复方倍他米松穴位注射联合中药浸泡治疗掌跖角化性湿疹的临床观察

目的探讨复方倍他米松穴位注射联合中药浸泡治疗掌跖角化性湿疹的疗效。方法将82例掌跖角化性湿疹患者随机分为治疗组(42例)和对照组(40例)。治疗组采用复方倍他米松1mL稀释于2%利多卡因中穴位注射,每穴位1mL,每2周1次,共2次;同时给予中药浸泡每日1剂,30min/次,2次/d,共4周。对照组外用卤米松乳膏和尿素霜2次/d,连用4周。结果治疗组有效率85.71%,痊愈率59.52%,对照组分别为55.00%和17.50%,两组比较差异均有统计学意义(P均<0.01)。3个月后,治疗组复发率为12.00%,对照组为57.14%,两组比较差异有统计学意义(P<0.05)。结论使用复方倍他米松穴位注射联合中药浸泡治疗掌跖角化性湿疹疗效高、复发率低。     

窄谱中波紫外线联合卤米松乳膏治疗掌跖角化性湿疹疗效观察

目的观察窄谱中波紫外线联合卤米松乳膏治疗掌跖角化性湿疹的疗效。方法将70例掌跖角化性湿疹患者分成两组,治疗组35例应用窄谱中波紫外线联合卤米松乳膏治疗;对照组35例应用卤米松乳膏治疗。结果3周后治疗组有效率85.71%,对照组51.43%,差异有统计学意义(χ~2=9.55,P<0.05)。结论窄谱中波紫外线联合卤米松乳膏治疗掌跖角化性湿疹疗效较好。     

阿米卡星洗剂及卤米松乳膏联合毫米微波治疗掌跖角化性湿疹临床观察

目的探讨阿米卡星洗剂(海南皇隆制药厂有限公司)及卤米松乳膏(商品名:澳能,生产厂家:香港澳美制药厂)联合毫米微波治疗掌跖角化性湿疹的临床疗效。方法将入选患者按就诊顺序,采用完全随机分组的方法分为治疗组和对照组,各39例,治疗组予阿米卡星洗剂外洗,卤米松乳膏卤米松乳膏薄层涂于患处,配合微波照射。对照组仅予卤米松乳膏薄层涂于患处。同时两组均口服地氯雷他定止痒,治疗4周后观察疗效。结果两组患者治疗4周后组内的5项观察指标及临床疗效与治疗前5项观察指标及临床疗效分别比较,差异均有统计学意义(P均<0.05),两组间治疗后5项观察指标及临床疗效比较,差异也有统计学意义(P<0.05),且两组患者治疗后复查肝肾功能和血脂均未见异常。结论阿米卡星洗剂及卤米松乳膏联合毫米微波治疗掌跖角化性湿疹疗效好,不良反应少。     

NB-UVB联合复方氟米松治疗掌跖角化性湿疹疗效观察

目的 观察窄谱中波紫外线(NB-UVB)联合复方氟米松软膏治疗掌跖角化性湿疹的疗效。方法 60例皮肤科门诊掌跖角化性湿疹患者随机分为两组,治疗组30例采用联合治疗方法,即隔日1次NB-UVB照射,初始剂量通常为最小红斑量(MED)的70%或者(0.3～0.5)J/cm2,复方氟米松软膏外用,2次/d;对照组30例仅外用复方氟米松软膏治疗,2次/d。3周后观察疗效。结果 治疗组有效率为96.67%,对照组为76.67%,两组差异有统计学意义(P<0.05)。结论 NB-UVB联合复方氟米松软膏治疗掌跖角化性湿疹疗效较好。     

0.05%卤米松乳膏联合20%尿素软膏治疗掌跖部慢性湿疹疗效观察

目的观察0.05%卤米松乳膏联合20%尿素软膏治疗掌跖部慢型湿疹的疗效、耐受性及不良反应。方法治疗组65例每日早上将0.05%卤米松乳膏均匀涂在患处,夜间将其与20%尿素软膏1:1比例等量混合涂于皮损处,局部封包;对照组58例每日早上将0.1%醋酸曲安奈德乳膏均匀涂于患处,夜间将其与20%尿素软膏1:1比例等量混合涂于皮损处,局部封包。每周随诊1次,共3周。结果治疗组有效率84.6%,对照组有效率55.2%,两组比较差异有显著性(P<0.001),未发现不良反应。结论0.05%卤米松乳膏联合20%尿素软膏治疗掌跖部慢性湿疹安全有效。     

角化性皮肤病

20091877 窄谱中波紫外线联合卤米松乳膏治疗掌跖角化性湿疹疗效观察/赵建伟(河北大学附院),赵桂香,张红岩…∥中国皮肤性病学杂志.-2009,23(2).-93～94将70例患者分成2组,治疗组35例应用窄谱中波紫外线联合卤米松乳膏治疗;对照组35例应用卤米松乳膏治疗。结果3周后治疗组有效率85.71%,对照组51.43%,差异有统计学意义(P<0.05)。认为窄谱中波紫外线联合卤米松乳膏治疗掌跖角化性湿疹疗较好。表1参4(惠海英)20091878安宫牛黄丸致砷角化病一例/杨少平(内蒙古包头医学院二附院皮肤科),石继海,张小燕…∥国际皮肤性病学杂志.-2009,35(4).-121男,2     

辣椒碱软膏联合丙酸氯倍他索乳膏治疗局限性神经性皮炎的临床研究

目的评价辣椒碱软膏联合丙酸氯倍他索乳膏治疗局限性神经性皮炎的疗效和安全性。方法将116例患者随机分为治疗组和对照组,治疗组将辣椒碱软膏和丙酸氯倍他索乳膏按1:1等量混合外用,2次/d。对照组则单用丙酸氯倍他索乳膏,2次/d,10天后进行疗效评定。结果治疗组和对照组有效率分别为86.2%和70.7%,差异有统计学意义(P<0.05),治疗组在起效时间、症状评分改善及不良反应发生率上均优于对照组。结论辣椒碱软膏联合丙酸氯倍他索乳膏治疗局限性神经性皮炎的疗效较单独使用皮质激素更有效,且不良反应较小。     

308nm准分子激光联合阿维A及曲安奈德治疗掌跖部角化性湿疹33例疗效观察

目的观察308nm准分子激光联合阿维A胶囊及醋酸曲安奈德软膏治疗掌跖部角化性湿疹的疗效和安全性。方法将入选的64例患者随机分为两组,对照组(31例)予醋酸曲安奈德软膏外用,并予阿维A胶囊10mg口服,均2次/d。治疗组(33例)在对照组治疗方法的基础上予308nm准分子激光照射,2次/周;疗程均为8周,疗程结束后观察疗效。结果治疗组有效率(93.94%)优于对照组(74.19%),差异有统计学意义(P<0.05)。治疗组12例、对照组10例主要表现为脱屑、皮肤瘙痒和红斑,但患者均可耐受。结论 308nm准分子激光联合阿维A胶囊及醋酸曲安奈德软膏治疗掌跖部角化性湿疹疗效好,不良反应少。     

卡介菌多糖核酸联合醋酸曲安奈德尿素乳膏治疗掌跖部慢性湿疹临床观察

目的观察卡介菌多糖核酸联合尿素乳膏治疗掌跖部慢性湿疹的临床疗效。方法66例患者随机分为2组,治疗组34例予卡介菌多糖核酸注射液0.5mg/mL肌注,隔日1次,15次(1个月)为1个疗程,并给予10%尿素乳膏封包疗法,对照组32例给予10%尿素乳膏夜间封包疗法,疗程1个月。结果治疗组和对照组有效率分别为90%和70%,二者比较差异有统计学意义(P<0.05)。结论卡介菌多糖核酸联合尿素乳膏治疗掌跖部慢性湿疹有较好的疗效和安全性。     

复方氟米松软膏治疗掌跖部慢性湿疹临床观察

目的探讨复方氟米松软膏治疗掌跖部慢性湿疹的临床疗效。方法80例患者随机分为两组,治疗组40例予复方氟米松软膏治疗,对照组40例予丙酸氯倍他索乳膏治疗,两组均于夜间给予封包疗法,疗程为14天。结果治疗组和对照组的有效率分别为90.00%和70.00%,二者比较差异有显著性(P<0.05)。结论复方氟米松软膏治疗掌跖部慢性湿疹具有较好的疗效和安全性。     

A single-center, double-blind, randomized trial of the atrophogenic effects of fluocinonide cream 0.1% versus clobetasol propionate cream 0.05% in participants with corticosteroid-responsive dermatoses

To compare the atrophogenic effects of fluocinonide cream 0.1% versus clobetasol propionate cream 0.05%, 20 participants with corticosteroid-responsive dermatoses were randomly assigned to receive fluocinonide cream 0.1% on one arm and clobetasol propionate cream 0.05% on the other arm. Study medications were applied to disease-free target areas on the inner arms twice daily for 2 weeks. The epidermal thickness of pretreatment and posttreatment punch biopsy specimens was measured. Skin examinations were performed evaluating clinical signs of atrophy. No significant reduction in epidermal thickness was observed in the fluocinonide-treated sites (mean, -0.0318 mm; standard deviation, 0.0239; P=.1991). A significant reduction in epidermal thickness was seen in the clobetasol-treated sites (mean, -0.1825 mm; standard deviation, 0.0239; P<.0001). This reduction was significantly greater than results from sites treated with fluocinonide cream 0.1% (difference, -0.1507; standard deviation, 0.0131; P<.0001). Although topical corticosteroids often are the first-line treatment for patients with various dermatoses, a side effect of continuous use is cutaneous atrophy. Our study demonstrated that clobetasol propionate cream 0.05% caused a significantly greater reduction in epidermal thickness compared with fluocinonide cream 0.1% when used twice daily for 2 weeks (P<.001). However, neither drug caused significant clinical signs of atrophy.     

外喷中药制剂联合曲安奈德益康唑乳膏治疗念球菌性龟头炎效果的临床观察

目的：观察中药汤剂改颗粒剂外喷联合曲安奈德益康唑乳膏治疗念球菌性龟头炎的临床疗效。方法：135例患者随机分为治疗组和对照A组和对照B组,每组45例。治疗组给予中药基本方取颗粒剂兑成中药汤液,装入专用容器外喷,2次/d,联合曲安奈德益康唑乳膏外涂,2次/d。对照A组,基本方水煎外洗,2次/d,联合曲安奈德益康唑乳膏外涂,2次/d。对照B组,单独使用曲安奈德益康唑乳膏,2次/d,连用14d。结果：联合用药组治疗念珠菌性包皮龟头炎的方法无论在治疗1周与2周时临床有效率（痊愈＋显效）均高于单独使用曲安奈德益康唑乳膏组,两组真菌学疗效无差异。而中药外喷组与中药外洗组在疗效上无明显差异。结论：中药汤剂外洗改颗粒剂外喷联合曲安奈德益康唑乳膏外涂治疗念球菌性龟头炎安全有效,可行。     

The treatment of vulval lichen sclerosus with a very potent topical steroid (clobetasol Propionate 0.05%) cream

The clinical and histological response to 12 weeks of treatment with a very potent topical fluorinated steroid was studied in 15 patients with vulval lichen sclerosus (LS) who were treated with twice daily applications of clobetasol propionate 0.05% cream (Dermovate, Glaxo U.K.). Thirteen patients completed the study and all showed a marked clinical improvement. Histological measurements of skin biopsies taken before and after treatment showed a significant reduction in the characteristic features of LS. One patient developed contact sensitivity to clobetasol propionate. There was no evidence of infection or skin atrophy during the study. Patients completing the study have been followed up for up to 22 months and have been maintained in remission with moderately potent topical steroids which had previously been ineffective.     

Treatment of bullous pemphigoid with topical clobetasol propionate

The potent topical corticosteroid clobetasol propionate was evaluated in an open-label study for its safety and efficacy in the treatment of bullous pemphigoid. Ten patients admitted to the hospital with this diagnosis had clobetasol propionate cream applied twice daily to affected skin until all lesions were healed and for 2 weeks thereafter. Complete epithelialization was achieved in every case within 4 to 17 days of treatment. After discharge, patients received decreasingly less potent corticosteroid creams as maintenance therapy for between 5 weeks and 13 months. As of this report, 7 of the 10 patients remain in remission (range 1 to 10 months). In one patient the disease was exacerbated, and therapy with corticosteroids could not be discontinued. No local or systemic side effects were observed during the study, and plasma cortisol levels were within the normal range when measured during the early tapering-off period while patients were receiving less potent topical corticosteroids. We conclude that clobetasol propionate cream produced rapid healing of bullous lesions without adverse effects and that this treatment followed by maintenance therapy with less potent topical corticosteroids was highly effective in patients with bullous pemphigoid.     

Psoriasis treatment: faster clearance when UVB-dithranol is combined with topical clobetasol propionate

Fifty patients with plaque psoriasis were treated with dithranol and UVB 5 days per week. Twenty-six of these patients also received 13 treatments (once daily in the 1st week, every other day in the 2nd week, twice in the 3rd week and once in the 4th week) with topical clobetasol propionate. The median time for clearance was 2.5 weeks for those on the clobetasol propionate-dithranol-UVB combination compared with 4 weeks when only dithranol-UVB was used. Scaling and induration of the lesions disappeared during the first 2 weeks of treatment with clobetasol propionate-dithranol-UVB which was a significant improvement compared with dithranol-UVB alone. The time of remission in patients completely cleared was the same in the two groups. Relapses occurred slightly more often in the clobetasol propionate treated than in the control group (during treatment 5 of 26 versus 2 of 24; after 6 months 7 of 18 versus 4 of 15) but the differences were not statistically significant. The study shows that addition of topical clobetasol propionate according to our schedule to the traditional dithranol-UVB regimen of psoriasis results in a more rapid clearance of lesions without undesirable side effects.     

Evaluation of topical 0.1% tazarotene cream in the treatment of palmoplantar psoriasis: an observer-blinded randomized controlled study

Background:

Palmoplantar psoriasis is a frequently encountered variant of psoriasis. It is difficult to treat and even more difficult to maintain remission as it is exacerbated by friction and trauma of the patient''s daily activities. Existing topical modalities of treatment are often inadequate and show unpredictable response.

Aim:

To study the efficacy and safety of a newer retinoid, tazarotene, as 0.1% cream in the treatment of palmoplantar psoriasis.

Materials and Methods:

Thirty adult patients with palmo-plantar psoriasis were randomized to therapy with once daily application of topical tazarotene cream (0.1%) or once daily application of clobetasol propionate cream (0.05%) for 12 weeks. The patients were assessed every 2 weeks for improvement in Erythema, Scaling, Fissures and Induration (ESFI) score and Physicians Global Assessment Scale.

Results:

At 12 weeks, the tazarotene group showed mean ESFI reduction to 1.12 (83.2%) from 6.65 at baseline. Complete clearance was noted in 52.9% of the patients. Clobetasol propionate group showed mean ESFI reduction to 0.62 (89.1%) from 5.69 at baseline, with complete clearance in 61.5% of the patients. Differences between the two groups were statistically insignificant. Side effects observed were initial irritation (41%) in the tazarotene group and hypopigmentation (53.8%) in the steroid-treated patients.

Conclusion:

Tazarotene is as effective as clobetasol propionate and provides a good alternative for the treatment of palmo-plantar psoriasis where hypopigmentation limits the use of clobetasol propionate cream.     

复方丙酸氯倍他索软膏治疗寻常性银屑病临床疗效观察

目的:观察复方丙酸氯倍他索软膏治疗寻常性银屑病的疗效和安全性。方法:将入组的360例寻常性银屑病患者分为治疗组(复方丙酸氯倍他索软膏组120例)、对照1组(0.02%丙酸氯倍他索霜组120例)和对照2组(0.05%全反式维A酸霜组120例),采用多中心、随机双盲、平行对照的方法对寻常性银屑病患者连续用药4周。结果:3组患者的痊愈率分别为48.33%、18.33%和3.48%,有效率分别为92.50%、50.83%和31.30%。组间比较(试验组与对照1组比较,试验组与对照2组比较)显示,痊愈率和有效率差异均有显著性(P<0.01)。试验组和对照1组的不良反应发生率较轻微,对照2组不良反应发生率为11.67%,有3例因不良反应较重中途停止治疗。结论:复方丙酸氯倍他索软膏是一种安全有效的治疗寻常性银屑病的外用药,其疗效优于单用丙酸氯倍他索霜或全反式维A酸霜。     

A comparison of clobetasol propionate 0.05 percent ointment and an optimized betamethasone dipropionate 0.05 percent ointment in the treatment of psoriasis

A multicenter, double-blind study compared the effectiveness of two highly potent topical corticosteroids in patients with moderate to severe signs of psoriasis. Left/right paired comparisons of clobetasol propionate ointment 0.05 percent, and an optimized formulation of betamethasone dipropionate ointment 0.05 percent, were made in 130 patients with roughly symmetrical psoriatic lesions. The ointments were applied by the patients twice daily, without occlusion, for two weeks. Both drugs were shown to be highly effective and were well tolerated. Significantly more patients showed greater improvement on the side treated with clobetasol propionate. Follow-up evaluation two weeks after the treatment period showed statistically significant (p less than 0.001) longer remissions resulting from the use of clobetasol propionate.     

Progression of actinic keratosis to squamous cell carcinoma revisited: clinical and treatment implications

High-potency topical corticosteroids are the cornerstone of psoriasis therapy. Although highly effective, long-term use of topical steroids can cause adverse side effects. Additionally, steroids alone do not address the multiple pathophysiologic factors that cause the disease. Psoriasis regimens that utilize high-potency steroids combined with nonsteroid-containing products such as vitamin D analogs have been used for many years to manage the disease, not only for the short-term treatment of the disease but also for long-term treatment to minimize the recurrence of symptoms. We report an open-label, multicenter study designed to evaluate a weekday/ weekend treatment regimen involving calcitriol ointment 3 microg/g and clobetasol propionate spray 0.05% for moderate plaque psoriasis. Participants applied calcitriol ointment 3 microg/g twice daily on the weekdays and clobetasol propionate spray 0.05% twice daily on the weekends for up to 4 weeks. Participants were evaluated at baseline, week 2, and week 4. The results of this study demonstrate that a 4-week regimen of calcitriol ointment 3 microg/g treatment on weekdays and clobetasol propionate spray 0.05% on weekends is effective and well-tolerated for the treatment of moderate plaque psoriasis.