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Background Methods Results Conclusion This study aims to assess the risk of drug‐associated glaucoma and track its epidemiological characteristics using real‐world data.Adverse event reports from the Food and Drug Administration Adverse Event Reporting System (FAERS) from January 2004 to December 2023 were analysed. Disproportionality analysis and the Bayesian Confidence Propagation Neural Network algorithm were used. The study classified drugs associated with glaucoma, assessed risk levels, and compared drug‐induced times across different categories.Eight hundred and five drugs were linked to glaucoma in the FAERS database. Disproportionality analysis identified 46 drugs with significant risk, mainly adrenergic medications (clobetasol propionate, fluocinolone acetonide), antihypertensives (hydrochlorothiazide), insulin (insulin human), anticholinergics (umeclidinium, darifenacin), VEGF inhibitors (brolucizumab, faricimab), and psychotropics (topiramate, ziprasidone). The top three high‐risk drugs were clobetasol propionate, umeclidinium, and fluocinolone acetonide. The shortest drug‐induced times were observed with indacaterol, salmeterol, and umeclidinium. Anticholinergic medications had the shortest drug‐induced time among all categories. Females (62.5%) and the elderly (average age 63.5 ± 16.8 years) were predominantly affected. Reports of drug‐associated glaucoma increased over the years.Preventing drug‐associated glaucoma is more effective than treatment. Identifying the risk and drug‐induced times of systemic and ophthalmic drugs can reduce occurrence risk. Clinical practitioners should be vigilant and inform patients of these risks. [ABSTRACT FROM AUTHOR]

Background Alopecia areata (AA) has a poor clinical course in children. There are no reliable therapeutic options for children with severe AA, including alopecia totalis (AT) and alopecia universalis (AU). Objectives We evaluated the efficacy and adverse effects of a potent topical corticosteroid (TCS) under occlusion in paediatric patients with severe AA. Methods We reviewed records of 23 patients under the age of 10 years with AT or AU treated with a potent TCS (0.05% clobetasol propionate or 0.3% diflucortolone valerate) for 8 h under occlusion with a plastic film. We used the Severity of Alopecia Tool (SALT) to measure clinical improvement. The primary endpoint was a SALT score of ≤ 20 at 6 months. We analysed the change in cortisol levels to identify the long-term safety of TCS therapy on the hypothalamus–pituitary–adrenal axis. Results Nineteen of the 23 patients (83%) reached SALT ≤ 20 at 6 months. Six patients relapsed over the 6-month follow-up period. Four patients were suspected of having adrenal insufficiency. However, the cortisol levels of the patients recovered to normal within 1 month of lowering the TCS potency or changing to nonsteroidal treatments. Limitations include the retrospective design and small sample size. Conclusions This study shows that a potent TCS occlusion may be a safe treatment option in paediatric patients with severe AA. Further long-term studies are required to evaluate the safety and recurrence of TCS occlusion therapy for paediatric AA. [ABSTRACT FROM AUTHOR]

Background According to current guidelines, systemic or topical corticosteroids are both recommended as first-line treatments for bullous pemphigoid (BP). There is evidence to suggest that topical application may be associated with a lower risk of mortality. However, there is a lack of comprehensive large-scale data comparing mortality rates, as well as the risk of major adverse cardiac events (MACE), infections and relapse, between systemic and topical corticosteroid treatments. Objectives To evaluate the risk of death, MACE, infections and relapse in patients with BP treated with systemic or topical corticosteroids. Methods A population-based retrospective cohort study was performed using the TriNetX US Collaborative Network. As a measure against bias, propensity score matching for age, sex, 10 diseases and 6 medications was done, and 3 sensitivity analyses were conducted. Results All-time risk of death was increased in US patients with BP exposed to any dose of systemic corticosteroids (n = 2917) vs. patients treated with topical clobetasol propionate [ n = 2932; hazard ratio (HR) 1.43, 95% confidence interval (CI) 1.28–1.58 (P < 0.001)]. This was consistent in time-stratified analysis (1- and 3-year mortality rates) and in analysis contrasting prednisone (equivalent) doses of 1–10 mg (low) or 30–100 mg (medium–high) systemic corticosteroid to topical treatment. The increased risk of death in US patients with BP exposed to any dose of systemic corticosteroids vs. topical treatment was accompanied by increased risks for MACE (HR 1.33, 95% CI 1.08–1.64; P = 0.008) and infections (HR 1.33, 95% CI 1.15–1.54; P < 0.001). The risk of continued disease or relapse was decreased in patients treated with systemic vs. topical corticosteroids (HR 0.85, 95% CI 0.77–0.94; P = 0.002). Results regarding mortality and continued disease or relapse persisted in three sensitivity analyses. Potential limitations included the retrospective data collection, bias for treatment selection and miscoding. Conclusions Pending validation in prospective studies, where feasible – and despite the heightened risk of relapse – topical corticosteroid treatment may be advantageous over systemic corticosteroid treatment owing to its significantly lower risk of death. [ABSTRACT FROM AUTHOR]

Multimodal treatment of cancer is an unstoppable revolution in clinical application. However, designing a platform that integrates therapeutic modalities with different pharmacokinetic characteristics remains a great challenge. Herein, we designed a universal lipid nanoplatform equipping a ROS-cleavable docetaxel prodrug (DTX-L-DTX) and an NF-E2-related factor 2 (NRF2) inhibitor (clobetasol propionate, CP). This simply fabricated nanomedicine enables superior synergistic molecularly targeted/chemo/radio therapy for lung cancer cascade by a transcription factor-driven ROS self-sustainable motion. Chemotherapy is launched via ROS-triggered DTX release. Subsequently, CP inhibits the expression of NRF2 target genes, resulting in efficient targeted therapy, meanwhile inducing sustained ROS generation which in turn facilitates chemotherapy by overcoming ROS consumption during the DTX release process. Finally, the introduction of radiotherapy further amplifies ROS, offering continuous mutual feedback to amplify the ultimate treatment performance. This strategy is conceptually and operationally simple, providing solutions to challenges in clinical cancer treatment and beyond. A transcription factor-driven ROS self-sustainable strategy developed herein empowers the flawless blend of targeted therapy, chemotherapy, and radiotherapy, three first-line therapies for lung cancer. [Display omitted] • A lipid nanodrug loaded with a targeted inhibitor and a chemo-prodrug is developed. • This nanodrug enables a transcription factor-driven ROS self-sustainable motion. • This ROS self-sustainable motion in-turn improves chemo-prodrug activation. • This nanodrug facilitates synergistic multimodal lung cancer therapy. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin disorder characterized by keratinocyte hyperproliferation, inflammation, and aberrant differentiation. Imiquimod-induced psoriasis in rodent models has been widely used to study the pathogenesis of the disease and evaluate potential therapeutic interventions. In this study, we investigated the efficacy of two commonly used treatments, Clobetasol and Tacrolimus, in ameliorating psoriatic symptoms in an Imiquimod-induced psoriasis Wistar rat model. Interestingly, rat models are poorly evaluated in the literature despite rats displaying several advantages in evaluating pharmacological substances. Psoriasis-like skin lesions were induced by topical application of Imiquimod cream on shaved dorsal skin for seven consecutive days. Following induction, rats in the treatment groups received either a Clobetasol or Tacrolimus ointment once daily for one week, while the control group did not receive any application. Disease severity was assessed using clinical scoring, histological examination, and measurement of proinflammatory cytokine levels. Both Clobetasol and Tacrolimus treatments significantly reduced psoriatic lesion severity compared to the control group. Clinical scoring revealed a decrease in erythema, scaling, transepidermal water loss, and thickness of skin lesions in both treatment groups with a more marked effect with Clobetasol. Histological analysis demonstrated reduced epidermal hyperplasia in treated animals compared to controls. Furthermore, Clobetasol led to a significant reduction in the expression levels of the interleukin-17 (IL-17a and IL-17f) proinflammatory cytokines in lesioned skin. Overall, our findings demonstrated the therapeutic efficacy of both Clobetasol and, in a modest manner, Tacrolimus in attenuating Imiquimod-induced psoriasis-like symptoms in a rat model. These results support the clinical use of these agents in the management of psoriasis and mitigating psoriatic inflammation. They also provide insights into the use of rats as a relevant species for the Imiquimod-induced psoriasis model. [ABSTRACT FROM AUTHOR]

Clobetasol propionate (CP) is a potent corticosteroid used for skin conditions but often causes side effects due its systemic absorption. To improve its solubility and reduce it side effects (like skin irritation, skin atrophy, hypopigmentation and steroidal acne), Microsponge (Msg) has been employed as a unique three-dimensional particle that can encapsulate hydrophilic and lipophilic drugs. This study aims to develop and evaluate CP Msg-loaded hydrogels. Two Clobetasol-loaded ethylcellulose-based Msg formulas were prepared using the quasi-emulsion solvent diffusion method, then they were incorporated into Carbopol hydrogel. Two ratios of Carbopol 940 (1% and 1.5% w/w) were used. The prepared hydrogel were assessed for appearance, pH, drug content, spreadability, extrudability, rheology, and in vitro release. The optimum hydrogel was compared to generic CP cream available locally and plain hydrogel. The results showed that both Msg formulas had good product yield, entrapment efficiency and highly porous micron size. The four prepared hydrogels revealed acceptable characterization including; pH ranged between 5.6and 6, drug content (98.8-100%) and % extrudability (80.7-92%) with pseudoplastic flow type. The hydrogel formula (F2Ha 1%) containing (1:1 weight ratio of CP: ethylcellulose) with (1%w\w Carbopol) was chosen as the optimized formula since it showed the highest spreadablility and approximately 43% of CP was released at 8 hours. The ex-vivo data including; the highest deposition in stratum corneum and epidermal/dermis with the flux, permeability coefficient and lag time of F2Ha were low, compared to plain hydrogel and marketed cream. Based on the study's finding, we concluded that CP Msg-loaded Carbopol hydrogel is a proper drug delivery system for topical application with minimized systemic absorption. [ABSTRACT FROM AUTHOR]

Background: Budesonide and tixocortol pivalate as markers of contact allergy to corticosteroids have been questioned, as they are not able to detect a significant percentage of allergic patients. Objectives: To investigate the potential role of clobetasol propionate in enhancing corticosteroid sensitisation detection. Methods: Between January 2022 and December 2023, patients who attended centres involved in the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy were tested with an extended baseline series that included budesonide, tixocortol pivalate, clobetasol propionate 0.1% in ethanol and 1% in petrolatum. Results: A total of 4338 patients were tested. Twenty‐four patients were allergic to budesonide (0.55%, 95% CI: 0.37–0.82); nine patients were allergic to tixocortol pivalate (0.21%, 95% CI: 0.11–0.39); and 23 patients were allergic to clobetasol (0.53%, 95% CI: 0.35–0.79). Only four of those patients allergic to clobetasol were detected by budesonide and one by tixocortol pivalate. No significant differences in the number of positive tests were found between clobetasol in petrolatum or ethanol. Conclusions: In Spain budesonide remains the main corticosteroid allergy marker whereas the role of tixocortol pivalate is questionable. The addition of clobetasol propionate to the Spanish baseline series would improve the ability to detect patients allergic to corticosteroids. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Oral lichen planus (OLP) is a common mucocutaneous disorder affecting approximately 1–2% of the population, predominantly middle-aged women. This study aims to analyse the demographic and clinical characteristics of OLP patients treated at the Oral Medicine Centre of Institute of Stomatology, Rīga Stradiņš University. The cohort comprised adult patients diagnosed with OLP, who underwent structured clinical evaluations. The study identified significant patterns in age, gender distribution, clinical forms, and associated discomfort levels. Females constituted 75.76% of the cohort, with a mean age of 60 years. The reticular form of OLP was most prevalent, while the erosive form, associated with considerable discomfort, was more common in females. Treatment regimens varied, with Sol Kenalog 0.2% and Ointment Clobetasol 0.05% being the primary therapies. Sol Kenalog 0.2% was more effective in providing symptom relief and reducing relapse frequency. Chronic diseases and stress were prevalent among patients, complicating management and treatment outcomes. The study emphasises the need for personalised treatment strategies that consider the severity of the clinical form, patient comfort, and comorbid conditions. Further research is recommended to validate these findings and explore the underlying mechanisms of gender differences and the impact of comorbidities on OLP. The insights from this study aim to enhance clinical practices and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim of current study is the development and optimization of biodegradable polymeric nanoparticles (NPs) to be used in the field of Endodontics as intracanal medication in cases of avulsed teeth with extended extra‐oral time, utilizing PLGA polymers loaded with the anti‐inflammatory drug clobetasol propionate (CP). Methodology: CP‐loaded nanoparticles (CP‐NPs) were prepared using the solvent displacement method. CP release profile from CP‐NPs was assessed for 48 h against free CP. Using extracted human teeth, the degree of infiltration inside the dentinal tubules was studied for both CP‐NPs and CP. The anti‐inflammatory capacity of CP‐NPs was evaluated in vitro measuring their response and reaction against inflammatory cells, in particular against macrophages. The enzyme‐linked immunosorbent assay (ELISA) was used to examine the cytokine release of IL‐1β and TNF‐α. Results: Optimized CP‐NPs displayed an average size below 200 nm and a monomodal population. Additionally, spherical morphology and non‐aggregation of CP‐NPs were confirmed by transmission electron microscopy. Interaction studies showed that CP was encapsulated inside the NPs and no covalent bonds were formed. Moreover, CP‐NPs exhibited a prolonged and steady release with only 21% of the encapsulated CP released after 48 h. Using confocal laser scanning microscopy, it was observed that CP‐NPs were able to display enhanced penetration into the dentinal tubules. Neither the release of TNF‐α nor IL‐1β increased in CP‐NPs compared to the LPS control, displaying results similar and even less than the TCP after 48 h. Moreover, IL‐1β release in LPS‐stimulated cells, decreased when macrophages were treated with CP‐NPs. Conclusions: In the present work, CP‐NPs were prepared, optimized and characterized displaying significant increase in the degree of infiltration inside the dentinal tubules against CP and were able to significantly reduce TNF‐α release. Therefore, CP‐NPs constitute a promising therapy for the treatment of avulsed teeth with extended extra‐oral time. [ABSTRACT FROM AUTHOR]

To evaluate the impact of high-potency topical steroid use on risk of recurrence of lichen sclerosus-associated vulvar cancer. This is a retrospective cohort study evaluating patients with lichen sclerosus (LS)- associated vulvar squamous cell cancer (VSCC). Demographic and clinical outcome data were compared between two comparison groups: patients who received steroids, mainly clobetasol, and patients who did not receive steroids following treatment of LS-related vulvar cancer. Categorical variables were compared using Fisher's exact test or chi-square test. Continuous variables were compared using a two-sided student's t-test. Time to recurrence (TTR) and overall survival (OS) were analyzed using Kaplan-Meier survival plot and compared using Mantel-Cox log rank test. Cox proportional hazard regression models were conducted to generate hazard ratios for both TTR and OS. A p value of <0.05 was considered statistically significant. A total of 49 patients were included, with 36 patients receiving steroid treatment and 13 patients in the expectant management group. The median age of diagnosis was 68. The average BMI was 31.7 +/− 7.0. The median length of follow up was 41 months. The majority of patients were diagnosed with stage I VSCC. There was no difference in demographics or oncologic management of vulvar cancer between the two cohorts. Overall recurrence was decreased among patients who received steroid treatment when compared to patients who did not, 12 patients (33.3%) versus 9 patients (69.2%) respectively (p = 0.048). High-potency topical steroid use following treatment of lichen sclerosus-associated vulvar squamous cell carcinoma is associated with decreased risk of recurrence and prolonged median time to recurrence. • Lichen sclerosus - associated vulvar cancer carries a worse prognosis when compared with HPV- associated vulvar cancer. • Topical steroids represent standard of care therapy for lichen sclerosus but its impact on vulvar cancer risk is unknown. • High-potency topical steroids may reduce risk of recurrence and prolong recurrence free survival in LS-associated VSCC. [ABSTRACT FROM AUTHOR]

Introduction: Lichen planopilaris (LPP) is one of the most common causes of scarring hair loss caused by immune‐mediated inflammation resulting in atrophy and scaling. The key to preventing this irreversible hair loss is diagnosing and starting treatment at the earliest possible stage. As there is no definite cure for LPP, the therapy could be challenging. In the study, we conducted a single‐blinded randomized clinical trial to evaluate the therapeutic effects, safety, and tolerability of platelet‐rich plasma versus topical clobetasol in the treatment of LPP. Method: A randomized single‐blinded controlled clinical trial was conducted in 24 LPP patients referring to our dermatology clinic between August 2022 and March 2023. Patients in the control group were treated with topical clobetasol 0.05% applied at night, and patients in the case group, in addition to topical clobetasol, received three sessions of PRP injection monthly. Both groups were assessed 1, 2, and 6 months after the start of the study by the Lichen Planopilaris Activity Index (LPPAI), physician and patient satisfaction, tolerability, and recording adverse effects. Results: The average age in the clobetasol and PRP groups was 43.75 ± 13.51 and 42.75 ± 9.67, respectively (p = 0.83). In terms of gender, all 12 cases (100%) in the clobetasol group and 9 cases (75%) in the PRP group were female (p = 0.21). Both PRP and topical clobetasol effectively reduced LPPAI in the first 2 months; however, after 6 months, the LPPAI significantly increased in the clobetasol group (p = 0.001). There were no significant differences in LPPAI between the two groups at the beginning of the study and after 1 month. However, the mean LPPAI score in the clobetasol group was significantly higher than in the PRP group at 2 and 6 months after the start of the study (p = 0.01). Patient satisfaction with treatment increased in both groups during follow‐up sessions, but at the end of the follow‐up period, it was significantly higher in the PRP group (p = 0.03). Finally, the study did not have any serious adverse effects, and the pain experienced during PRP injection was tolerable for the patients. Overall, treatment tolerability was excellent in both groups. Conclusion: Given the different efficacy profiles, PRP could be considered a new and effective choice for the treatment of LPP. [ABSTRACT FROM AUTHOR]

Psoriasis is a long-lasting, immune-related inflammatory skin disease that affects 2–3% of the global population. It is distinguished by erythematous, silvery, and scaly patches. Ramelteon is a type of melatonin agonist that is used to treat insomnia. It has enhanced non-classical immunomodulatory and anti-inflammatory activities. The aim of the study is to assess the ameliorative effects of topical ramelteon on imiquimod (IMQ)-aggravated psoriasiform-like dermatosis in mice. The 32 albino mouse males were placed into six groups of eight animals, all of them. With the exception of the control group, all groups gained a once-a-day regimen of topical imiquimod 5% cream at a dose of 62.5 mg for eight uninterrupted days, while mice in the control group gained vaseline-based ointment alternately. Immediately after an 8-day induction period in the imiquimod group, mice in the clobetasol and ramelteon treatment groups obtained a twice-daily regimen of topical clobetasol propionate 0.05% ointment and 0.1% ointment, respectively, for a further 8 days. This extends the total duration of the experimental study to 16 continuous days. The findings of our study found that ramelteon significantly mitigated the concentrations of inflammatory cytokines in the skin tissue, including interleukin (IL)-6, IL-17A, IL-23, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF), as well as the scores associated with psoriatic lesions, including erythema, scaling, skin thickening, ear thickness, and overall cumulative PASI scores. Additionally, the anti-inflammatory impact of ramelteon was achieved by markedly increasing IL-10 levels in the skin tissue and correcting cutaneous histopathological alterations. Ramelteon ointment (0.1%) was comparable to that of clobetasol (0.05%) ointment in alleviating a mouse model of imiquimod-induced psoriasiform inflammation; this is probably due to its potential anti-inflammatory and immunomodulatory activities. Therefore, ramelteon could be a good additive option for therapeutic management of immune-triggered inflammatory conditions such as psoriasis. [ABSTRACT FROM AUTHOR]

Lichen Planus is an inflammatory condition of the skin and mucous membrane that can also affect oral mucosa in a variety of forms. The mucosal form has six types and at least two of them carry a risk for malignant transformation and thus warrant a follow-up. The cutaneous form is pruritic and sometimes can be self-limiting but oral lichen planus (OLP), is a chronic inflammatory disease with relapses and remissions. A case of erosive lichen planus, treated with topical clobetasol propionate 0.05% and systemic corticosteroids is reported. The lesion healed after 3 weeks of treatment, following which the patient was referred for needful restorative treatment. The patient had a recurrence during the follow-up and the second course of treatment was administered. There is no welldefined treatment for OLP yet steroids have a vital role in symptomatic relief. Although topical steroids are the mainstay, recurrent, multiple, and large lesions are supplemented with systemic corticosteroids. [ABSTRACT FROM AUTHOR]

Psoriasis is characterized by an aberrant immune response due to myeloid dendritic cells and T helper cells intertwining with keratinocyte hyperproliferation. Skin integrity alterations may predispose patients to physiological imbalances, such as xerosis, reduced elasticity, and increased friability. This study aims to assess the epidermal barrier dysfunction in chronic plaque psoriasis and gain a comprehensive view of the dynamic changes in the epidermal barrier during various topical therapies. Adult patients with chronic plaque psoriasis were enrolled in this observational study. For each patient, skin barrier parameters, stratum corneum hydration (SCH), transepidermal water loss (TEWL), elasticity, erythema, and melanin levels were measured in lesional and non-lesional skin. Two extensions of the initial study design, with subsequent epidermal barrier determinations, were made as follows: one in which patients with moderate psoriasis were treated with clobetasol propionate 0.5% and the second one in which mild psoriasis was treated with either clobetasol propionate 0.5% or clobetasol propionate 0.5% with 10% urea. TEWL and erythema were found to be higher in the sites affected by psoriatic lesions than the unaffected sites, while SCH and elasticity were decreased. Severe psoriasis presented with higher TEWL (p = 0.032), erythema (p = 0.002), and lower SCH (p < 0.001) compared with the mild and moderate forms. SCH significantly improved during clobetasol propionate 0.5% treatment (p = 0.015). Clobetasol propionate 0.5% with 10% urea was found to be superior to clobetasol propionate 0.5% in improving TEWL and SCH in psoriasis. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin condition affecting multiple systems and the skin, with topical therapy representing the fundamental treatment modality for psoriasis. Investigate the effect of topical Roquinimex (ROQ) alone and combined with Clobetasol propionate (CLO) on imiquimod (IMQ)-induced mouse model as a novel approach to treating psoriasis. Sixty male Swiss Albino mice were divided into six groups of ten mice; all groups except the negative control received IMQ cream 5% (62.5 mg) as a once-daily topical application for six days. On the seventh day, five groups (except negative control) received one of the following treatments for eight days: no treatment (positive control), Petrolatum gel 15% as a twice-daily topical application (Petrolatum control), CLO 0.05% ointment once daily, ROQ ointment 1% w/w twice daily topically, topical preparation of 0.025% CLO ointment combined with ROQ ointment 0.5% w/w twice daily; the total duration of the study is 14 days. The clinical, pathological, and laboratory effects were then measured. The use of ROQ ointment alone or combined with CLO resulted in significant improvement in psoriasis lesions (measured by Baker's and PASI scores) compared to positive control groups (2.15±1.08, 1.60±0.61, 9.00±0.00, and 7.60±0.84, respectively for Baker's score) (1.50±1.08, 1.30±0.95, 11.70±0.48, 9.30±0.67, respectively for PASI score), a similar improvement seen for various inflammatory markers, including interleukin (IL)-10 (140.53±60.68, 285.63±92.16, 31.83±3.03, and 92.50±27.13 pg/ml, respectively), IL-17 (126.58±40.98, 124.26±61.40, 553.04±141.32, and 278.52±100.27 pg/ml, respectively), tumor necrosis factor-α (72.34±23.40, 30.11±7.01, 807.13±500.06, and 281.79±240.17 pg/ml, respectively), and vascular endothelial growth factor (109.71±29.35, 80.96±24.58, 552.20±136.63, 209.56±73.31 pg/ml and respectively). Roquinimex exerts its antipsoriatic effect through multiple mechanisms; its combination treatment with Clobetasol is a promising therapy for managing psoriasis. [ABSTRACT FROM AUTHOR]

Background: Sarcoidosis, characterized by non-caseating epithelioid granulomas, presents diagnostic and therapeutic challenges. Method: Here we present a 38-year-old woman who exhibited erythematous and infiltrated skin lesions on her facial region following fractional laser treatment. Results: Histological analysis confirmed cutaneous sarcoidosis. Initial interventions with topical clobetasol and oral chloroquine provided transient relief. Subsequent outpatient management comprised topical tacrolimus and clobetasol, as well as systemic methotrexate, later substituted with prednisone. Gradual tapering resulted in lesion reduction. Conclusions: This case underscores the intricate nature of cutaneous sarcoidosis and the necessity for personalized therapeutic approaches. The association with cosmetic procedures highlights the importance of understanding potential triggers. The presented case highlights and reminds the medical community that lasers are not only used for therapeutic purposes but can also induce specific responses through laser therapy. Notably, while laser therapy is frequently employed in treating cutaneous sarcoidosis, its role in inducing sarcoidosis warrants further investigation. [ABSTRACT FROM AUTHOR]

Objetivo: identificar os efeitos e aplicação do propionato de clobetasol na cicatrização de feridas em humanos, e em quais feridas é mais frequente o uso dessa corticoideterapia tópica. Método: revisão integrativa, com a estratégia PICO, realizada entre janeiro e março de 2024 nas bases de dados U.S National Library of Medicine (PubMed), Cochrane Library, Scientific Electronic Library Online (SciELO) e no Google Acadêmico. Utilizou-se o seguinte algoritmo de busca: “Clobetasol” AND “Wound Healing” AND “Patients” com recorte temporal de 10 anos. Resultados: foram encontrados 1939 estudos, sendo selecionados 18 para a revisão. A maioria foi do tipo relato de caso. O tipo de ferida mais prevalente foi o pioderma gangrenoso ulcerativo, sendo a aplicação do clobetasol duas vezes na semana por até 14 dias. Os efeitos com uso do medicamento foram a diminuição dos sinais de inflamação e resolução na cicatrização das feridas. Conclusão: os dados sugerem que a aplicação tópica do propionato de clobetasol, em conjunto com outras terapias, em humanos portadores de feridas do tipo pioderma gangrenoso, penfigoide bolhoso, hipergranulação, queimaduras, dermatoses e líquen escleroso promove melhoras no processo cicatricial.

This article discusses the use of abrocitinib and tofacitinib in the treatment of prurigo nodularis, a chronic inflammatory skin disorder characterized by severe itching. The studies conducted on both medications showed promising results in reducing pruritus and improving the condition of patients with prurigo nodularis. However, further research is needed to determine the long-term efficacy and safety of these medications. These findings suggest that abrocitinib and tofacitinib may be potential therapeutic options for prurigo nodularis, but more research is necessary to confirm their effectiveness. [Extracted from the article]

Juan Francisco Mir-Bonafé,1 Jaime Piquero-Casals,2 Ludmila Prudkin,3 Jesus Delgado,3 Julia Santamaria Martínez,3 Vicente Garcia-Patos Briones4 1Department of Dermatology, Hospital Son Llàtzer, Palma de Mallorca, Spain; 2Department of Aesthetic Dermatology and Laser, Dermik, Clínica Dermatológica Multidisciplinar, Barcelona, Spain; 3Innovation and Development, ISDIN, Barcelona, Spain; 4Department of Dermatology, Hospital Vall d’Hebron, Barcelona, SpainCorrespondence: Jaime Piquero-Casals, Department of Aesthetic Dermatology and Laser, Dermik, Clínica Dermatológica Multidisciplinar, Barcelona, Spain, Tel +34 935464710, Email j.piquero@dermik.esBackground: Noninfectious inflammatory dermatoses of the scalp are common, and their symptomsin particular, those affecting appearance, can have a psychological effect that may be disproportionate to their clinical severity. Effective, cosmetically acceptable treatments are important to manage these conditions. Topical corticosteroids form the cornerstone of acute treatment for many of these conditions. We surveyed practicing dermatologists and dermatology residents to determine the current clinical practice in prescribing topical corticosteroids for these disorders in their various preparation formats.Methods: A Delphi method was used, consisting of 2 questionnaire rounds. The first round contained 34 questions and was completed by 612 dermatologists and dermatology residents via email. The first round of responses was analyzed, and points that had > 70% agreement were used to form a second questionnaire of 21 statements. This second round was completed by 346 participants, and their responses were used to generate a final report. Participants were practicing in both public and private practices.Results: Clobetasol propionate 0.05% topical solution was considered to be the most appropriate treatment for noninfectious inflammatory scalp dermatoses in general, with 75.1% agreement in the second round of questionnaire. The main advantages of clobetasol propionate over other topical corticosteroids were reported as potency, effectiveness, and broad action spectrum (94.8% agreement). The preferred pharmaceutical format was the solution of clobetasol propionate.Conclusion: Clobetasol propionate was the preferred topical treatment for the management of scalp dermatoses, usually as first-line treatment; solution was the preferred preparation.Keywords: seborrheic dermatitis, psoriasis, shampoo, topical, solution, clobetasol, scalp, therapy

Background: Vitiligo is an inveterate disease of great aesthetic concern presenting with depigmented macules and patches. It is often incorrigible to medical treatment. Aim: To study the clinical profile of vitiligo patients and evaluate the effect of 5% 5‑fluorouracil (5‑FU) cream with microneedling. Materials and Methods: This observational analytical study was conducted from November 2019 to July 2021. A total of 33 adult vitiligo patients were treated with oral mini‑pulse (dexamethasone) therapy and topical corticosteroid (clobetasol propionate 0.05%). Patient’s total number of vitiligo lesions with <10‑cm size were counted and half of the lesions were treated with 5‑FU + microneedling (Group A), while a remaining number of lesions were not treated with 5‑FU + microneedling (Group B). In the case of the odd number of lesions, the total number of lesions minus one was considered and then divided into equal numbers for treatment. The procedure was performed every 2 weeks for 3 months. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading scores. Results: Initiation of repigmentation started in the first month in Group A, whereas in Group B, it was seen in the second, which was statistically significant (P < 0.0001). Excellent improvement (>75% repigmentation) was noted in Group A as compared to Group B at the end of 6 months (P < 0.0001). Conclusions: Needling with 5% 5‑FU appears to be a simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy. [ABSTRACT FROM AUTHOR]

Clobetasol Propionate is a highly strong corticosteroid that is used in a variety of topical medication formulations, including foam, ointment, lotion, spray and shampoo; with a dosage strength of 0.05% (w/w). The goal of this research was to identify and characterize a substantial unknown impurity (UK) detected during the stability testing of a Clobetasol Propionate foam pharmaceutical product in accelerated conditions (40°C and 75% relative humidity). Developing a single, robust and accurate HPLC method that is LC–MS compatible for quantifying all 14 potential Clobetasol Propionate impurities in therapeutic drugs is another goal. Preparative column chromatography was used to separate the impurity, and spectroscopic techniques like IR, NMR and MS were used to characterize its structure. The structure of isolated UK was effectively characterized and defined using spectroscopic data evaluation. The chromatographic method has also been validated according to the International Conference on Hominization's Q (2) quality guidelines. The isolated and characterized impurity had the same equivalence as the impurity found during stability testing. Precision, accuracy, linearity, robustness and ruggedness are all met in the method validation data. [ABSTRACT FROM AUTHOR]

Background: Improper use of over‑the‑counter (OTC) steroid medication has been linked to recalcitrant dermatophytosis. There is proven evidence of HPA axis suppression by the use of long‑term oral steroids. This study aims to determine the prevalence and pattern of inappropriate OTC steroid use and its effects on the hypothalamus‑pituitary‑adrenal (HPA) axis in adults with recalcitrant dermatophytosis. Materials and Methods: This cross‑sectional study of 2 months was conducted in a hospital setting and included patients of recalcitrant dermatophytosis with a history of OTC steroid use. Clinico‑demographic details and basal serum cortisol levels were recorded in all and analyzed. Result: Of a total of 103 patients, 59.22% (n = 61/103) were males, and the mean duration of steroid abuse was 17.78 months. About 48.54% (n = 50/103), 3.88% (n = 4/103), and 47.57% (n = 49/103) patients reported the use of topical steroids, oral steroids, and both oral and topical steroids, respectively. Among all the topical steroid users (n = 99), clobetasol propionate 48.48% (n = 48/99), while among oral steroid users (n = 53), prednisolone 45.28% (n = 24/53) were the most commonly used agents, respectively. The morning serum cortisol levels (8–9 AM) were found to be decreased in 42.7% (n = 44/103), with a mean value of 44.28 ± 17.34 μg/dL. Conclusion: Improper OTC steroid use in recalcitrant dermatophytosis leads to HPA axis suppression. This highlights the need for intervention from apex health officials. [ABSTRACT FROM AUTHOR]

Bullous pemphigoid (BP) is an antibody-mediated blistering disease predominantly affecting the elderly. The pathogenesis involves both complement-dependent and complement-independent mechanisms. The therapeutic potential of targeting complement-independent mechanism has not yet been determined. The mainstay of treatment, corticosteroid, has many side effects, indicating the needs of better treatments. We tempted to establish an in vitro model of BP which resembles complement-independent mechanism and to examine the therapeutic potential of a novel anti-inflammatory agent, diacerein. Cultured HaCaT cells were treated with purified antibodies from BP patients, with or without diacerein to measure the cell interface presence of BP180, protein kinase C, and the production of proinflammatory cytokines. An open-label, randomized, phase 2 trial was conducted to compare topical diacerein and clobetasol ointments in patients with mild-to-moderate BP (NCT03286582). The reduced presentation of BP180 at cell interface after treating with BP autoantibodies was noticed in immunofluorescence and western blotting studies. The phenomenon was restored by diacerein. Diacerein also reduced the autoantibody-induced increase of pro-inflammatory cytokines. Reciprocal changes of BP180 and protein kinase C at the cell interface were found after treating with BP autoantibodies. This phenomenon was also reversed by diacerein in a dose-dependent manner. The phase 2 trial showed that topical diacerein reduced the clinical symptoms which were comparable to those of topical clobetasol. Diacerein inhibited BP autoantibody-induced reduction of BP180 and production of proinflammatory cytokines in vitro and showed therapeutic potential in patients with BP. It is a novel drug worthy of further investigations. [ABSTRACT FROM AUTHOR]

Objective: Glucocorticoids suppress the hypothalamic–pituitary–adrenal axis, which may lead to glucocorticoid‐induced adrenal insufficiency. The study aimed to investigate the prevalence of this state in patients with oral lichen planus treated with topical clobetasol propionate. Methods: In this cross‐sectional study, 30 patients with oral lichen planus receiving long‐term (>6 weeks) clobetasol propionate gel 0.025% were invited to participate. Adrenal function was assessed by measuring morning plasma cortisol after a 48‐h withdrawal of clobetasol treatment. In patients with plasma cortisol <280 nmol/L, a cosyntropin stimulation test was performed. Results: Twenty‐seven patients were included. Twenty‐one (78%) patients presented with plasma cortisol ≥280 nmol/L (range 280–570 nmol/L), and six (22%) <280 nmol/L (range 13–260 nmol/L). Five of these six patients underwent cosyntropin stimulation that revealed severe adrenal insufficiency in two patients (cortisol peak 150 nmol/L and 210 nmol/L) and mild adrenal insufficiency in three patients (cortisol peak 350–388 nmol/L). Conclusion: In this study, approximately 20% of patients receiving intermittent topical glucocorticoid treatment for oral lichen planus had glucocorticoid‐induced adrenal insufficiency. It is essential for clinicians to be aware of this risk and to inform patients about the potential need for glucocorticoid stress doses during intercurrent illness. [ABSTRACT FROM AUTHOR]

Aim: Rosacea is a chronic inflammatory skin disease characterized by consistent erythema, papules, pustules, telangiectasias, and recurrent hot flashes, mainly on the cheeks, nose, and forehead. Many palliative treatment options are available for this condition; currently, no radical treatment option is available. However, improvement has been observed in some cases after the use of Kampo medicine. In this study, we aimed to analyze the effects of Jumi‐Haidokuto (JHT) and a mixture of Keishi‐Bukuryo‐gan‐ka‐Yokuinin (KBY) and JHT on steroid‐induced rosacea in mice. Methods: Clobetasol propionate ointment was applied to the mice for 10 days and then the mice were provided food mixed with JHT and JHT + KBY for 28 days. Subsequently, the average velocity of capillary flow, area of the purpura, histopathologic features, and fecal metabolome were investigated. Results: Recovery of the capillary flow velocity, reduction in the area of purpura, and restoration of the epidermal features were observed in JHT‐ and JHT + KBY‐fed mice. The improvement in circulatory disturbances observed after JHT and JHT + KBY administration might have contributed to the reduction in telangiectasias and erythema. Recovery of the skin barrier system by both Kampo medicine might be the key factor of ameliorating rosacea‐like symptoms. [ABSTRACT FROM AUTHOR]

Objectives: The a im of this study is to evaluate and compare the efficacy of Nigella sativa (75% v/v) cream and clobetasol propionate (0.05% w/w) gel for the management of oral lichen planus (OLP). Study design: Sixty clinically diagnosed cases of OLP were stratified into moderate cases or severe cases based on burning sensation before getting allocated to group I receiving Nigella sativa cream and group II receiving clobetasol propionate gel, two times a day for 45 days. Patients were examined every 15 days for a change in burning sensation and size of the lesion using the numeric pain rating scale (NRS) and a standard Vernier caliper, respectively. Statistical tests including Mann–Whitney U, Wilcoxon signed-rank, Friedman's, Dunn's post hoc, unpaired t, paired t, one-way repeated measures ANOVA, and Bonferroni's post hoc were applied. Results: There was a statistically significant reduction in the burning sensation as well as the size of the lesion in both groups (P ≤ 0.05). There was an 87.8% (moderate cases) and 85.7% (severe cases) reduction in the mean NRS scores on the 45th day in group I when compared to the 96.5% (moderate cases) and 93.48% (severe cases) in group II. There was a 92.9% (moderate cases) and 90.7% (severe cases) reduction in the size of the lesion in group I when compared to the 92.6% (moderate cases) and 93.1% (severe cases) in group II. Conclusion: The topical application of Nigella sativa cream was effective and comparable to clobetasol propionate 0.05% gel in the management of OLP, without any side effects. Hence, this study recommends the use of topical Nigella sativa cream therapy in the management of OLP. Clinical relevance: The current mainstay of treatment for OLP is the administration of topical or systemic corticosteroids, which are known to cause side effects, demanding a search for an alternative. Nigella sativa oil cream could be a safe, promising, cost-effective, adjunctive, or alternative modality. Clinical trial registration number: CTRI/2020/07/026745 (India). [ABSTRACT FROM AUTHOR]