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1.
Int J Dermatol ; 63(9): 1221-1226, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38411257

RESUMEN

BACKGROUND: Clobetasol has demonstrated remarkable results in treating melasma within a short time frame; however, its use is limited because of the risk of local side effects. To date, there is no controlled trial on sequential clobetasol/hydroquinone for melasma. This study aimed to investigate the tolerability and efficacy of 0.05% clobetasol followed by 4% hydroquinone (CLOB-HQ) in comparison to the isolated use of 4% hydroquinone (HQ). METHODS: A double-blinded, randomized clinical trial involving 50 women with facial melasma was performed. They were directed to apply 0.05% clobetasol every night for 14 days, followed by 4% hydroquinone for 46 days (CLOB-HQ group), or the use of hydroquinone for 60 days (HQ group). Evaluations were carried out at inclusion, and after 14 and 60 days of treatment, measuring modified Melasma Area and Severity Index (mMASI), Melasma Quality of Life scale (MELASQoL), and colorimetry. The Global Aesthetic Improvement Scale (GAIS) was assessed by a blinded evaluator. RESULTS: There was no difference in the main outcomes at D14 and D60 (P > 0.1). For CLOB-HQ, the mean (CI 95%) reduction in mMASI was 13.2% (5.1-21.3%) and 43.1% (32.2-54.0%) at D14 and D60, and for HQ, they were 10.6% (5.9-27.5%) and 44.8% (33.2-52.3%). The MELASQoL, colorimetric luminosity, and GAIS showed a progressive improvement for both groups despite no difference between them. No severe side effects were identified. No cases of telangiectasias, atrophy, or perioral dermatitis were associated with the use of CLOB. CONCLUSION: The sequential CLOB-HQ regimen was safe and well tolerated, even though its efficacy was not different from HQ after 14 or 60 days of treatment. Based on these findings, the use of clobetasol 14 days before hydroquinone is not advisable for the treatment of melasma.


Asunto(s)
Clobetasol , Quimioterapia Combinada , Hidroquinonas , Melanosis , Calidad de Vida , Índice de Severidad de la Enfermedad , Humanos , Hidroquinonas/administración & dosificación , Hidroquinonas/efectos adversos , Melanosis/tratamiento farmacológico , Melanosis/diagnóstico , Femenino , Método Doble Ciego , Adulto , Clobetasol/administración & dosificación , Clobetasol/efectos adversos , Persona de Mediana Edad , Dermatosis Facial/tratamiento farmacológico , Esquema de Medicación , Administración Cutánea , Resultado del Tratamiento , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos
2.
BMC Res Notes ; 16(1): 33, 2023 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-36894959

RESUMEN

OBJECTIVES: The main objective of the study was to describe and compare the feasibility of using fractional CO2 laser to the usual treatment with Clobetasol. Randomized clinical trials brought together 20 women from a Brazilian university hospital, 9 of them were submitted to Clobetasol treatment and 11 to laser therapy. Sociodemographic data were obtained and quality of life parameters, vulvar anatomy, self-perception and histopathological analysis of vulvar biopsies were evaluated. Evaluations were made before the beginning of the treatment, during its implementation, right after its completion (3 months), and 12 months after. The SPSS 14.0 software was used, obtaining descriptive measurements. The level of significance adopted was 5%. RESULTS: The clinical/anatomical characteristics of the vulva did not differ between the treatment groups, as much before as after its performance. There was no statistically significant difference between the treatments performed regarding the impact on the life quality of the patients. A higher satisfaction degree with the treatment was obtained with the patients in the Laser group in the third month of evaluation. Laser therapy also revealed higher occurrence of telangiectasia after treatment completion. Fractional CO2 laser has proven to be well accepted and is a promising therapeutic option. Registration number and name of trial registry The institutional review board status was approved by the Research Ethics Committee of HU/ UFJF under advisory number 2881073 and registered in the Brazilian Clinical Trials, with consent under registration RBR-4p9s5y. Access link: https://ensaiosclinicos.gov.br/rg/RBR-4p9s5y.


Asunto(s)
Láseres de Gas , Liquen Escleroso Vulvar , Humanos , Femenino , Clobetasol/uso terapéutico , Clobetasol/efectos adversos , Liquen Escleroso Vulvar/tratamiento farmacológico , Liquen Escleroso Vulvar/inducido químicamente , Dióxido de Carbono , Glucocorticoides , Láseres de Gas/uso terapéutico , Estudios de Factibilidad , Calidad de Vida
3.
Oral Dis ; 29(3): 1250-1258, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34817126

RESUMEN

OBJECTIVES: To evaluate the serum and salivary levels of IL-1ß, IL-6, IL-17A, TNF-α, IL-4, and IL-10 in patients with oral lichen planus (OLP) treated with Photobiomodulation (PBM) and clobetasol propionate 0.05%. MATERIAL AND METHODS: Thirty-four OLP patients were randomized into two groups: Control (clobetasol propionate 0.05%) and PBM (660 nm, 100 mW, 177 J/cm2 , 5 s, 0.5 J per point). Serum and saliva were collected at baseline and at the end of treatment (after 30 days) and evaluated using ELISA. The cytokine results were correlated with pain, clinical subtypes, and clinical scores of OLP. RESULTS: IL-1ß, IL-6, IL-17A, TNF-α, and IL-4 levels were higher in saliva in relation to serum. IL-1ß was the most concentrated cytokine in saliva, and a positive correlation with the severity of OLP was noticed. After treatment with corticosteroid, IL-1ß in saliva decreased significantly. No modulation of all cytokines was observed after PBM. CONCLUSION: IL-1ß appears to be an important cytokine involved in OLP pathogenesis. In addition, the mechanisms of action of PBM do not seem to be linked to the modulation of pro or anti-inflammatory cytokines at the end of treatment. It is possible that this events occurred early during treatment.


Asunto(s)
Citocinas , Liquen Plano Oral , Humanos , Citocinas/análisis , Interleucina-6/análisis , Interleucina-17 , Factor de Necrosis Tumoral alfa , Clobetasol/uso terapéutico , Liquen Plano Oral/tratamiento farmacológico , Liquen Plano Oral/radioterapia , Interleucina-4 , Saliva/química
4.
An Bras Dermatol ; 97(6): 747-756, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36089549

RESUMEN

BACKGROUND: Vulvar diseases are common in the general population and have a negative impact on the quality of life. OBJECTIVES: To describe our experience as dermatologists in the management of vulvar dermatosis consultations. METHODS: A retrospective observational study was conducted with patients who attended monographic vulvar consultations over a 5-year period. Clinical information was obtained from the patient's charts. RESULTS: 148 women were studied. Their mean age was 43.24 years (standard deviation: 15.15 years), with ages ranging from 4 months to 80 years. 53.4% of patients took between 2 and 5 years to seek medical attention for the first time. The most frequent diagnosis was lichen sclerosus (41.9%), irritative eczema of the vulva (14.9%), and lichen simplex chronicus (10.1%). 83.8% reported anogenital itching, 66.2% pain, and 45.9% dyspareunia. The most frequently prescribed treatment was ultra-potent topical corticosteroids (clobetasol propionate; 41.2%). Patients with lichen sclerosus were significantly older than those who presented with any of the other diseases. No differences were found in terms of either the time of disease evolution or in symptom presentation. STUDY LIMITATIONS: Retrospective study. Vulvar diseases with an infectious cause are usually managed in primary care, therefore, were not included. All patients were recruited from a single private hospital which limits the comparisons with the public health system. CONCLUSIONS: Vulvar diseases frequently occur and are associated with high morbidity. It is essential to promote the development of specific vulvar consultations in hospitals. Specialties such as dermatology, gynecology, urology, or physiotherapy must be part of these units.


Asunto(s)
Liquen Escleroso y Atrófico , Enfermedades de la Vulva , Liquen Escleroso Vulvar , Adulto , Clobetasol/uso terapéutico , Estudios Transversales , Femenino , Glucocorticoides/uso terapéutico , Humanos , Liquen Escleroso y Atrófico/tratamiento farmacológico , Calidad de Vida , Estudios Retrospectivos , Vulva , Enfermedades de la Vulva/diagnóstico , Enfermedades de la Vulva/tratamiento farmacológico , Liquen Escleroso Vulvar/diagnóstico , Liquen Escleroso Vulvar/tratamiento farmacológico
5.
Rev. Hosp. Ital. B. Aires (2004) ; 42(2): 84-86, jun. 2022. ilus
Artículo en Español | LILACS, UNISALUD, BINACIS | ID: biblio-1378739

RESUMEN

La alopecia frontal fibrosante es una alopecia cicatricial que se caracteriza por la recesión de la línea de implantación frontotemporal que afecta principalmente a mujeres caucásicas en edad posmenopáusica y rara vez a hombres. Actualmente los mecanismos específicos de desarrollo continúan en estudio; sin embargo hay varias hipótesis sobre la asociación de la alopecia frontal fibrosante con otros trastornos autoinmunitarios. Se comunica el caso de un paciente masculino de 58 años con alopecia frontal fibrosante en áreas comprometidas por vitiligo. (AU)


Frontal fibrosing alopecia is a cicatricial alopecic characterized by progressive regression of the frontotemporal hairline. It usually affects postmenopausal caucasian women, and rarely men. Currently the specific mechanisms of development remain unknown, however there are several hypotheses about the association of frontal fibrosing alopecia with other autoimmune disorders. The case of a 58-year-old male patient with frontal fibrosing alopecia in areas affected by vitiligo. (AU)


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Vitíligo/complicaciones , Alopecia/complicaciones , Alopecia/diagnóstico , Alopecia/tratamiento farmacológico , Vitíligo/patología , Clobetasol/administración & dosificación , Tacrolimus/administración & dosificación , Alopecia/patología , Dutasterida/administración & dosificación
6.
Revista Digital de Postgrado ; 10(3): 322, dic. 2021. ilus
Artículo en Español | LILACS, LIVECS | ID: biblio-1425537

RESUMEN

Los corticoesteroides tópicos son drogas muy comunes, frecuentemente utilizadas en patologías dermatológicas. Su mal uso puede causar efectos sistémicos, como el síndrome de Cushing y la supresión del eje hipotalámico ­ hipofisiario ­ adrenal. Presentamos un caso de un lactante menor de siete meses quien desarrolla un síndrome de Cushing secundario al uso de Clobetasol por una dermatitis en el área del pañal, por tiempo prolongado, sin prescripción médica. Al examen físico se evidencia obesidad a predominio central, con fascie de luna llena, hipertricosis en región frontal, telangiectasias aisladas en mejillas y cuello de búfalo. Los paraclínicos demuestran una hipercolesterolemia, hipertrigliceridemia, elevación de las transaminasas y cortisol sérico en la mañana disminuido. Se concluye que se debe informar a los padres de los efectos adversos sistémicos de los esteroides tópicos y se sugiere evitar en pacientes pediátrico(AU)


Topical corticosteroids are very common drugs used in the treatment of inflammatory skin diseases. Prolonged ormisuse of them may cause systemic adverse effects, including Cushing syndrome and hypothalamic-pituitary-adrenal axissuppression. We present a case of a seven months old maleinfant who developed iatrogenic Cushing syndrome after diaperdermatitis treatment through misuse of Clobetasol, withoutdoctor's prescription. We observe redness and a moon face, abuffalo hump, central obesity and hirsutism. Laboratory values revealed hypercholesterolemia, hypertriglyceridemia, elevationin liver enzymes and low early morning cortisol. To conclude,parents must be informed by physicians about the adverse effect of steroids and the should be avoided in very young infant(AU)


Asunto(s)
Humanos , Masculino , Lactante , Clobetasol , Corticoesteroides , Síndrome de Cushing , Dermatitis , Glucocorticoides , Signos y Síntomas , Enfermedades de la Piel , Terapéutica , Preparaciones Farmacéuticas
7.
An. bras. dermatol ; An. bras. dermatol;96(1): 94-96, Jan.-Feb. 2021. graf
Artículo en Inglés | LILACS | ID: biblio-1152782

RESUMEN

Abstract We report four cases of ulcerated striae following misuse of fixed dose combinations creams containing clobetasol propionate with antifungal and antibacterial agents.


Asunto(s)
Humanos , Antialérgicos , Estrías de Distensión/inducido químicamente , Úlcera , Clobetasol/efectos adversos , Corticoesteroides/efectos adversos
8.
Oral Dis ; 27(5): 1205-1216, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33012017

RESUMEN

OBJECTIVES: To compare the efficacy of photobiomodulation to that of topical clobetasol 0.05% in patients with symptomatic oral lichen planus (OLP). SUBJECTS: Thirty-four patients with symptomatic OLP were randomly allocated into two groups: (a) the Control group (n = 17), application of topical clobetasol propionate 0.05% three times a day for 30 consecutive days with laser placebo applied twice a week to mask the treatment, and (b) the photobiomodulation group (n = 17), laser application twice a week, totalling 8 sessions, and gel placebo for 30 consecutive days to mask the treatment. Evaluations were performed once a week during treatment and 30, 60 and 90 days after treatment. The following parameters were evaluated: pain, clinical scores, clinical resolution and recurrence rate. RESULTS: Photobiomodulation and propionate clobetasol 0.05% were able to significantly decrease pain in oral lichen planus patients and improve clinical scores during treatment and follow-up. Both the Control and photobiomodulation groups presented similar clinical resolution and recurrence rates. Most importantly, no difference was observed between treatments during treatment and follow-up. CONCLUSIONS: These findings indicate that photobiomodulation twice a week is as effective as corticoid therapy in treating oral lichen planus. Moreover, photobiomodulation is a safe and non-invasive therapy with the remarkable advantage of no adverse effects.


Asunto(s)
Liquen Plano Oral , Administración Tópica , Clobetasol/uso terapéutico , Método Doble Ciego , Glucocorticoides/uso terapéutico , Humanos , Liquen Plano Oral/tratamiento farmacológico , Resultado del Tratamiento
9.
An Bras Dermatol ; 96(1): 94-96, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33288366

RESUMEN

We report four cases of ulcerated striae following misuse of fixed dose combinations creams containing clobetasol propionate with antifungal and antibacterial agents.


Asunto(s)
Antialérgicos , Estrías de Distensión , Corticoesteroides/efectos adversos , Clobetasol/efectos adversos , Humanos , Estrías de Distensión/inducido químicamente , Úlcera
10.
Rev. Salusvita (Online) ; 40(3): 23-36, 2021.
Artículo en Portugués | LILACS | ID: biblio-1524581

RESUMEN

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.


Asunto(s)
Humanos , Mucosa Bucal/lesiones , Clobetasol/uso terapéutico , Boca
11.
Sci Rep ; 10(1): 176, 2020 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-31932640

RESUMEN

Clobetasol propionate (CLO) is a potent glucocorticoid used to treat inflammation-based skin, scalp, and hair disorders. In such conditions, hair follicles (HF) are not only the target site but can also act as drug reservoirs when certain formulations are topically applied. Recently, we have demonstrated nanostructured lipid carriers (NLC) containing CLO presenting epidermal-targeting potential. Here, the focus was evaluating the HF uptake provided by such nanoparticles in comparison to a commercial cream and investigating the influence of different physical stimuli [i.e., infrared (IR) irradiation (with and without metallic nanoparticles-MNP), ultrasound (US) (with and without vibration) and mechanical massage] on their follicular targeting potential. Nanosystems presented sizes around 180 nm (PdI < 0.2) and negative zeta potential. The formulation did not alter skin water loss measurements and was stable for at least 30 days at 5 °C. Nanoparticles released the drug in a sustained fashion for more than 3 days and increased passively about 40 times CLO follicular uptake compared to the commercial cream. Confocal images confirmed the enhanced follicular delivery. On the one hand, NLC application followed by IR for heat generation showed no benefit in terms of HF targeting even at higher temperatures generated by metallic nanoparticle heating. On the other hand, upon US treatment, CLO retention was significantly increased in deeper skin layers. The addition of mechanical vibration to the US treatment led to higher follicular accumulation compared to passive exposure to NLC without stimuli. However, from all evaluated stimuli, manual massage presented the highest follicular targeting potential, driving more than double the amount of CLO into the HF than NLC passive application. In conclusion, NLC showed great potential for delivering CLO to HF, and a simple massage was capable of doubling follicular retention.


Asunto(s)
Clobetasol/administración & dosificación , Portadores de Fármacos/química , Folículo Piloso/metabolismo , Lípidos/química , Nanopartículas/administración & dosificación , Absorción Cutánea , Piel/metabolismo , Clobetasol/química , Folículo Piloso/efectos de los fármacos , Humanos , Rayos Infrarrojos , Nanopartículas/química , Piel/efectos de los fármacos , Estrés Mecánico , Ultrasonido
12.
Dermatol Online J ; 26(12)2020 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-33423421

RESUMEN

The increased use of monoclonal antibodies that target the immune checkpoint T cell receptor programmed death-1 (PD1) to treat numerous solid tumors has led to several reports describing associated cutaneous adverse events. Although lichenoid reactions have been well described, we propose that PD1 inhibitor-induced inverse lichenoid eruption (PILE) is a distinct variant. We describe two patients who presented with nearly identical deeply erythematous, malodorous, eroded anogenital plaques with focal crusting. Diagnosis of PILE was established given the biopsy findings and temporal association with PD1 inhibitor therapy. Treatment with clobetasol ointment was successful without necessitating discontinuation of immunotherapy. The findings were consistent with the only other previously published case of inverse lichenoid eruption in the groin secondary to PD1 inhibitors.


Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Erupciones Liquenoides/patología , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Abdomen/patología , Adenocarcinoma/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Nalgas/patología , Clobetasol/administración & dosificación , Femenino , Glucocorticoides/administración & dosificación , Humanos , Erupciones Liquenoides/tratamiento farmacológico , Erupciones Liquenoides/etiología , Neoplasias Pulmonares/tratamiento farmacológico , Persona de Mediana Edad , Pomadas , Perineo/patología , Piel/patología
13.
PLoS One ; 14(5): e0217718, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31150479

RESUMEN

This study aimed to evaluate the potential adverse effects of the dermal administration of Dillenia indica Linnaeus (D. indica) fruit extract in healthy rodents; the extract was standardized to betulinic acid. In the initial phase, the acute effects were evaluated on the skin application site of a single extract dose. A skin irritation test was performed in male Wistar rats (n = 8/group) receiving the extract (50-150 mg/mL) with betulinic acid (0.5-1.5%, respectively). A photosensitivity test was performed in male BALB/c mice (n = 6/group) receiving the extract (150 mg/mL). Afterwards, other BALB/c mice (n = 20, male:female, 1:1) were used to assess the systemic alterations caused by 14 daily repeated doses (150 mg/mL) by monitoring the effects on mortality, body morphology, behavior, nutrition status, neuromotor reactions, organ morphology and weight, and blood tests. At this time, 0.5 mg/mL clobetasol was used as the positive control. The skin irritation index suggested that negligible skin irritation had occurred, even when the extract was applied to the rat skin at 150 mg/mL. However, the extract acted as a photosensitizer on mouse skin, showing a photosensitizing activity close to that of 10 mg/mL 5-methoxypsoralen. Repeated doses caused no mouse mortality, aggressiveness, piloerection, diarrhea, convulsions, neuromotor alterations or nutrition status changes. The mouse organ weights did not change, and the mice did not have alterations in their blood compositions. Clobetasol caused a reduction in the mononuclear leukocyte numbers. In general, the data suggest that the extract was safe in healthy rodents but indicate that caution should be taken with the photosensitizing activity; in addition, this activity should be further explored as it may be useful for phototherapeutic drug development.


Asunto(s)
Clobetasol/farmacología , Dilleniaceae/química , Fármacos Fotosensibilizantes/farmacología , Piel/efectos de los fármacos , Administración Cutánea , Animales , Frutas/química , Humanos , Leucocitos Mononucleares/efectos de los fármacos , Ratones , Triterpenos Pentacíclicos , Fármacos Fotosensibilizantes/química , Extractos Vegetales/química , Extractos Vegetales/farmacología , Ratas , Pruebas de Irritación de la Piel , Triterpenos/química , Triterpenos/farmacología , Ácido Betulínico
14.
An. bras. dermatol ; An. bras. dermatol;93(6): 878-880, Nov.-Dec. 2018. graf
Artículo en Inglés | LILACS | ID: biblio-973628

RESUMEN

Abstract: Granuloma annulare is a relatively common, idiopathic, benign inflammatory dermatosis, with a varied clinical presentation that often makes diagnosis difficult. It mainly affects the extremities, such as the dorsa of the hands and feet, forearms and legs. Palmar and plantar regions are generally spared. It occurs mainly in young female patients. The presentation of the palmar variant in an elderly patient is a rarity.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Granuloma Anular/patología , Dermatosis de la Mano/patología , Clobetasol/administración & dosificación , Granuloma Anular/tratamiento farmacológico , Glucocorticoides/administración & dosificación , Dermatosis de la Mano/tratamiento farmacológico
15.
An Bras Dermatol ; 93(6): 878-880, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30484534

RESUMEN

Granuloma annulare is a relatively common, idiopathic, benign inflammatory dermatosis, with a varied clinical presentation that often makes diagnosis difficult. It mainly affects the extremities, such as the dorsa of the hands and feet, forearms and legs. Palmar and plantar regions are generally spared. It occurs mainly in young female patients. The presentation of the palmar variant in an elderly patient is a rarity.


Asunto(s)
Granuloma Anular/patología , Dermatosis de la Mano/patología , Clobetasol/administración & dosificación , Femenino , Glucocorticoides/administración & dosificación , Granuloma Anular/tratamiento farmacológico , Dermatosis de la Mano/tratamiento farmacológico , Humanos , Persona de Mediana Edad
16.
BMJ Open ; 8(10): e024083, 2018 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-30297352

RESUMEN

INTRODUCTION: Oral lichen planus (OLP) is an idiopathic chronic mucocutaneous disease with a wide range of clinical manifestations, including white reticular patches, erosive/ulcerative and atrophic lesions, both associated with intense symptomatology. Topical corticosteroids are commonly used as standard therapy. However, patients frequently present relapses after the discontinuation of treatment as well as developing resistance to corticosteroid therapy. Photobiomodulation (PBM) has been shown to be a potential therapeutic tool to treat inflammatory disorders, including OLP. The aim of this study was to compare the efficacy of PBM (660 nm) with corticosteroid therapy with clobetasol propionate 0.05% for the treatment of OLP. METHODS AND ANALYSIS: Forty-four patients with symptomatic and histopathological diagnosis of OLP will be randomised into two experimental groups in a double-blind manner: control group (n=22): clobetasol propionate 0.05%+placebo PBM, and experimental group (n=22): PBM (λ=660 nm, power 100 mW, radiant exposure: 177 J/cm2 and 0.5J per point)+placebo gel. Laser will be applied 2×/week for 1 month and clobetasol propionate three times a day for 30 days and the same for placebo treatments. The primary variable (pain) and the secondary variables (clinical score, evaluation of functional scores, clinical resolution, OLP recurrence, quality of life and anxiety and depression) will be evaluated at the baseline, once a week during treatment (depending on the variables) and after 30 days and 60 days of follow-up. Pain will be evaluated using visual analogue scale and clinical characteristics will be scored using the Thongprasom Index. The quality of life and anxiety and depression will be evaluated by Oral Health Impact Profile-14 questionnaire and by Hospital Anxiety and Depression Scale for anxiety scale, respectively. The serum and salivary levels of interleukin (IL)-6, IL-10, IL-1ß, INF-γ and tumour necrosis factor-α will be evaluated by ELISA at baseline and at the end of treatment. ETHICS AND DISSEMINATION: This protocol was approved (#2.375.410) by the Nove de Julho University (UNINOVE) Research Ethics Committee. The data gathered using this protocol will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03320460.


Asunto(s)
Antiinflamatorios/uso terapéutico , Clobetasol/uso terapéutico , Liquen Plano Oral/tratamiento farmacológico , Liquen Plano Oral/radioterapia , Terapia por Luz de Baja Intensidad , Administración Tópica , Método Doble Ciego , Alemania , Glucocorticoides/uso terapéutico , Humanos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
17.
Curr Drug Deliv ; 15(7): 998-1008, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29165079

RESUMEN

BACKGROUND: The aim of this paper is to evaluate a simple in vitro skin penetration experiment in which the drug is extracted from the whole skin piece as a test valid for formulation screening and optimization during development process, equivalence assessment during quality control or postapproval after changes to the product. METHODS: Twelve clobetasol propionate (CP) formulations (six creams and six ointments, being five generics and one reference from each formulation type) from the local market were used as a model to challenge the evaluated methodology in comparison to in vitro skin penetration following tape-stripping for drug extraction. To support the results, physicochemical tests for pH, viscosity, density and assay, as well as in vitro release were performed. RESULTS: Both protocols, extracting the drug from the skin using the tape-stripping technique or extracting from the full skin were capable of differentiating CP formulations. Only one formulation did not present statistical difference from the reference drug product in penetration tests and only other two oitments presented equivalent release to the reference. The protocol is straightforward and reproducible. CONCLUSION: Results suggest the bioinequavalence of tested CP formulations reinforcing the necessity of such evaluations.


Asunto(s)
Clobetasol/farmacocinética , Medicamentos Genéricos/farmacocinética , Glucocorticoides/farmacocinética , Pomadas/farmacocinética , Crema para la Piel/farmacocinética , Piel/metabolismo , Administración Tópica , Animales , Química Farmacéutica , Liberación de Fármacos , Concentración de Iones de Hidrógeno , Absorción Cutánea , Solubilidad , Porcinos , Equivalencia Terapéutica , Viscosidad
18.
An Bras Dermatol ; 92(5 Suppl 1): 27-29, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29267438

RESUMEN

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.


Asunto(s)
Acantoma , Clobetasol/administración & dosificación , Glucocorticoides/administración & dosificación , Neoplasias Primarias Múltiples , Pezones , Neoplasias Cutáneas , Acantoma/tratamiento farmacológico , Acantoma/patología , Administración Tópica , Adolescente , Biopsia , Femenino , Humanos , Neoplasias Primarias Múltiples/tratamiento farmacológico , Neoplasias Primarias Múltiples/patología , Pezones/patología , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patología , Resultado del Tratamiento
20.
Clin Exp Dermatol ; 42(7): 755-759, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28748570

RESUMEN

BACKGROUND: Lichen planopilaris (LPP) is characterized by lymphocytic infiltrate, fibrosis and potential destruction of the hair follicle. Demographic and clinical studies in LPP are limited, and racial differences have not been thoroughly investigated. AIM: To analyse epidemiological data and clinical profiles of Chilean adults with LPP, and report on the treatments used. METHODS: This was a retrospective review of medical records and clinical follow-up of Chilean adults with a clinical and histopathological diagnosis of LPP. Treatment response was categorized clinically as none (with progression of condition), mild or satisfactory. RESULTS: The study assessed 103 patients with LPP [67 women (mean age 54.1 years) and 36 men (mean age 39.1 years)]. Of the 103 patients, 41 women and 34 men were diagnosed with classic LPP (CLPP) and 26 women and 1 man with frontal fibrosing alopecia (FFA), while Graham-Little-Piccardi-Lassueur syndrome (GLPLS) was identified in 1 man. Men with CLPP had a significantly (P < 0.001) earlier age of onset than women. Scalp dysaesthesia, erythema and peripilar hyperkeratosis were common findings, and 51 (66%) of patients with CLPP had cicatricial patches, most of which were circumscribed in the vertex area. All patients with FFA had band-like scarring in the frontal and temporal hairlines. Morbidities associated with LPP were hypothyroidism, dyslipidaemia, hypertension and depression. For most patients, treatment halted or improved their inflammatory/scarring condition. A sustained combination of at least one topical (clobetasol, minoxidil and salicylic acid) and one systemic (cetirizine, hydroxychloroquine, finasteride, methotrexate and isotretinoin) medication was necessary in all of our patients with LPP. CONCLUSION: This investigation is one of the first to describe the demographic, clinical and therapeutic features of LPP in a Latin American population. Similar profiles to previous reports may encourage research in larger multicentre international studies.


Asunto(s)
Liquen Plano/tratamiento farmacológico , Liquen Plano/epidemiología , Dermatosis del Cuero Cabelludo/tratamiento farmacológico , Dermatosis del Cuero Cabelludo/epidemiología , Administración Tópica , Adulto , Edad de Inicio , Alopecia/etiología , Cetirizina/uso terapéutico , Chile/epidemiología , Clobetasol/uso terapéutico , Quimioterapia Combinada , Femenino , Glucocorticoides/uso terapéutico , Humanos , Liquen Plano/complicaciones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Distribución por Sexo , Factores Sexuales
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