Olmutinib Induced Lichen Planus Like Eruption

Drug induced lichen planus like eruption is an uncommon cutaneous adverse effect of several drugs. This appears symmetric eruption of erythematous or violaceous plaques resembling lichen planus on the trunk and extremities. A 50-year-old male presented with scaly, violaceous plaques and dusky brown macules on whole body. For four months, the patient was treated with olmutinib, an oral, third-generation epidermal growth factor receptor-tyrosine kinase inhibitor. In May 2016, olmutinib received its first global approval in South Korea for the treatment of patients with locally advanced or metastatic epidermal growth factor receptor T790M mutation-positive non-small cell lung cancer. The biopsy specimen from the patient showed features of lichen planus. We diagnosed him with olmutinib-induced lichen planus like eruption. He was treated with oral methylprednisolone and topical desoxymethasone 0.25% ointment. At the same time, olmutinib dose was decreased to three-fourths of this patient's starting dose. After that, the cutaneous lesions improved.

Barrier Rcovery after Topically Applied Desoxymethasone Ontment, Vaseline and Hydrobase on Benzalkonium Chloride-irritated Hairless Mice Skin / 대한피부과학회지

BACKGROUND: Topical irritants disrupt the cutaneous permeability barrier through the removal of stratum comeum lipids. This perturbation of barrier integrity stimulates a variety of homeostatic repair responses that ultimately result in the normalization of bamer function. Object To measure the effect of desoxymethasone ointment, vaseline and hydrobase on the barrier recovery of benzalkonium chloride (BKC) imtated skin. MATERIALS AND METHODS: The left flank skin of 2-3 monthold hairless mice was treated with BKC and then desoxymethasone ointment, vaseline and hydrobase were applied. Transepidermal water loss (TEWL) was checked after 0, 3, 6, 9, 12, 15, 18, 21 and 24 hours. Electron microscopic examination was performed after 3 and 24 hours after desoxymethasone, vaseline and hydrobase had been applied. RESULTS: The recovery of TEWL was most prominantly observed in the desoxymethasone ointment treated group followed by vaseline and hydrobase. Electron microscopic examination using ruthenium tetroxide fixation revealed that secretion and numbers of lamellar bodies and complete formatice of lipid bilayers were most prominent at desoxymethasone ointment and vaseline treated group. CONCLUSION: Desoxymethasone ointment, vaseline and hydrobase can be good agents in improving bamer recovery after exposure to irritant material.

Comparative Study of Calcipotriol and Desoxymethasone Ointments in the Treatment of Psoriasis Vulgaris: The Clinical Effect and Immunohistochemical Change / 대한피부과학회지

BACKGROUND: Calcipotrol, topical vitamin D analogue, has been demonstrated to have an effect for the treatment of psoriasis with good tolerability. It is required to have comparative studies with the other topical agents which are widely used for the treatment of psoriasis. OBJECTIVE: Our purpose is to compare calcipotriol with desoxymethasone ointemtn in their therapeutic efficacy and ability to affect dermal inflammatory cellular events. METHODS: This study was a randomized, double blind, right/left comparison over 8weeks in 10 patients. The ointments were applied twice daily to the lesions of psoriasis. Clinical efficacy, as measured by the Psoriasis Area and Severity Index(PASI) was assessed at 2, 4, 6 and 8weeks after starting treatments. The changes in the numbers of dermal immunocytes were assessed on frozen and paraffin-embedded sections by using immunohistochemical stain methods before and after the treatemtns. RESULTS: Reduction of PASI was statistically significant at all time points for both of the treatments (P<0.01) but there was no significant defference between the two treatment modalities. At the completion of 8 weeks of treatments, the mean PASI reduction was 65 percents and 67 percents for calcipotriol and desoxymethasone ointments, respectively. On immunohistochemical staining, the numbers of LCA and HLA-DR positive cells were decreased significantly(P<0.05), and IL-2R and CD4 positive cells were not significaltly reduced in each group after the treatment. CONCLUSION: Calcipotriol ointment was as effective as desoxymethasone ointment, judged by the PASI and the dermal inflammatory cellular events on immunohistochemical staining.

Measurement of Vascular Corticosteroid Effect in Human using Laser Doppler Flowmeter / 대한피부과학회지

Vasoconstrictive effect of several topicsl corticosteroids was measured using laser Doppler flowmeter. Hydrophilic ointment base, 1% hydrocortisone cream, 0.1% clocortolone pivalate cream, and 0.25% desoxymethasone cream were applied on both forearms of 20 volunteers. To augment the vasoconstrictive effect of the corticosteroids, We had cut off the blood flow to forearms for 4 minutes by tourniquet. The reactive hyperemia was measured by laser Doppler flowmeter and the ares under the curve were calculated by digitizer aided by a computer. The mean areas of esch drugs were in the following order : hydrophilic ointment base, 0.1% clocortolone pivalate cream, 1% hydrocortisone crearn and 0.25% desoxymethasone cream. However, the standard deviations were too large for the difference to be statistically significant. We concluded that laser Doppler flowmeter is not suitable for the measurement of vasoconstrictive effect of corticosteroid.

A Study of Topical Corticosteroid Effect on the Rat Skin Mast Cell / 대한피부과학회지

The effect of long-term topical application of corticosteroids on rat cutaneous mast cells was examined under the light microscopy. Two potent corticosteroids, 0.05% clobetasol-17-propionate and 0.25% desoxymethasone, produced a remarkable decresse greater than 50% of pretreatment mast cell number by two weeks. Wheress a less potent corticosteroid, 0.1% hydrocotisone-17-valerate, produced a remarkable decrease greater than 50% of pretreatment mast cell number by four weeks. All corticosteroids produced a remarkable decrease greater than 80% of pretreatment mast cell number by six weeks. These results suggest that long-term topical application of corticosteroids may have the deleterious effects on cutsneous mast cells.

Effects of Topical Anti-inflammatory Agents and Emollients on UVB Erythema and Pigmentation in Normal Korean Males / 대한피부과학회지

In healthy Korean adult males, 6 hour-MED was 51 2+22.6mJ/cm,24 hour-MED was 67. 5+26. 7mJ/cm, and MMD was 86. 5 t21. 3mJ/cm for UVB irradiation respectively. UVB-MED and UVB-MMD was increased by desoxymethasone, hydrocortisone, and bufexama.c creams. Hydrophilic ointment base increased only 24 hour-MED. For 1 MED of UVB, all test agents inhibited erytherna for 48 hours, For 2 MEDs of UVB, desoxymethasone, bufexamac; and hydrocortisone creams inhibited erythema at 6 hours, while desoxymethasone and hydrophilic ointment base could suppress erythema at: 24. hours after irradiation. However, desoxymethasone was the most effective. Hydrophilic ointment base was efficacious only at 24 hours after irradiation. For 1 MMD of UVB, desoxymethasone, hydrocortisone, and bufexamac creams could reduced the delayed tanning (DT) reaction.

Influence of Occlusive Dressing with Topical Corticosteroids on the Corneocytes of Normal Human Skin / 대한피부과학회지

This study was designed to investigate the effects of occlusive dressing with corticosteroid on the count, size and morphology of corneocytes of normal human skin. We select 16 male volunteers, aged 23 to 25 years, without skin lesions. They were divided to 2 groups according to duration of occlusive dressing, 3 days to group 1 and 6 days to group II. Specimens were obtained from 4 sites on the back, which were studied for the effect of occlusive dressings without any topicals, with 0.l% hydrocortisone-l7-butyrate cream, with 0.25% desoxymethasone ointment, and with base of desoxymethasone, before and every 3 to 5 days after occlusive dressings, up to a total 4 times in group I and 5 times in group II. (countinued..)

Clinical Trials of Frason on Various Dermatosis / 대한피부과학회지

Esperson(R), a new topical steroid ointment containing 0. 05% 17-Desoxymethasone,. was used in several kinds of dermatoses. Framycetin which was isolated and uientified by the research organisation of Roussel Laboratories (SOFRAPEN) in 1950 from culture broths of a strain of Streptomyces species is a wide spectrum antibiotics on various bacterial infectious diseases. Total 50 patients including 10 cases of 2ndary infected Atopic dermatitis, 10 of infected Contact dermatitis, 6 of infected Seborrheic dermatitis, 7 of infected Neurodermatitis, 3 of infected Chronic dermatitis, 5 of lmpetigo, 2 of infected Nummular eczema, 2 of infected Infantile ecze;na, 1 of infected Intertrigo, 1 of Eczematoid Otitis extema, 1 of 2nd degree Bum, 1 of infected Pruritis ani, 1 of infeeted 1nsect bite. were treated with Frason(R) (0.05% 17-desoxymethasone & 0.5% Framycetin combination). Among these 50 patiants, we observed excellent effects in 7 patients (14%), good effect in 29 patients (58%), fair effect in 10 patients (20%), Totally 36 patients (72%) revealed excellent to good therapeutic effects on their skin conditione after unoccluded application of Frason(R). 3 times daily for about 14 days. There was no sid ffect in all subjects after application of Esperson-F.

Clinical experience with Fluocinonide cream / 대한피부과학회지

Lidex(Fluacinonide) 0.05% in FAPG base is a new fluorinated topical corticosteroid. 30 patients with different steroid responsive dermatoaes were treated with 0. 05% Lidex. The diagnosis included atopic dermatitis, contact dermatitis, neurodermatitis, seborheic dermatitis, nummular eczema, psoriasis vulgaris, chronic eczema and pustulosis pahmaris et plantaris. In the majority of cases Lidex cream produced excellent to good result(70%) after unoccluded application 3 times daily for 10 days. Two patients complained burning or itching sensation after the initial application of Lidex. 0.05% Lidex was compared with 0. 25% Desoxymethasone cream and 0. 25% Fluocortolone cream and was found slightly more effective in Lidex.

Clinical Trials of Esperson on Various Dermatoses / 대한피부과학회지

Esperson, a new topieal steroid ointment containing 0. 25% 17-desoxymethasone, w as used in several kinds of dermatoses. Total 32 patients including 8 cases of contact dermatitis, 2 of atopic dermatitis, 5 of seborrheicdennatitis, 3 of neurodermatitis, 4 of nummular eczema, 2 of hand eczema, 1 of chronic eczema, 1 of perioral dermatitis, 5 of psoriasis and 1 of pityriasis rosea were treated with Esperson. Among these 32 patients, we observed excellent effects in 11 patients (34.4%), good effects in 16 patients (50%) and fair effects in 4 patients (12. 5%). Namely, among these 32 patients, 27 patients (84. 4%) revealed excellent to good therapeutic effects on their skin conditions with Esperson. In some details, 22 out of 26 patients (84.6%) with eczema and 4 out of 5 patients (80%) with psoriasis revealed excellent to good therapeutic effects respectively. No untoward side effect was noted in all subjects treated with Esperson.