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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 50-year-old woman developed eczema on the backs of her legs, mainly in the popliteal fossae, while applying hydrocortisone aceponate cream to psoriatic lesions strictly limited to the lower back. There was no eczema on or around the site of application itself. An identical reaction occurred when betamethasone dipropionate was used to treat the psoriasis on the back. Extensive patch testing, including a corticosteroids series with dilution testing and the 2 commercial corticosteroid preparations used by the patient, revealed only negative reactions at day 2, 4 and 7. A repeated open application test with hydrocortisone aceponate cream and with hydrocortisone aceponate 0.127% elicited an annular positive reaction surrounding the site of application at D4. Some other corticosteroids were tested in a ROAT, showing a positive result to tixocortol pivalate 1% pet. on day 15 (3). This case was highly unusual in the sense that eczema only appeared at distant sites and not at the application site. Systemic contact dermatitis (localization in the popliteal fossae is suggestive) with suppression of the allergic reaction at the application site (and the patch tests) from the anti-inflammatory action of the corticosteroid is a possibility.
Orthopaedic Pharmacology
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Manoj Ramachandran, Daud Chou, Natasha Rahman
Mildly potent (class I): hydrocortisone.Moderately potent (class II): triamcinolone.Potent (class III): methylprednisolone.Very potent (class IV): betamethasone dipropionate.
Alopecia areata: Pathogenesis, clinical features, diagnosis, and management
Published in Jerry Shapiro, Nina Otberg, Hair Loss and Restoration, 2015
The efficacy of minoxidil solution can be enhanced with anthralin or betamethasone dipropionate [194]. In combination with topical minoxidil, anthralin is applied 2 hours after the second minoxidil application. Betamethasone dipropionate cream is applied twice daily, 30 minutes after each use of minoxidil (Figure 5.16). Although combination therapy has been found to be more effective than monotherapy, this therapy is not effective in patients with AT/AU.
Long-term topical management of psoriasis: the road ahead
Published in Journal of Dermatological Treatment, 2022
Siegfried Segaert, Piergiacomo Calzavara-Pinton, Pablo de la Cueva, Ahmad Jalili, Dominique Lons Danic, Andrew E. Pink, Diamant Thaçi, Melinda Gooderham
Once-daily treatment regimens are often preferred for induction therapy (49), with less frequent (once- or twice-weekly) application during maintenance treatment. Current German guidelines state that, if used for long-term management, calcipotriol should be given once or twice daily for up to 1 year; however, the guidelines acknowledge that the majority of evidence for the use of calcipotriol is short term (11). UK guidelines state that if once-daily topical preparations would improve adherence in those patients for whom twice-daily potent corticosteroids or coal tar preparations are indicated, a combined product containing calcipotriol and betamethasone dipropionate should be offered and applied once daily for up to 4 weeks (8). Topical long-term management with the application of two-compound products once or twice a week after initial therapy was recommended more recently in Germany (14).
Perspectives on the pharmacological management of psoriasis in pediatric and adolescent patients
Published in Expert Review of Clinical Pharmacology, 2021
Emmanuel Mahé, Maud Amy De La Bretêque, Céline Phan
Calcipotriol/betamethasone dipropionate as a fixed-dose combination treatment has been evaluated in open-label trials involving patients with plaque and scalp psoriasis. A review of these studies concluded that the efficacy of the treatment was good, with no significant toxicity [39]. This combined treatment is not licensed for use in children, even though the recommendations for calcipotriol state that this agent can be used in combination with steroids. Indeed, calcipotriol/betamethasone dipropionate is often used as a first-line therapy in clinical practice [40]. A recent phase II clinical trial evaluating the safety and efficacy of a 4-week treatment with a fixed-dose combination of calcipotriol (50 μg/g)/betamethasone dipropionate (0.5 mg/g) in adolescents with psoriasis found that the treatment was well tolerated, and that there was no evidence of dysregulation of either the hypothalamic–pituitary–adrenal axis or calcium homeostasis in patients with more severe disease [41].
Emerging drugs for the treatment of vitiligo
Published in Expert Opinion on Emerging Drugs, 2020
Priyanka Karagaiah, Yan Valle, Julia Sigova, Nicola Zerbinati, Petar Vojvodic, Davinder Parsad, Robert A. Schwartz, Stephan Grabbe, Mohamad Goldust, Torello Lotti
In an open-label study of 458 patients with vitiligo to evaluate the safety and efficacy of Bioskin, a targeted 311-nm narrowband-microphototherapy device, 370 patients were treated with bioskin either alone or in combination with other treatment modalities like betamethasone dipropionate 0.05% cream twice daily (28 patients), tacrolimus 0.1% ointment twice daily (59 patients), pimecrolimus 1% cream twice daily (63 patients), calcipotriol ointment 50μg/g twice daily (60 patients), and 10% L-phenylalanine cream twice daily (60 patients). Bioskin monotherapy had excellent repigmentation rates (>75%) in 72% of patients and greater repigmentation was achieved when combined with other treatment options. Maximum response was seen in combination with betamethasone dipropionate with 90.2% of patients showing >75% repigmentation. This is devoid of generalized pigmentation and early photo-aging associated with wholebody phototherapy but it would be inconvenient to irradiate large surface areas with the targeted device and thus is suitable for lesions involving <10% of BSA [98].