream 0.025%

The most widely prescribed drugs for the treatment of a variety of dermatoses are Topical corticosteroids (TC). These medications are approved for the treatment of inflammatory and pruritic manifestations of dermatologic disorders due to their powerful symptom-relieving impact. Clobetasol propionate (CP) is the most popular (TC) used to relieve itching, redness, and oedema caused by a variety of skin disorders. Anti-inflammatory, anti-pruritic, and vasoconstrictive characteristics are all present in it. CP works by binding to cytoplasmic glucocorticoid receptors and activating glucocorticoid receptor-mediated gene expression, resulting in the production of anti-inflammatory proteins while suppressing the production of inflammatory mediators. The formulation is free from known contact allergens, such as propylene glycol, short-chain alcohols, and sorbitol-based emulsifiers, and has demonstrated hypoallergenic effects. The efficacy, safety, and clinical experience of utilizing CP 0.025% cream for the treatment of various dermatologic disorders are discussed in this case series

Eficácia do propionato de clobetasol 0, 05 nas lesões ulceradas da cavidade bucal / Efficacy of 0.05% clobetasol propionate in ulcerated lesions of the oral cavity

O uso tópico de Propionato de Clobetasol 0,05% em solução aquosa para lesões ulceradas na cavidade bucal é pouco divulgado nacionalmente e tem sido pouco citado em traba-lhos científicos a respeito de sua eficácia, tempo de regressão da lesão e efeitos adversos. Portanto, o objetivo deste estudo foi avaliar retrospectivamente prontuários de pacientes que foram tratados de lesões ulceradas através do uso do Propionato de Clobetasol 0,05%, no ambulatório de estomatopatologia de uma Instituição, a fim de investigar sua eficácia. Foram selecionados prontuários de pacientes que apresentaram a alteração fundamental ulcerada ou erosiva e que fizeram o uso tópico de Propionato de Clobetasol 0,05%. A aná-lise retrospectiva foi feita por um examinador, que fez a seleção da amostra seguindo os critérios de inclusão e exclusão. Foram coletadas as informações: Idade, gênero, diagnós-tico da alteração; quantidade de lesão, tempo de uso, evolução da lesão, tempo exato de regressão e presença de reações adversas. Foram incluídos 17 prontuários, dos quais cinco eram de pacientes com lesões erosivas de líquen plano, três úlceras traumáticas, três lesões liquenóides, dois eritemas multiformes, uma alergia a lactose, uma afta e uma gengivite descamativa. Todos os casos apresentaram resolução da sintomatologia, porém as altera-ções clínicas permaneceram em seis casos, embora mais leves e assintomáticas. Não foi ob-servada nenhuma reação adversa registrada no prontuário. A análise estatística não apontou associação em relação ao sexo (teste Exato de Fisher; p=0,49; p>0,05). Não foi observada diferença estatística significativa na frequência das lesões (teste exato de Fisher; p= 0,85; p>0,05). O uso do Propionato de Clobetasol 0,05% prescrito por até cinco dias se mostrou eficaz no tratamento de lesões ulceradas da mucosa bucal, principalmente para o alívio sintomático, além disso, não revelou efeitos adversos.

The treatment of ulcerated lesions of the oral cavity is usually carried out using topical analgesic drugs, anti-inflammatory corticosteroids, and alcohol-free oral antiseptics. The topical use of 0.05% Clobetasol Propionate in aqueous solution for ulcerated lesions in the oral cavity is little publicized nationally and little mentioned in scientific studies regarding its effectiveness, lesion regression time, and adverse effects. Therefore, the objective of this study was to retrospectively evaluate the medical records of patients who were treated for ulcerated or erosive lesions, using Clobetasol Propionate 0.05%, in the stomatology clinic of an institution to investigate its effectiveness. Medical records of patients who presented the fundamental ulcerated alteration and made topical use of 0.05% Clobetasol Propionate were selected. An examiner selected the sample following the inclusion and exclusion cri-teria and performed the retrospective analysis. The types of information collected were age, gender, diagnosis of the disorder, amount of injury, time of use, the evolution of the injury, exact time of regression, and presence of adverse reactions. A total of 17 medical records were included, of which five were from patients with erosive lichen planus lesions, three traumatic ulcers, three lichenoid lesions, two multiform erythema, one lactose allergy, one cold sore, and one scaly gingivitis. All cases had their symptoms solved, but, in six cases, the clinical changes remained, although milder and asymptomatic. No adverse reaction was noted in the medical record. The statistical analysis showed no association in relation to gender (Fisher's exact test; p = 0.49; p> 0.05). There was no statistically significant diffe-rence in the frequency of injuries (Fisher's exact test; p = 0.85; p> 0.05). The use of 0.05% Clobetasol Propionate, prescribed for up to five days, proved effective in treating ulcerated lesions of the oral mucosa, mainly for symptomatic relief. Furthermore, it revealed no ad-verse effects.

Identification and quantitation of related substances of super potent steroid in its topical combination drug product with vitamin D3 analogue

Clobetasol propionate is an internationally accepted common name for 21-chloro-9-fluoro-11beta,17-dihydroxy16beta-methylpregna-1,4-diene-3,20-dione 17-propionate. The combination of calcipotriol (vitamin D3 analogue) andclobetasol propionate (super potent steroid) is being used as a topical formulation for the treatment of psoriasis fromseveral years. In this work, an ultra-high performance liquid chromatography equipped with photodiode array detectorand a mass compatible mobile phase in a gradient elution is employed for the separation of five related substancesin presence of calcipotriol and its two impurities with a last eluting impurity in less than 11 minutes. A simple andefficient sample extraction procedure was developed to achieve the highest sensitivity as of today with limit of detectionand limit of quantitation of 0.03% and 0.10%, respectively, as required by industry for drug product of clobetasolpropionate and its combination products. Stationary phase with fused core particle technology is employed for theseparation of impurities. Precision of the method is found to be less than 1.0% Relative standard deviation (RSD). Thecorrelation coefficient is >0.999. Accuracy of method is ranged from 93.3% to 108.0%. This is the first reported Ultrahigh performance liquid chromatography (UHPLC) method for the estimation of five related substances of clobetasolpropionate in its combination product with calcipotriol.

Qualitative and quantitative assessment of related substances in the Compound Ketoconazole and Clobetasol Propionate Cream by HPLC-TOF-MS and HPLC / 药物分析学报

Related substances in pharmaceutical formulations are associated with their safety, efficacy and stability. However, there is no overall study already published on the assessment of related substances in the Compound Ketoconazole and Clobetasol Propionate Cream. In this work, a reliable HPLC-TOF-MS qua-litative method was developed for the analysis of related substances in this preparation with a quick and easy extraction procedure. Besides the active pharmaceutical ingredients, two compounds named ke-toconazole impurity B′ optical isomer and ketoconazole impurity E were identified. Furthermore, a new HPLC method for qualitative and quantitative assessment on related substances and degradation pro-ducts, which were found in the stability test, was established and validated. The single standard to determine multi-components method was applied in the quantitative analysis, which was an effective way for reducing cost and improving accuracy. This study can provide a creative idea for routine analysis of quality control of the Compound Ketoconazole and Clobetasol Propionate Cream.

Determination Method Improvement for the Two Ingredients in Ketoconazole and Clobetasol Propionate Cream / 中国药师

Objective:To establish a method for the content determination of two ingredients in ktoconazole and clobetasol propio -nate cream.Methods:HPLC was performed on a Kromasil C 18 column (250 mm ×4.6 mm, 5 μm) with the mobile phase of metha-nol-sodium acetate with gradient elution at a flow rate of 1.0 ml· min-1 .The detection wavelength was 239 nm, the column tempera-ture was 30℃and the injection volume was 10 μl.Results:The linear range was 160.30-1282.40 μg· ml-1 for ketoconazole (r=1.0000) and 4.03-32.24μg· ml-1 for clobetasol propionate (r=1.0000).The average recoveries were 100.9％(RSD=0.52％, n=9) and 100.2％(RSD=0.56％,n=9), respectively.Conclusion:The method is accurate with good specificity and high sensi-tivity, which can be used for the detection of ketoconazole and clobetasol propionate .

Bilateral clear cell acanthoma of the areola and nipple: good response to topical corticosteroids

Abstract: Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids. Case report: A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis. Discussion: We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.

Eosinophilic annular erythema in adults: report of two cases and review of the literature

Abstract We herein report two cases of eosinophilic annular erythema in adults, which is rare. In both patients, lesions developed rapidly in few days and were located mainly on the trunk, buttocks, and extremities. Diagnosis was histopathological, with typical features including acute dermal inflammatory infiltrate with abundant eosinophils. One of the patients recurred after treatment on three occasions and finally cured spontaneously. The second patient recurred once and was then successfully treated with topical clobetasol. Clinical and histopathological features of eosinophilic annular erythema in adults have rarely been reported. A review of the literature and discussion of relationship with Wells syndrome are also included.

Topical application of clobetasol propionate cream in the treatment of phimosis in prepubertal children: A report of 237cases / 中华男科学杂志

Objective@#To investigate the clinical effect of 0.02% clobetasol propionate cream (CPC) on phimosis in prepubertal children.@*METHODS@#We retrospectively analyzed the clinical data about 237 prepubertal children with phimosis present at the Outpatient Department from June 2012 to December 2015. The patients were aged 2－14 (mean 8.6) years, all treated by topical application of 0.02% CPC to the narrowed opening and adhered part of the foreskin twice a day, in the morning and evening respectively. At the time of CPC application, the foreskin was slightly retracted. We evaluated the therapeutic effect every week from the end of the first week of treatment.@*RESULTS@#Totally, 233 of the patients completed the 8-week treatment, of whom 181 (77.68%) showed full retraction of the foreskin, 28 (12.01%) experienced improvement (disappearance of the phimotic ring), and 24 (10.30%) failed to respond, with a total effectiveness rate of 89.70%. No significant local or systemic adverse reactions were observed during the treatment.@*CONCLUSIONS@#Topical application of 0.02% Clobetasol Propionate Cream is a safe, effective, painless, and inexpensive option for the treatment of phimosis in prepubertal chilodren.

Comparison of compound flumethasone ointment and clobetasol propionate cream on serum and skin lesion Th cell related cytokines secreted in eczema / 中国生化药物杂志

Objective To compare the effect of compound flumethasone ointment and clobetasol propionate cream on serum and skin lesion Th cell related indicators in patients with eczema. Methods 156 patients with chronic eczema were chosen. According to the type of topical drugs, they were divided into two groups: the flumethasone group and the clobetasol propionate group. The changes of eczema treatment effect, serum and skin lesions Th cell related indicators of the two groups were compared. Results After treatment, the serum interferon-γ (IFN-γ) of the flumethasone group was (27.57 ± 5.67) pg/mL, IL-2 was (36.51 ± 8.03) pg/mL and IL-4 was (26.37 ± 5.29) pg/mL, IL-10 was (25.38 ± 4.64) pg/mL and INF-γof skin lesions was (56.53 ± 21.81) pg/L , IL-2 was (51.69 ± 15.67) pg/L, IL-4 was (159.42 ± 25.64) pg/L and (139.62 ± 24.58) pg/L, significantly lower than those of clobetasol propionate group (P <0.05), but the clinical benefit rate (94.87%) was significantly higher than (80.77%) of clobetasol propionate group (P <0.05). Conclusion Compared with clobetasol propionate cream, the effect of compound flumetasone ointment is more effective in treating eczema, and its mechanism may regulate the expressions of Th cell related cytokines.

Comparative histological study on wound healing on rat's skin treated with Mitomycin C or Clobetasol propionate

PURPOSE:To compare histologically the action of Mitomycin C and that of Clobetasol propionate for surgical wound healing in rats.METHODS:A circular skin fragment was surgically removed from 57 Wistar rats. Twenty-two animals were treated with Mitomycin C with topical medication in a single dose, 22 with Clobetasol propionate with a cream medication once a day for 15 days and 13 did not receive any medication. The animals were euthanized 30 and 60 days, and the scars subjected to histological examination.RESULTS: The histological analysis on the samples did not show statistically significant differences regarding the quantities of fibroblasts, fibrocytes and vascular proliferation in the three groups, in the evaluations after 30 and 60 days. In the treated groups with Mitomycin C and Clobetasol there was a decrease in collagen concentration over the 30-day period and an increase in collagen concentration over the 60-day period, in comparison with the control group.CONCLUSIONS: The actions of Mitomycin C and Clobetasol were equivalent and not interfere in fibroplasias and in angiogenesis. Both drugs initially cause a decrease in collagen over a 30-day period and an increase over a 60-day period, demonstrating a delay in the wound healing.

The reservoir effect of topical steroids in vitiliginous skin: A cross-sectional study.

Background: Prolonged and frequent use of topical steroids may lead to decrease in effi cacy as well as many local adverse effects. Stratum corneum has a unique property of reservoir effect. Aims: To study the reservoir effect of topical steroids in a steroid-responsive condition which may enable a decrease in the dosing frequency of topical steroids. Methods: A cross-sectional study design was used. Patients with at least three vitiliginous patches of more than 2 cm2 present over the trunk or limbs were included. Exclusion criteria were topical or systemic corticosteroid use within the previous 4 weeks, antihistamine use within the previous 7 days, history of any allergy in the past and immunosuppression. Clobetasol propionate cream was applied on the fi rst vitiliginous area (site A) and fl uticasone propionate ointment was applied on the second vitiliginous area (site B). The third vitiliginous area, site C (control site) was left without applying any medication. Histamine-induced wheal suppression test was performed on each site, at the same time of the day, on every consecutive day following steroid application, until the values obtained at sites A and B approached those obtained at site C. SPSS software for Windows, version 16.0 was used for statistical analysis. The mean and standard deviation of the various studied parameters were calculated for various treatment groups and compared using analysis of variance (ANOVA) test. Results: Forty patients were included in the study. The average wheal volumes and average erythema sizes at sites A and B were signifi cantly smaller than the corresponding values at site C for up to 5 days after applying medication (P < 0.001). Limitations: The presence of a cutaneous reservoir of topical steroid was confi rmed based on its suppressive effect on the wheal and fl are response to histamine. It is not certain that the concentration that suppresses histamine-induced wheal and fl are is suffi cient for therapeutic effi cacy in vitiligo. Conclusion: The reservoir effect of topical clobetasol propionate and fl uticasone propionate persisted for 5 days in vitiliginous skin. Hence, it may be possible to reduce the frequency of topical steroid application in vitiligo.

Evaluation of Efficacy, Safety and Tolerability of a Combination of Clobetasol, Neomycin and Miconazole Versus Betamethasone, Clotrimazole and Neomycin Versus Betamethasone, Gentamycin and Miconazole in Subjects with Eczematous Disorders Associated with underlying Tinea or Yeast Infections.

Lobate GM Neo, 15 mg is a triple drug combination of a steroid clobetasol with anti-fungal miconazole and antibacterial neomycin in treatment of Eczematous disorders associated with underlying Tinea or Yeast Infections. Aims and Objectives: The study was designed to evaluate the efficacy, safety and tolerability of a combinations of clobetasol, neomycin and miconazole (Group A) versus betamethasone, clotrimazole, neomycin (Group B) versus betamethasone, gentamicin, miconazole (Group C) in subjects with any type of eczematous disorder associated with underlying tinea or yeast infection. Materials and Methods: This was an open label, parallel group, randomized comparative study. The primary endpoint analyzed was improvement in clinical score from baseline at the end of day 7 and other primary endpoint like hyperpigmentation were analyzed by the visual analogue scale of 1 to 10 at the end of day 7. Results: Thirty-six subjects were randomized to three groups. The clinical score showed a significant reduction from baseline at the end of day 7 in all the groups, i.e. 82.9%, 81.3% and 85.6% in Group A, B and C respectively. However, the difference between the groups were not statistically significant. Mean hyper pigmentation score showed significant decrease of 82.9% in Group A, 81.6% in Group B and 92.2% in Group C from baseline at the end of day 7. Conclusion: The triple combination of antifungal, antibacterial and potent steroid was found to be efficacious, safe and tolerable in reducing signs and symptoms (scaling, inflammation, burning and itching) of eczematous disorder associated with underlying tinea/yeast infection.

Efficacy comparison of clobetasol propionate ointment and vitamin A acid cream in the treatment of skin papule type amyloidosis / 中国基层医药

Objective To compare clinical efficacy of clobetasol propionate ointment and vitamin A acid cream in the treatment of skin papule type amyloidosis.Methods 100 cases of skin papule type amyloidosis were randomly divided into the observation group and control group,each had 50 patients.The control group was treated with Vitamin A acid cream while the observation group used clobetasol propionate ointment for treatment.Skin lesion area,infiltration,skin color,skin itching score as well as the cure rate and efficiency were compared after 4 weeks of treatment.Results The two groups' symptoms was improved,symptom scores was decreased gradually after treatment than before,the observation group's symptom scores at 1,2,3,4 weeks were (9.35 ± 1.88),(6.54 ±2.16),(4.08 ±1.32),(2.04 ± 0.95) points which was significant better than (10.86 ± 2.08),(7.98 ± 2.57),(6.25 ± 1.44),(4.56 ± 1.18) points of the control group,the difference of two groups was statistically significant (t =6.22,6.71,7.30,7.41,all P ＜ 0.05) ;4 weeks after treatment,the observation group's efficience and cure rates were 94％ and 34％,significantly higher than 70％ and 22％ of the control group,the difference was statistically significant (x2 =9.040,8.391,all P ＜ 0.05).Conclusion Clobetasol propionate ointment has a exact effect in treatment of skinpapule type amyloidosis than vitamin A acid cream,which is worthy of clinical application.

Comparison of nail lacquer clobetasol efficacy at 0,05%, 1% and 8% in nail psoriasis treatment: prospective, controlled and randomized pilot study / Comparação da eficácia do clobetasol em esmalte 0,05%, 1% e 8% no tratamento da psoríase ungueal: estudo piloto, prospectivo, controlado e randomizado

BACKGROUND: Nail psoriasis may affect up to 90% of patients with psoriasis in the course of the disease throughout their lives and it is often a therapeutic challenge to dermatologists. Topical treatments described in the literature have demonstrated variable efficacy, and unsatisfactory results have been associated to inefficient penetration of the active ingredient into the nail plate and proximal nail fold. Recently the use of clobetasol on nail lacquer vehicle has been suggested, with satisfactory results and no side effects. OBJECTIVE: To determine the efficacy and safety of clobetasol in nail lacquer vehicle in three concentrations (0.05%, 1% and 8%) in patients with nail psoriasis. METHODS: Prospective, controlled, randomized pilot study in fifteen patients with nail bed and/or nail matrix psoriasis in both hands, subdivided into three groups: A(0.05% clobetasol nail lacquer), B(1% clobetasol nail lacquer) and C(8% clobetasol nail lacquer). All groups used clobetasol nail lacquer on the left hand and base coat nail lacquer as control on the right, twice a week for 16 weeks. Clinical evaluation was done by photographic records and the NAPSI score of both treated and control hands, as well as modified NAPSI score of the most affected nail of the treated hand. RESULTS: Group C showed a statistically relevant clinical response compared to the other groups, reflected in the improvement of clinical parameters, of treated hand NAPSI score, when compared to the control hand, and modified NAPSI score of the most affected nail in the treated hand. CONCLUSION: The 8% clobetasol nail lacquer was effective and safe, and it can be considered a good option of topical therapy in the treatment of nail psoriasis.

FUNDAMENTOS: A psoríase ungueal, de difícil manejo terapêutico, pode afetar até 90% dos portadores de psoríase no transcurso da doença, ao longo de suas vidas. Os tratamentos tópicos descritos na literatura têm eficácia variável, muitas vezes com resultados insatisfatórios causados pela ineficiência da penetração da substância ativa através da placa ungueal e dobra proximal. Recentemente tem sido proposto o uso do clobetasol em veículo esmalte, demonstrando resultados satisfatórios e ausência de efeitos colaterais. OBJETIVO: Determinar a eficácia e segurança do clobetasol em veículo esmalte em três concentrações (0,05%, 1% e 8%) nos pacientes com psoríase ungueal. MÉTODOS: Estudo piloto, prospectivo, controlado e randomizado com quinze pacientes portadores de psoríase ungueal em ambas as mãos. Os pacientes foram subdivididos em três grupos: A (esmalte clobetasol 0,05%), B (esmalte de clobetasol 1%) e C (esmalte de clobetasol 8%). Os pacientes usaram esmalte de clobetasol na mão esquerda e esmalte base (sem medicação - controle) na direita, aplicandoos duas vezes por semana, por 16 semanas. Fez-se a avaliação clínica por registros fotográficos e pelos MÉTODOS: NAPSI da mão tratada e controle e NAPSI modificado da unha mais acometida da mão tratada. RESULTADOS: O grupo C apresentou de forma estatisticamente significativa a resposta clínica mais relevante, refletida na melhora dos parâmetros clínicos, do NAPSI da mão tratada comparado ao da mão controle e do NAPSI modificado da unha mais acometida da mão tratada. CONCLUSÕES: Neste estudo piloto, o esmalte de clobetasol a 8% foi eficaz e seguro, mostrando-se uma boa opção de terapêutica tópica no tratamento da psoríase ungueal.

Effect of Clobetasol Propionate and Clobetasol Butyrate with Biopolymer on Skin Inflammatory Model in Wistar Rats.

The treatment of chronic inflammatory skin conditions are not satisfactory. There is a need for better antiflammatory drugs for these conditions. This study was done to compare the efficacy of biopolymer based formulations of clobetasol propionate and clobetasol butyrate with commercially available Preparations of clobetasol in animal models of superficial skin inflammation in rats. The croton oil ear edema in rats was the chronic inflammatory model used in this study. In this model, the animals treated with clobetasol propionate and clobetasol butyrate with biopolymer showed a significant decrease in inflammation as compared to commercially available preparations of clobetasol(Tenovate and Eumosone).

In vitro skin penetration of clobetasol from lipid nanoparticles: drug extraction and quantitation in different skin layers

Clobetasol propionate (CP) is a potent topical corticosteroid that causes several cutaneous and systemic side effects. In the present work, CP was encapsulated in nanostructured lipid carriers (NLCs) to increase drug retention in the outer skin layers and improve the safety of topical therapy. NLCs were prepared using a microemulsion technique with a mixture of lecithin, taurodeoxycholate, stearic acid, and oleic acid. In vitro penetration studies were performed in a modified Franz-type diffusion cell, and porcine ears were used as a model of human skin. A simple and sensitive liquid chromatographic method was developed and validated for clobetasol determination in different skin layers. NLCs presented uniform size distribution, high zeta potentialand entrapment efficiency values (> 98%). The analytical procedure was validated according to FDA guidelines. Clobetasol recoveries from skin samples were higher than 85%, with no interference of skin components and NLC ingredients. In experiments, after 6 h, a higher drug accumulation in the stratum corneum arising from NLCs compared to aqueous CP solution was observed. Thus, the NLCs demonstrated high potential for targeting CP to the skin and ensuring drug accumulation in the stratum corneum.

Proprionato de clobetasol (CP) é um potente corticóide tópico, que apresenta vários efeitos adversos cutâneos e sistêmicos. No presente trabalho, CP foi encapsulado em carreadores lipídicos nanoestruturados (NLCs) visando aumentar a retenção do fármaco nas camadas superficiais da pele e a segurança da terapia tópica. NLCs foram preparados usando a técnica de diluição de microemulsão com mistura de lecitina, taurodesoxicolato, ácido esteárico e ácido oléico. Estudos de penetração in vitro foram realizados em células de difusão de Franz modificadas usando pele de orelha de porco como modelo de pele humana. Um método simples e sensível de cromatografia líquida foi desenvolvido e validado para a determinação de clobetasol nas diferentes camadas da pele. NLCs apresentaram distribuição de tamanho uniforme e valores elevados de potencial zeta e eficiência de encapsulação (>98%). O procedimento analítico foi validado de acordo com as diretrizes do FDA. A recuperação de clobetasol a partir das amostras de pele foi maior que 85%, sem interferência dos componentes da pele e dos excipientes das NLCs. Após 6 horas de experimento observou-se maior acúmulo do fármaco a partir das NLCs comparado à solução aquosa de CP. Dessa forma, as NLCs mostraram elevado potencial para direcionar o CP para a pele, pois elas possibilitaram o acúmulo do fármaco no estrato córneo.

Constrição fetal do canal arterial após autouso materno de propianato de clobetasol tópico: relato de dois casos / Constriction of fetal ductus arteriosus after maternal self-use of clobetasol propianato topic: case report

A constrição prematura do ducto arterioso não é uma malformação estrutural e sim uma anormalidade funcional importante na vida fetal, podendo evoluir com insuficiência cardíaca (IC), hidropisia fetal e até óbito. Habitualmente, decorre do uso materno de drogas anti-inflamatórias (AINH) que aceleram a sensibilidade do ducto, podendo ocorrer na ausência de fatores desencadeantes identificáveis. Este estudo relata dois casos de constrição fetal ductal, após automedicação de creme de propianato de clobetasol. Objetiva-se demonstrar que essa anormalidade cardíaca fetal deve ser suspeitada pela ultrassonografia obstétrica e encaminhada para ecocardiografia fetal, exame que possibilita o diagnóstico, acompanhamento e melhora no prognóstico desses casos.

Premature ductal constrition is not a structural malformation, but may cause functional impairment during intrauterine life progressing to heart failure (CHF) and fetal hydrops witch can lead to death. Usually arises from the maternal use of drugs that speed up the sensitivity of the duct, witch may occurs in the absence of triggering factors. This study reports two cases of intrauterine ductal constriction after topic use of clobetasol. It aims to demonstrate that this fetal cardiac abnormality should be suspected by obstetric ultrasound and referred to fetal echocardiography that allows the diagnosis, monitoring and improving prognosis of these cases.

Observation of therapeutic effect of Tacrolimus ointment on patients with erosive oral lichen planus / 实用口腔医学杂志

To investigate the effects of Tacrolimus ointment on patients with erosive oral lichen planus. A total of 62 cases were collected and divided into two groups randomly: 31 cases were treated with Tacrolimus ointment (treatment group), and 31 cases with clobetasol propionate ointment (control group). There was no significant difference between two groups of the effective rate and side-effect occurrence during the therapy, and relapse rate within six months after treatment. The results of the present work demonstrate that Tacrolimus ointment is an effective therapy for oral lichen planus.

Psoriasis ungueal: experiencia con el tratamiento combinado de clobetasol al 8 por ciento en laca ungueal y calcipotriol / Combined clobetasol and calcipotriol treatment for nail psoriasis

La psoriasis ungueal es un problema común en los pacientes psoriáticos, con una incidencia de vida de 90%. A pesar de su alta incidencia y del gran impacto que produce en la calidad de vida, ha sido poco estudiada y el tratamiento óptimo aún no está bien dilucidado. Los corticoides tópicos y los análogos de la vitamina D son las terapias más usadas, pero no existe un esquema estándar para su uso. La combinación de estos agentes se ha estudiado en los últimos años para pacientes con afectación de la matriz y del lecho ungueal, mostrando muy buenos resultados. El caso que presentamos demuestra la sinergia entre estos agentes.

Nail psoriasis is a common problem among psoriatic patients, with a lifetime incidence of 90%. Despite its high incidence and severe impact on the quality of life, it has not been fully studied and the optimal treatment is still unclear. Topical glucocorticosteroids and vitamin D analogues are the most used therapies, but there is no standard therapeutic regimen for their use. The combination of both of these agents has been studied during the last years for the treatment of patients with matrix and bed nail compromise, showing very good results. The case that we present shows the synergy between these agents.