RESUMEN
Introduction: Topical corticosteroids, available in an array of vehicles are used to control a variety of inflammatory skin diseases. Patients preferences for different vehicles may affect their willingness to use treatment. We assess corticosteroid vehicle preference and potential impact of topical characteristics on adherence and quality of life in patients with psoriasis.Methods: Subjects with psoriasis were recruited from Wake Forest University Dermatology Clinic. Subjects sampled desoximetasone 0.25% spray, betamethasone valerate 0.1% cream, triamcinolone acetonide 0.1% ointment, fluocinonide 0.05% gel, betamethasone valerate 0.1% lotion, clobetasol propionate 0.05% foam, and fluocinonide 0.05% solution in a predetermined randomized order. Subjects completed a Vehicle Preference Measure, Determinants of Adherence Measure, and a Determinants of Quality of Life Measure.Results: Patients preferences for the various products were highly variable. Regarding Determinants of Adherence, patients perception of absorption of the medication was ranked as 'quite important/extremely important' by 85% of total subjects. A majority of patients rated medication side effects as 'quite important/extremely important' when asked to consider topical characteristics effect on quality of life.Discussion: There was wide variation in patient preference for topical medication vehicles used for treating psoriasis. Several vehicle characteristics were considered important to adherence. Given the marked variation in vehicle preference, topical treatment should be individualized according to patients preferences.
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Glucocorticoides/uso terapéutico , Vehículos Farmacéuticos/química , Psoriasis/tratamiento farmacológico , Administración Tópica , Valerato de Betametasona/efectos adversos , Valerato de Betametasona/química , Valerato de Betametasona/uso terapéutico , Clobetasol/efectos adversos , Clobetasol/química , Clobetasol/uso terapéutico , Desoximetasona/efectos adversos , Desoximetasona/química , Desoximetasona/uso terapéutico , Composición de Medicamentos , Femenino , Fluocinonida/efectos adversos , Fluocinonida/uso terapéutico , Glucocorticoides/efectos adversos , Glucocorticoides/química , Humanos , Masculino , Persona de Mediana Edad , Prioridad del Paciente/psicología , Psoriasis/patología , Calidad de VidaRESUMEN
PURPOSE: The safety and potential side effects of desoximetasone 0.25% and 0.05% sprays have not previously been studied. The primary objective of this study was to determine the irritation potential of desoximetasone 0.25%, 0.05% and vehicle sprays in response to irradiation. MATERIALS AND METHODS: Thirty-four subjects were enrolled in the study, each with three study treatments (desoximetasone 0.25%, 0.05% topical sprays and vehicle) were applied to two sites each on the back of every subject, with half of the sites irradiated with filtered UV light. Dermal reactions at the test sites were evaluated using a visual scale with corresponding numerical scores that rated the degree of erythema and oedema. RESULTS: Desoximetasone 0.25%, 0.05%, and vehicle caused no detectable signs of phototoxicity when examined on days 3 and 4. Mean scores of desoximetasone 0.25%, 0.05% and vehicle to non-irradiated treatment areas showed no signs of irritation. CONCLUSIONS: Our results suggest that regular application of desoximetasone 0.25% and 0.05% topical sprays do not induce photosensitization or photoirritation. The safety of this topical spray may help with clinical management of patients using topical corticosteroids while also receiving therapeutic UV light exposure. Thus, patients can use desoximetasone sprays without concerns of side effects due to therapeutic light or sun exposure.
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Fármacos Dermatológicos/farmacología , Desoximetasona/farmacología , Piel/efectos de los fármacos , Administración Tópica , Adulto , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/química , Desoximetasona/efectos adversos , Desoximetasona/química , Método Doble Ciego , Eritema/patología , Eritema/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Piel/efectos de la radiación , Rayos Ultravioleta , Adulto JovenRESUMEN
Glucocorticoids (GCs) are very effective at preventing carcinogen- and tumor promoter-induced skin inflammation, hyperplasia, and mouse skin tumor formation. The effects of GCs are mediated by a well-known transcription factor, the glucocorticoid receptor (GR). GR acts via two different mechanisms: transcriptional regulation that requires DNA-binding (transactivation) and DNA binding-independent protein-protein interactions between GR and other transcription factors, such as nuclear factor kappa B (NF-κB) or activator protein 1 (AP-1; transrepression). We hypothesize that the transrepression activities of the GR are sufficient to suppress skin tumor promotion. We obtained two GCs (RU24858 and RU24782) that have dissociated downstream effects and induce only transrepression activities of the GR in a number of systems. These compounds bind the GR with high affinity and repress AP-1 and NF-κB activities while showing a lack of GR transactivation. RU24858, RU24782, or control full GCs desoximetasone (DES) and fluocinolone acetonide (FA) were applied to the dorsal skin of SENCAR mice prior to application of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA), two times per week for 2 weeks. DES, FA and RU24858 reversed TPA-induced epidermal hyperplasia and proliferation, while RU24782 treatment had no effect on these markers of skin tumor promotion. All tested compounds decreased TPA-induced c-jun mRNA levels in skin. DES, FA, and RU24858, but not RU24782, were also able to reverse TPA-induced increases in the mRNA levels of COX-2 and iNOS. These findings show that RU24858 but not RU24782 reduced TPA-induced epidermal hyperplasia, proliferation, and inflammation, while both compounds reversed c-jun mRNA increases in the skin.
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Transformación Celular Neoplásica/efectos de los fármacos , Transformación Celular Neoplásica/metabolismo , Desoximetasona/análogos & derivados , Glucocorticoides/farmacología , Neoplasias Cutáneas/metabolismo , Animales , Animales no Consanguíneos , Anticarcinógenos/química , Anticarcinógenos/farmacología , Biomarcadores , Proliferación Celular/efectos de los fármacos , Ciclooxigenasa 2/genética , Desoximetasona/química , Desoximetasona/farmacología , Epidermis/efectos de los fármacos , Epidermis/patología , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Glucocorticoides/química , Hiperplasia , Interleucina-6/genética , Ratones , Óxido Nítrico Sintasa de Tipo II/genética , Proteínas Proto-Oncogénicas c-jun/genética , ARN Mensajero , Neoplasias Cutáneas/inducido químicamente , Neoplasias Cutáneas/genética , Acetato de Tetradecanoilforbol/efectos adversosRESUMEN
The applications of Pulsed Laser Deposition (PLD) for producing nanoparticles, nanostructures and nanocomposites coatings based on recently developed laser ablating techniques and their convergence are being reviewed. The problems of in situ synthesis of hybrid inorganic-organic nanocomposites coatings by these techniques are being discussed. The novel modification of PLD called Pulsed Laser Adaptive Deposition (PLAD) technique is presented. The in situ synthesized inorganic/organic nanocomposites coatings from Magnesium (Mg) alloy/Rhodamine B and Mg alloy/ Desoximetasone by PLAD are described. The trends, applications and future development of discussed patented methods based on the laser ablating technologies for producing hybrid nanocomposite coatings have also been discussed in this review.
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Rayos Láser , Nanocompuestos/química , Aleaciones/química , Desoximetasona/química , Magnesio/química , Metales/química , Patentes como Asunto , Rodaminas/químicaRESUMEN
The physical and chemical compatibility of desoximetasone ointment 0.25% and tacrolimus ointment 0.1%, both widely used to treat atopic dermatitis, were determined. A 1:1 (w/w) mixture of desoximetasone ointment 0.25% (Topicort, Taro Pharmaceuticals USA, Inc.) and tacrolimus ointment 0.1% (Protopic, Fujisawa Healthcare, Inc.) were prepared and stored under three different temperature/relative humidity conditions: 25 degrees C/60% RH; 30 degrees C/60% RH; and 40 degrees C/75% RH. Unmixed ointments stored under the same temperature and humidity conditions as the mixture served as controls. Samples were evaluated at days 1, 2, 7, 14, and 28 for color, degree of physical separation, and chemical stability via reverse-phase high performance liquid chromatography. Ranges of relative recovery for each active ingredient for all storage conditions ((% Mixture/% Control) x 100) were 89.6-109.3% for tacrolimus and 99.0-103.4% for desoximetasone. No significant difference in physical appearance or chromatographic profile between the mixture and controls was observed. Therefore, we conclude that desoximetasone ointment 0.25% (Topicort) and tacrolimus ointment 0.1% (Protopic) are physically and chemically compatible up to four weeks when mixed in a ratio of 1:1 (w/w).