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This study investigates the efficacy of monobenazone, a novel topical agent, in treating psoriasis-like lesions in an imiquimod (IMQ)-induced murine model. Female BALB/c mice were allocated to four groups: negative control, IMQ-treated positive control, monobenazone treatment, and clobetasol propionate treatment. The Psoriasis Area and Severity Index (PASI), histopathological analysis, and cytokine quantification (TNF-α and IL-6) were used to assess treatment outcomes. Monobenazone significantly reduced PASI scores and ameliorated histopathological features, including acanthosis and dermal inflammation, compared to the positive control. Furthermore, monobenazone treatment resulted in decreased levels of pro-inflammatory cytokines TNF-α and IL-6. These findings suggest that monobenazone exhibits therapeutic potential in mitigating psoriasis-like symptoms, potentially through modulation of inflammatory responses. While promising, further research is necessary to elucidate its mechanism of action and clinical applicability as a novel psoriasis treatment. [ABSTRACT FROM AUTHOR]

Background: The study aimed to compare the effectiveness of photodynamic therapy (PDT) and topical clobetasol therapy in treating oral lichen planus (OLP). To address the absence of commercially available drug carriers, innovative proprietary solutions were developed. These carriers were designed to enhance the therapies: one for the photosensitizer to reduce its contact time with the mucosa, and another for the steroid to prolong its contact duration. Methods: A randomized, single-blind clinical trial lasting three months was conducted on 29 patients with bilateral oral lichen planus using a full contralateral split-mouth design. The authors utilized proprietary carriers containing 5% methylene blue and 0.025%. Lesion size, as well as scores on the Thongprasom, Abisis, and VASs, were assessed during the study. Results: Relatively low rates of complete remission of lichen were demonstrated immediately after treatment, 10.3% after PDT and 3.4% after clobetasol, but after 3 months, 79% after PDT, and 62% after CLO. After 3 months of treatment, a reduction of 79.88% for PDT and 56.3% for CLO in the area of the evaluated lesions was achieved. Conclusions: PDT emerges as an equally effective method for treating OLP in terms of clinical outcomes, with the added advantage of avoiding many complications associated with conventional therapy. [ABSTRACT FROM AUTHOR]

This study assesses the potential positive impact of a 0.05% isoxsuprine ointment on psoriasiform skin inflammation generated by imiquimod in mouse models. Thirty-two male albino mice were allocated into four groups: the control group (which received topical emollients twice daily for 16 days), the induction group (which received imiquimod cream (5%) for 8 days, twice daily followed by petrolatum gel (15%) for another 8 days), and the other two groups, which received imiquimod cream (5%) for 8 days followed by either clobetasol ointment (0.05%) or isoxsuprine ointment (0.05%) twice daily for an additional 8 days. At the end of the experiment, mice were sacrificed by ethical standards, and levels of TNF-α, IL-6, IL-17A, IL-23, and VEGF were measured; PASI and Backer's score were examined, in addition to the histopathology of skin tissue. Each clobetasol and isoxsuprine group displayed a significant reduction in tissue homogenate levels of TNF-α, IL-6, IL-17A, IL-23, and VEGF, besides increments in IL-10 compared to the induction group. Some markers (IL-17A, IL23, and VEGF) showed no significant difference between clobetasol and the isoxsuprine group. In contrast, the other markers (TNF-α, IL6, and IL10) showed significant differences between clobetasol and isoxsuprine groups. Isoxsuprine ointment showed comparable efficacy to clobetasol ointment in treating imiquimod-induced psoriasiform skin inflammation in mice models, probably due to its possible effect of anti-inflammatory and immunomodulatory activities. [ABSTRACT FROM AUTHOR]

The use of antidepressant medications in the treatment of lichen simplex chronicus (LSC) also known as neurodermatitis, is not well-documented in the literature. The primary aim of our study is to evaluate the impact of duloxetine 30 mg on the quality of life in patients with LSC, focusing on both pruritus and psychopathological aspects. The secondary aim is to investigate the relationship between LSC and anxiety and depression. The observational prospective clinical study, conducted from November 2023 to November 2024, included male and female patients aged 18 and older diagnosed with neurodermatitis (lichen simplex chronicus). Inclusion criteria required a confirmed diagnosis by a dermatologist. Exclusion criteria included other skin conditions, polyneuropathies (e.g., diabetic, chemotherapy-induced), malignancy, current use of antidepressants or neuropathic pain medications, and medications known to cause itching (e.g., β-blockers, ACE inhibitors, antacids). Patients with LSC at the dermatology clinic were assessed by a dermatologist using the DLQI and a neurologist using the Beck Depression and Anxiety Inventory before and after three months of treatment. The study included 219 patients with a mean age of 39.6 (12.2) years, 69.5% female and 30.5% male. Post-treatment, the Duloxetine 30 mg + 0.05% alpha clobetasol propionate group showed the most significant improvement in DLQI scores (p < 0.05). This group also had a notable reduction in itchiness scores by the third month, with more change over time. The greatest reduction in scores on the Beck Depression Inventory-II and Beck Anxiety Inventory was observed in the Duloxetine 30 mg + 0.05% alpha-clobetasol propionate group, with this reduction continuing in a decreasing pattern in the Duloxetine 30 mg and 0.05% alpha-clobetasol propionate groups, respectively. Significant changes in the time-group interaction were observed only in the Duloxetine 30 mg + 0.05% alpha-clobetasol propionate and Duloxetine 30 mg groups (p < 0.05). No significant time effect was seen in the 0.05% alpha clobetasol propionate group. In the regression analysis, both BAI and BDI-II showed significant and strong effects on DLQI (p < 0.05). Our study suggests that duloxetine 30 mg may be effective in treating LSC by reducing pruritus and addressing comorbid psychiatric conditions like anxiety and depression. The multidisciplinary approach, involving both dermatological and neuropsychiatric evaluations, is essential for treatment. Long-term, multicenter studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Although topical agents have been used to treat cutaneous lupus erythematosus (CLE), there was previously no high-quality evidence of which agents were most effective and which clinical scores were most suitable. On 22 December 2023, a search was conducted across five databases to identify randomized controlled trials (RCTs) for CLE. Two authors independently screened the titles and abstracts of articles based on predetermined criteria. Selected articles were then assessed for inclusion in a blinded manner, with any disagreements resolved through consensus. Data were abstracted in duplicate, and a random-effects model was utilized for network meta-analysis. The certainty of the evidence was evaluated according to the PRISMA guidelines, using the GRADE approach. The analysis was finalized in January 2024, with the primary outcome focused on the change in Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) from baseline. Seven RCTs involving 231 participants were analysed. The network meta-analysis revealed that nicotinamide 4% demonstrated the highest probability of achieving the intended outcomes, with a mean difference (MD) of 3.10 and a 95% confidence interval (CI) of 1.99–4.21. Additionally, clobetasol 0.05%, nicotinamide 2% and tacrolimus 0.1% also exhibited statistically significant differences, with MDs of 2.30 (95% CI of 0.73–3.88), 2.30 (95% CI 0.97–3.63) and 1.30 (95% CI 0.03–2.57), respectively. This NMA demonstrates with a high level of evidence that nicotinamide 4%, clobetasol 0.05%, nicotinamide 2% and tacrolimus 0.1% are statistically significant topical agents for CLE. CLASI may be an appropriate outcome to evaluate drug efficacy in CLE. [ABSTRACT FROM AUTHOR]

Topical treatment with glucocorticosteroids is a mainstay therapy for many dermatologic conditions. Though efficacious in many, topical therapies often fail to achieve desired positive results in clinical practice. SKIN-CAP spray (Cheminova Laboratories International SA, Madrid, Spain), a product containing activated zinc pyrithione, and subsequently found to have contained clobetasol, provided unprecedented clearing of psoriasis even when ultra-high potency topical glucocorticosteroids had failed. A PubMed for terms related to corticosteroids, topical therapy, patient adherence, and SKIN-CAP spray was performed. Articles from 1997 to 2023 were included in the review of SKIN-CAP spray. In this review, we report the background of SKIN-CAP as well as studies that were performed in an attempt to explain its perceived high efficacy. The remarkable efficacy that occurred with SKIN-CAP over other delivery systems for high potency topical corticosteroids was initially speculated to be a consequence of an interaction between the zinc pyrithione and the clobetasol. However, no synergistic efficacy was identified, and there was no greater drug delivery. Better adherence to the SKIN-CAP product may explain the efficacy. The SKIN-CAP story provides insights into the need for healthy skepticism, the importance of treatment adherence, and ways to encourage better adherence to topical medications.

Abstract Objectives This study aims to compare the therapeutic effects of acyclovir nanofiber and acyclovir-clobetasol nanofiber formulations with their non-nano formulations (cream formulation) on recurrent labial herpes. Materials and methods Eighty patients with labial herpes lesions were divided into four groups, each receiving one of the following treatments: acyclovir-clobetasol nano patch, acyclovir-clobetasol cream, acyclovir nano patch, or acyclovir cream. Pain levels and recovery times were assessed. The Wilcoxon test compared pain levels, while the log-rank test compared healing and scabbing times. Results Acyclovir-clobetasol nanofiber and cream, along with acyclovir nanofiber, significantly reduced symptoms compared to the acyclovir cream. The recovery and scabbing times were shorter in patients who received acyclovir-clobetasol formulations compared to those receiving acyclovir alone. Conclusion Acyclovir-clobetasol combinations accelerated recovery times compared to acyclovir alone. Additionally, nanofiber formulations demonstrated enhanced healing efficacy over cream formulations. Trial registration This trial was retrospectively registered by Iranian Registry of Clinical Trials (IRCT) at 14/11/2023. Trial Registration number: IRCT20230926059521N1.

Background: Long-term use of oral or parenteral corticosteroids is the most common cause of hypothalamic–pituitary–adrenal axis suppression and iatrogenic Cushing's syndrome. Still, iatrogenic Cushing's syndrome occurs rarely following the administration of topical corticosteroids. Case presentation: This case study discusses the misuse of a high-potency corticosteroid cream by an Iranian 5-year-old male with plaque-form psoriasis, resulting in Cushingoid symptoms including moon face, buffalo hump, red striae, and weight gain. The child experienced different complications following iatrogenic Cushing's syndrome, such as frequent vomiting and fever, which led to expiration. Conclusion: Proper use and monitoring of topical corticosteroids are emphasized, especially among children. This study also underlines the potential side effects of high-potency corticosteroids and the importance of physicians' and parents' awareness, highlighting the avoidance of excessive topical corticosteroid prescriptions. [ABSTRACT FROM AUTHOR]

Introduction: Topical therapies are used in almost all patients with psoriasis. A novel fixed topical combination cream (GN-037) with a lower concentration (0.0356%) of clobetasol 17-propionate (CP) was developed together with urea, salicylic acid, and retinoic acid to provide a better benefit–risk ratio. The present multicenter randomized double-blind vehicle-controlled parallel group phase 2 study aimed to investigate the efficacy and safety of GN-037 in patients with mild-to-moderate plaque psoriasis (MMPP). Methods: Patients (n = 190) were randomized (2:2:1) to receive GN-037 or CP or vehicle (V) cream twice daily to a selected target body lesion for 4 weeks. The primary endpoint was treatment success defined as percentage of patients with at least two-grade improvement in Investigator's Global Assessment Score (IGA) and IGA score equal to 0 or 1 evaluated at weeks 2, 4, 6, and 8 in each arm compared with baseline. Treatment-emergent adverse events (TEAEs) and safety were evaluated throughout the study. Results: GN-037 demonstrated statistically significant superiority over V throughout the study. At week 4, treatment success was achieved in 37.9% of patients in the GN-037 arm compared with 29.2% and 9.1% in the CP and V arms, respectively. At least two-grade improvement compared with baseline was achieved by 57.6%, 72.7%, and 80.3% of the patients in the GN-037 arm for erythema, plaque elevation, and scaling, respectively. The mean changes in affected BSA were −2.1 ± 2.9, −1.8 ± 2.4, and −0.5 ± 1.6 in the GN-037, CP, and V arms, respectively. The TEAEs were similar among the arms and the most frequently observed TEAEs were Psoriasis Area and Severity Index (PASI) increase in all arms. Conclusions: GN-037 was more effective than V in achieving primary and all secondary endpoints throughout the study. Safety data did not reveal any new safety concerns with the combination cream product. Therefore, 4 weeks of GN-037 treatment demonstrated an excellent efficacy and safety profile in patients with MMPP. Trial Registration number: ClinicalTrials.gov identifier, NCT05706870. [ABSTRACT FROM AUTHOR]

Drug therapy for secondary lymphedema has not yet been established. Conventional oral and intravenous administration is difficult to administer in sufficient doses due to adverse events. Therefore, it is necessary to develop a transdermal delivery system that can deliver high concentrations of drugs to the edema area. In this study, we examined the efficacy of transdermal drug delivery in a mouse model of tail edema using ultrasound irradiation (sonication method). Ultrasound irradiation can deliver high-molecular-weight substances subcutaneously, and the percutaneous administration of clobetasol propionate to the mouse tail edema model prevented the enlargement of lymphatic vessels with reduced tail volume. Therefore, steroid administration utilizing ultrasound irradiation is effective in decreasing tail swelling in a mouse tail edema model. Thus, ultrasound irradiation could have the potential to innovate the treatment of secondary lymphedema by directly administering the drug to the edema. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to compare the therapeutic effects of acyclovir nanofiber and acyclovir-clobetasol nanofiber formulations with their non-nano formulations (cream formulation) on recurrent labial herpes. Materials and methods: Eighty patients with labial herpes lesions were divided into four groups, each receiving one of the following treatments: acyclovir-clobetasol nano patch, acyclovir-clobetasol cream, acyclovir nano patch, or acyclovir cream. Pain levels and recovery times were assessed. The Wilcoxon test compared pain levels, while the log-rank test compared healing and scabbing times. Results: Acyclovir-clobetasol nanofiber and cream, along with acyclovir nanofiber, significantly reduced symptoms compared to the acyclovir cream. The recovery and scabbing times were shorter in patients who received acyclovir-clobetasol formulations compared to those receiving acyclovir alone. Conclusion: Acyclovir-clobetasol combinations accelerated recovery times compared to acyclovir alone. Additionally, nanofiber formulations demonstrated enhanced healing efficacy over cream formulations. Trial registration: This trial was retrospectively registered by Iranian Registry of Clinical Trials (IRCT) at 14/11/2023. Trial Registration number: IRCT20230926059521N1. [ABSTRACT FROM AUTHOR]

The current work aims to develop a bigel-containing clobetasol propionate-loaded PLGA microparticles and further assess its in vitro, ex vivo, and in vivo behavior for psoriasis management. PLGA microparticles (2%w/w) containing clobetasol propionate were developed by solvent evaporation technique. For the developed particles, size, drug loading, entrapment efficiency, and surface morphology were determined. Further, the particles were suspended into bigel developed from oleogel and hydrogel (40:60) and assessed for stability, in vitro drug release, ex vivo skin permeation, retention, and in vivo study in BALB c mice for antipsoriatic potential. PLGA microparticles developed by solvent evaporation were found to have a mean particle size of 19.45 ± 1.74 μm. Drug loading and entrapment efficiency for clobetasol were found to be 43.5 ± 4.94% and 94.5 ± 3.68%, respectively. For the developed bigel, sustained in vitro drug release was observed till 7 h. Ex vivo skin permeation with the developed formulation was found to be higher than the marketed formulation and drug suspended in bigel. A retention study performed on pig skin suggested the topical skin retention of the drug. Further, the psoriatic model was developed in BALB c mice with IMQ cream, and it was observed that the developed formulation helped considerably reduce the irritation score and PASI scoring in mice as compared to the standard treatment. The same is corroborated with the help of histopathological studies performed by Hematoxylin and Eosin (H&E) staining in the same animals. The study findings suggest that clobetasol microparticle-loaded bigel formulation appeared to be a promising therapy option for psoriasis. [ABSTRACT FROM AUTHOR]

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]

Objective To assess the effectiveness of topical tacrolimus combined with topical super potent steroids to treat Chronic Hand Eczema (CHE). Methods This study had one hundred and twenty patients in total, divided into two groups. Patients in Group A were treated with topical clobetasol 0.05% while Group B received same strength of clobetasol combined with 0.1% tacrolimus. Using Physician Global Assessment (PGA), Dermatology Quality of Life Index (DLQI), and Hand Eczema Severity Index (HECSI), disease severity was evaluated at baseline and then on a monthly basis. Final Assessment done after 6 months. Results In Group A, the female to male ratio was 1.4 compared to 1.8 in Group B. In Groups A and B, the duration of disease was 5.6±2.7 years and 6.1±3.4 years, respectively. The two groups' disease severity at baseline was comparable. Patients in Group B showed better signs and symptoms improvement than those in Group A after 6 months, which was correlated with higher decreases in HESCI, DLQI, and PGA scores, respectively (p value <0.05). Conclusion Our study showed that the treatment of CHE was more effective when topical tacrolimus was combined with super potent steroids. [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]

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]

The article in the Clinical & Experimental Dermatology journal discusses a case of a 58-year-old man who developed hypertrophic lichenoid dermatitis on an old tattoo site as a side effect of pembrolizumab treatment for clear-cell renal-cell carcinoma. The patient also experienced hypothyroidism and a pruritic skin eruption during the course of treatment. The dermatological examination revealed violaceous papules and plaques on the upper limbs and nodules on the lower limbs, with histopathological findings consistent with hypertrophic lichenoid dermatitis. Treatment with corticosteroids and antibiotics led to significant improvement, allowing the patient to resume pembrolizumab treatment. The case highlights the importance of managing cutaneous immune-related adverse events to continue life-prolonging cancer treatment. [Extracted from the article]

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]

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]

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: Topical corticosteroid misuse on the face is a growing concern, leading to various dermatological conditions. Despite guidelines, improper use persists, causing significant adverse effects. Our study aims to evaluate the clinical and dermatoscopic features of patients with facial dermatoses due to topical steroid misuse. Methods: A prospective, cross-sectional study was conducted at the Dermatology OPD of Santosh Medical College and Hospital, Ghaziabad, from January 2023 to January 2024. A total of 234 patients (aged 18-60 years) who applied topical steroids for more than two weeks were recruited. Clinical presentations and dermatoscopic findings were recorded at the first visit and monitored monthly over three months post-steroid withdrawal. Results: The majority of patients were female (85.04%), with the highest prevalence in the 18-30 years age group (52.56%). Commonly misused steroids included Betamethasone Valerate (32.90%) and Clobetasol Propionate (27.35%). Frequent clinical presentations were itching (77.78%) and photosensitivity (90.17%). Dermatoscopic findings included linear vessels (98.30%), red diffuse areas (93.16%), and brown globules (95.30%). After three months, significant improvements were observed in redness, itching, and dermatoscopic features. Conclusion: Topical steroid misuse on the face leads to significant clinical and dermatoscopic changes, which improve over time with steroid cessation. Early detection and intervention are crucial for recovery. [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]

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]

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]

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]

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]

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]

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]

This study investigates the impact of Saussurea involucrata polysaccharide on glucocorticoid-induced epidermal atrophy and barrier dysfunction. The topical application of Saussurea involucrata polysaccharide to the shaved dorsal skin of mice, administered 30 min after clobetasol propionate treatment twice daily for 6 d, significantly prevented clobetasol propionate-induced transepidermal water loss elevation and reduction in stratum corneum hydration. This was accompanied by an increase in epidermal thickness. Nile red staining demonstrated Saussurea involucrata polysaccharide augmentation of the overall epidermal lipid amount. Molecular analyses, including real-time quantitative polymerase chain reaction and immunohistochemical analysis, unveiled Saussurea involucrata polysaccharide influence on the upregulation of major lipidsynthesizing enzymes (serine-palmitoyl transferase, 3-hydroxy-3-methylglutaryl-coenzyme A reductase and fatty acid synthase) and epidermal differentiation-related proteins (filaggrin and involucrin). In conclusion, these findings suggest that Saussurea involucrata polysaccharide effectively prevents glucocorticoid-induced epidermal atrophy and barrier impairment by enhancing epidermal lipid synthesis and stimulating keratinocyte differentiation. [ABSTRACT FROM AUTHOR]