Combination of 1,064-nm Neodymium-doped Yttrium Aluminum Garnet Laser and Steroid Tape Decreases the Total Treatment Time of Hypertrophic Scars: An Analysis of 40 Cases of Cesarean-Section Scars.

BACKGROUND: The 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (Cutera, Inc., Brisbane, CA) and steroid tape (fludroxycortide tape) have been used to treat keloids and hypertrophic scars. OBJECTIVE: To evaluate the efficacy of contact-mode 1,064-nm Nd:YAG laser therapy and steroid tape for hypertrophic cesarean-section scars versus conservative therapy (steroid tape only). MATERIALS AND METHODS: A medical record review identified 40 consecutive Japanese patients who had hypertrophic scars (total Japan Scar Workshop Scar Scale [JSS] 2015 evaluation scores of 9 to 12) for more than 1 year after a vertical cesarean section and who were treated at our scar-specialist clinic from July 2015 to December 2017. All 40 patients continued treatment until the total JSS score dropped below 3. Recurrence was defined as a ≥1-point increase in the total JSW score 6 months after achieving a total JSS score <3. RESULTS: The patients had a mean age of 34.2 years. The test (n = 25) and control (n = 15) groups took on average 16.9 and 24.3 months to achieve a total JSS score <3, respectively (p < .01). In the following 6 months, none of the scars recurred. CONCLUSION: Nd:YAG laser treatment effectively decreased the total treatment time of hypertrophic cesarean-section scars. An algorithm for treating mild and severe hypertrophic cesarean-section scars is proposed.

In vitro penetration through the skin layers of topically applied glucocorticoids.

Corticoids are actives widely used in the treatment of skin diseases. This work aims to study the penetration of 3 corticoids (betamethasone, clobetasol, and flurandrenolide), their relationship with their Log D values and the effects of the vehicles. The 3 compounds were applied on a Franz-type diffusion cell in propylene glycol solution and their respective commercial creams and ointments. The active amounts found in the stratum corneum, epidermal, and dermal layers of the skin were investigated. Their diffusions were greatly affected by the formulation; moreover higher amounts of substance in the epidermis and dermis were detected in ointments than in creams. The enhancement effect of propylene glycol was also observed. The differences between the 3 substances could be related to their lipophilicity, molecular structure, and molecular weight. The more hydrophobic compounds (clobetasol and betamethasone) are present in higher amounts in the epidermis and dermis, while the hydrophilic compound (flurandrenolide) is mostly present in the receptor fluid.

Transmittance properties of flurandrenolide tape for psoriasis: helpful adjunct to phototherapy.

BACKGROUND: Flurandrenolide tape is a valuable agent in the treatment of lichen simplex chronicus and in psoriasis. The corticosteroid is helpful for reducing the symptoms and induration of the lichen simplex chronicus lesion, and occlusion of the lesion with the tape reduces the patient's opportunity to rub and scratch the affected area. OBJECTIVES: The purpose of this study was to determine to what extent flurandrenolide tape may block ultraviolet (UV) light and interfere with phototherapy of psoriasis. METHODS: Flurandrenolide tape was applied to quartz spectroscopy cuvettes, and the absorption spectrum was determined using a Beckman DU-600 spectrophotometer. The effect of the tape on UV light transmission was also determined using our UVA-UVB office phototherapy unit. RESULTS: Flurandrenolide tape has considerable UV absorption in the UVC range with less absorption in the UVB and UVA range. The transmittance is greater (less absorption) with longer wavelengths. There was greater UV absorption in the UVB range than in the UVA range. CONCLUSION: Although flurandrenolide tape may be left in place during PUVA therapy, adjustment of UV dose or removal of the tape is probably needed during UVB phototherapy.

Comparative efficacy of once-daily flurandrenolide tape versus twice-daily diflorasone diacetate ointment in the treatment of psoriasis.

BACKGROUND: Flurandrenolide tape has recently been listed as a group I topical corticosteroid. There are no studies that compare this product to group I ointments in the treatment of steroid-responsive dermatoses. OBJECTIVE: Our purpose was to determine the relative efficacy of flurandrenolide (4 microg/cm2) tape versus 0.05% diflorasone diacetate ointment in plaque psoriasis. METHODS: Thirty patients participated in an investigator-blinded, randomized, bilateral paired-comparison study of flurandrenolide tape applied to lesions of one side of the body once daily for up to 16 hours versus diflorasone diacetate ointment applied contralaterally twice daily. Lesions were assessed at baseline, then reevaluated at 2 and 4 weeks. RESULTS: Flurandrenolide tape-treated plaques showed consistently greater clearing in terms of erythema, scaling, induration, and treatment success for all plaques, as well as the subset of knee and elbow plaques, when compared with the lesions receiving diflorasone diacetate ointment. CONCLUSION: The efficacy of flurandrenolide tape in the treatment of psoriatic plaques surpasses that of diflorasone diacetate ointment.

[Anti-inflammatory activity of a topical glucocorticoid, fludroxycortide tape in experimental animals (author's transl)].

Fludroxycortide tape is a thin plastic tape which contains a synthetic glucocorticoid, fludroxycortide of 4 microgram/cm2. fludroxycortide tape with a topical application of 1 cm2 inhibited significantly contact hypersensitivities to oxazolone and picryl chloride in the ear skin of mice and PCA caused by IgE-like antibodies in the depilated abdominal skin of rats. Topical application of 1 to 4 cm2 of fludroxycortide tape produced a significant inhibition against histamine-induced vascular permeability, skin edema induced by intradermal injection of carrageenin into the depilated back and ear edema induced by topical application of croton oil in rats. Topical to oxazolone in dose-dependent manner, and had no thymolytic action, while in a dose of 100 microgram/ear, thymus atrophy occurred. Ear edema induced by croton oil was markedly inhibited by topical application of fludroxycortide (0.4 microgram/ear). Thus, fludorxycortide tape has topical anti-inflammatory activity against both allergic and non-allergic inflammation in mice and rats, and the topical anti-inflammatory activity of fludroxycortide appears to be favourably dissociated from its thymolytic action.

Open-angle glaucoma associated with topical administraion of flurandrenolide to the eye.

Intraocular pressure was elevated in both eyes and a glaucomatous field defect developed in one eye of an 18-year-old Caucasian man after prolonged topical use of flurandrenolide. Spontaneous remission occurred in one eye, the eye with least drug exposure, within a few weeks. The other eye continued to show evidence of elevated intraocular pressure and further field loss developed over 4 years after discontinuation of the steroid. The most serverly affected eye became myopic. This case strongly suggests that chronic application of flurandrenolide into the conjuctival sac can produce corticosteroid-induced glaucoma in susceptible individuals. Although both eyes were normal before exposure to the steroid and elevations of the same level developed in both eyes at the peak of the disease, the eye with the least drug exposure underwent complete and spontaneous remission whereas the eye exposed more frequently appeared to show irreversible changes in the aqueous humor outflow pathway with subsequent loss of visual field.

Flurandrenolide tape.

PIP: The effectiveness, mechanism of action and safety of copper in IUDs are briefly reviewed. In 1 study, 18.3 pregnancies occurred per 100 women during the 1st year of use of a T-shaped IUD whereas with a copper wire wound around the device, only 2 pregnancies occurred. The mechanism of action may be related to infiltration of polymorphonuclear leukocytes in the uterine mucosa or to a toxic effect of copper on the embryo. The dissolved copper ions appear to be the actual contraceptive agent since a large fraction of copper wire placed in a human uterus dis appears within a year and metals with low solubility are not effective. The duration of effectiveness and the safety of these experimental devices have not been established.^ieng