Stratum corneum absorption kinetics of 2 potent topical corticosteroid formulations: a pilot study.

Fluocinonide and halcinonide are class II topical corticosteroids that are indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses and generally are applied to affected skin at least twice daily. This pilot study compared the absorption kinetics of cream formulations of fluocinonide and halcinonide in the stratum corneum within a 9-hour period following application. A dermal tape-stripping protocol was used to quantify corticosteroid concentration at 6 sequential depths in the skin of 4 sites on the forearm. Halcinonide and fluocinonide were extracted from the strips and concentrations were measured using liquid chromatography-mass spectrometry. Results demonstrated the immediate absorption of fluocinonide and halcinonide into the stratum corneum within 1 hour of application followed by a sustained release of halcinonide and a steady decline of fluocinonide after peaking.

Demonstration of the biphasic release of 0.1% halcinonide cream.

Halcinonide in Halog Cream is formulated in a unique cream base that allows a biphasic release of this Class II steroid. Halcinonide in this product exists in two phases--a solution phase that is released immediately and a suspension phase that has a delayed release over time. The goal of this study was to evaluate this biphasic release of halcinonide into the skin using a novel noninvasive method. A dermal tape stripping protocol was used to quantify halcinonide concentration at 6 sequential depths in the skin of 4 sites on the forearms of 5 subjects. D-Squame strips were sequentially applied with consistent pressure and removed at 1, 3, 6, and 9 hours after application of halcinonide. Halcinonide was extracted from the strips and quantified using liquid chromatography mass spectrometry. The highest concentration of halcinonide was detected in strip 1 from the superficial stratum corneum with subsequent reduction in deeper stratum corneum layers as expected. The concentration increased beyond the first hour after application and demonstrated a sustained release into hour 6 before beginning declining. Similarly, the average concentration of halcinonide in strips 1 to 6 peaked at hour 1 and remained elevated for 6 hours. Data collected from the tape strips demonstrated a biphasic release of halcinonide--immediate release within 1 hour of application from the solution phase and continued, sustained release from the suspension phase following the first hour of application.

Tropical application of halcinonide cream reduces the severity and incidence of intraperitoneal adhesions in a rat model.

BACKGROUND: Systemic or intraperitoneal administration of corticosteroids has been reported to have conflicting effects on the prevention of peritoneal adhesions. Painting corticosteroid cream directly on the likely site of adhesion formation, owing to its high concentrations and persistent effects, may be a promising approach to prevent peritoneal adhesion formation. METHODS: Adhesions were induced by abrading of the cecum, followed by dropping of 95% ethanol. Sixty Wistar rats were randomly allocated to two control groups with no further treatment of the cecum and to two therapy groups treated with 0.1% halcinonide cream painted directly on the damaged surface of the cecum. After 3 and 7 days, adhesion scores, adhesion incidence, and intraperitoneal leukocytes were evaluated. RESULTS: On both postoperative days 3 and 7, halcinonide cream resulted in a significant decrease in mean adhesion scores (6.80 versus 0.67, 10.40 versus 1.26; P <0.001, P <0.001, respectively). The adhesion incidence was 43.3% for the therapy groups and 100% for controls (P <0.01). On day 3, the total numbers of intraperitoneal leukocytes were 120.73 +/- 24.01 millions for the therapy groups and 270.40 +/- 34.68 for controls (P <0.001). CONCLUSIONS: Painting halcinonide cream directly on the damaged surface of the cecum could effectively reduce the severity and incidence of adhesion, possibly by suppression of early inflammatory exudate and of late fibroblast invasion and proliferation.

Avaliaçäo terapêutica da halcinonida creme e pomada em pacientes portadores de dermatoses: aplicaçäo única diária / Therapeutic evaluation of halcinonide both crems and ointments in patients with dermatoses: a single darly use

Trinta e três pacientes portadores de dermatoses, na maioria eczematosas, foram submetidos a terapêutica tópica com creme ou pomada de halcinonida a 0,1% oclusivo, por um período de uma a quatro semanas. A avaliaçäo da eficácia da droga foi baseada em critérios objetivos e subjetivos, tendo havido de modo concordância ente ambos. Os resultados foram excelentes em 28 casos (85%), bons em quatro e regular em um único caso. Näo houve relato de evidência de efeitos colaterais importantes. Este novo esquema terapêutico quer pelos resultados observados como pela aceitaçäo por parte do paciente frente a comodidade de uma aplicaçäo diária

A trial of the Actiderm dermatological patch and topical corticosteroids in the treatment of psoriasis vulgaris. The Actiderm Multi-Center Study Group.

The use of the Actiderm dermatological patch in conjunction with topical corticosteroids was evaluated in a multi-centered, paired-comparison study of 189 patients with chronic psoriasis. In each patient, two lesions of comparable severity were selected for treatment. One plaque was treated with a twice-daily application of a steroid cream (triamcinolone acetonide 0.1 percent, betamethasone valerate 0.1 percent, or halcinonide 0.1 percent) while the second plaque was treated with a forty-eight hour application of the same steroid cream under Actiderm. At follow-up visits during the three-week treatment period and at four weeks post-treatment, the lesions were evaluated for the following parameters: erythema, induration, scale, and fissuring. For each of the three steroid preparations, the Actiderm and steroid therapy produced significant improvement in all parameters compared to the steroid therapy alone. This improvement was sustained through the post-treatment phase (p is less than 0.05 in all groups). No measurable differences in therapeutic efficacy were identified among the three steroid groups. Reports of adverse experiences in the Actiderm and steroid groups were infrequent. We conclude that the Actiderm and steroid combination is a safe and highly effective treatment for psoriasis.

[Thermographic study of the percutaneous absorption of corticosteroids]. / Studio termografico sull'assorbimento percutaneo dei corticosteroidi.

The results of a study on the percutaneous absorption of two corticosteroids, Halcinonide at 0.1% and Triamcinolone acetonide at 0.1%, employing an original thermographic method, are reported. In a first group of subjects treated with one application of the two corticosteroids a stronger activity of the Halcinonide was found than in a second group of subjects, after repeated applications, resulting progressively more evident and of longer duration in comparison with Triamcinolone.

Polymorphic light eruption in childhood.

The purpose of this article is to acquaint the pediatrician with polymorphic light eruption (PMLE) a light-induced, eczematous, cutaneous reaction that frequently begins in childhood. This sun-induced eruption is frequently misdiagnosed because of its similarity to atopic dermatitis.

A comparative study of amcinonide and halcinonide in the treatment of eczematous dermatitis.

Thirty-three patients with acute or subacute eczematous dermatitis were treated for two weeks in a double-blind, parallel-group study to compare the efficacy and cosmetic acceptability of 0.1 percent amcinonide cream and 0.1 percent halcinonide cream. Patients in both treatment groups showed significant (p less than 0.05) improvement from baseline for most signs and symptoms at the three evaluation times (days 3, 7, and 14). Comparisons between groups showed no significant differences at any evaluation except at day 14, when the amicinonide-treated patients had significantly (p = 0.04) less edema. The physician's evaluations were not significantly different except at day 7, when the halcinonide patients showed significantly (p = 0.04) more overall improvement. The patients' overall evaluations were not significantly different at any time. In general, both creams were cosmetically acceptable. At day 3, seven amcinonide patients noted skin tightening compared to one halcinonide patient; four halcinonide patients (as well as two at day 7 and one at day 14) reported stinging compared to only one amcinonide patient. In addition, two halcinonide patients reported a burning sensation at one or more evaluations compared to no such reports from amcinonide patients. One other side effect, a metallic taste in the mouth, occurred in a halcinonide-treated patient.

The use of halcinonide solution, 0.1 percent, in the treatment of eczematous diseases.

Halcinonide solution, 0.1 percent, was used to treat sixty-six patients with eczematous dermatoses. The majority of the responses were excellent, with the condition clearing completely in eight patients within the first week. The total mean amount of medication used by each patient for twice a day application for one or two weeks was less than 24 ml.

Short-term topical corticosteroid therapy (halcinonide ointment) in the management of atopic dermatitis.

The efficacy of short-term treatment of acute exacerbations of atopic dermatitis with a corticosteroid ointment (halcinonide, 0.1 percent) was demonstrated by comparing such a formulation with its ointment base (placebo). A double-blind, paired comparison study was conducted in 214 patients. Within two weeks the therapeutic response was judged excellent in 137 (64 percent) of the patients receiving the corticosteroid treatment. The number of responses judged good to excellent was 182 (85 percent). With the placebo, there was an excellent response in 50 (23 percent) of the patients and the number judged good to excellent was 95 (44 percent). Although these placebo responses attested to the appropriateness of a highly occlusive ointment vehicle in this condition, the corticosteroid containing formulation was superior (p less than 0.001). In only 10 (5 percent) of the patients was there a poor response to corticosteroid treatment. direct comparison of the response of similar bilateral lesions showed the corticosteroid to be superior to the placebo in 147 (69 percent) patients and the placebo to be superior in just 31 (15 percent) (p less than 0.001). No adverse reactions occurred with either preparation. We conclude that in the management of atopic dermatitis, full advantage should be taken of short-term corticosteroid therapy (preferably in ointment form), which is virtually free of those potential unwanted effects of chronic therapy with this class of drugs.

Evaluation of a new halcinonide formulation in the treatment of common dermatoses.

An open evaluation of halcinonide 0.1 percent in a hydrophilic vanishing cream base was conducted in one hundred patients with common steroid-responsive dermatoses, including eczema, contact dermatitis, atopic dermatitis stasis dermatitis, and neurodermatitis. Patients applied the cream two or three times a day for two weeks (or less if the clinical response warranted earlier discontinuation). Follow-up assessments were made on days 4, 7, and 14 of the study. Ninety-eight percent of the patients showed some degree of improvement, and eighty-five percent had complete clearing or marked improvement. One patient had no response and one worsened. Seventy-seven percent of the patients who responded achieved their maximum response within the first week of treatment. One case of urticaria was the only side effect noted in this series. Ninety-six percent of the patients rated their acceptance of the new formulation as excellent or good.

A comparison of single and multiple applications of halcinonide cream.

A double-blind paired comparison was made of once daily and three times daily regimens of 0.1% halcinonide cream in 149 patients with atopic dermatitis and 194 with psoriasis. In a simultaneously conducted study once daily application of 0.1% halcinonide was compared to the cream base alone (placebo) in 48 patients with atopic dermatitis and 78 with psoriasis. Results show that a once daily regimen can be an effective treatment in both conditions, and can be recommended as a starting regimen in certain circumstances such as the treatment of young children or pregnant women, or where long-term treatment is likely. The three times daily regimen, however, was superior overall, and is still recommended as the treatment of choice, at least in severe psoriasis.

Comparative merits of two topical corticosteroid antimicrobial drugs.

The anti-inflammatory and antimicrobial activities of two topical creams, one containing halcinonide, neomycin and nystatin (HNN), and the other betamethasone valerate, gentamicin, iodochlorhydroxyquin and tolnaftate (BGI), were compared in a randomized, parallel study of 154 patients (eighty-seven secondarily infected eczematous dermatoses; sixty-seven cutaneous candidiasis). Repeated clinical assessments showed that the two creams produced equivalent therapeutic responses both in patients with infected eczematous lesions and candidiasis. HNN and BGI creams eradicated the bacterial pathogens isolated prior to treatment in 80% and 76%, respectively, of the patients with eczematous dermatoses. The organism most frequently isolated in these patients was S. aureus. Local irritation prompting discontinuance of therapy occurred in just one patient receiving HNN, and two patients receiving BGI.

Treatment of psoriasis and atopic dermatitis with halcinonide cream applied once and three times daily.

In a double-blind multi-centre study, comprising ninety-five patients with psoriasis and atopic dermatitis, 0.1% halcinonide cream applied once daily was equally as effective as the cream applied three times daily. However, the onset of action was more rapid when the cream was applied three times daily. In a control study once daily application of 0.1% halcinonide cream was found to be superior to the vehicle alone in the treatment of forty patients with the same diseases.