Efficacy of bufexamac cream versus betamethasone valerate cream in contact dermatitis: a double-blind trial.

A double-blind controlled study was carried out in 72 patients with atopic or contact dermatitis, who were randomly allocated to receive treatment with either 5% bufexamac, 0.1% betamethasone valerate or placebo creams. Patients applied the cream twice daily for 2 weeks. Assessments of the degree of severity of inflammation, induration, lichenification, crusts, scaling, and pruritus were made before and after treatment. The results showed that both active preparations were equally effective in improving the skin condition in the majority of the patients. In younger patients, however, the improvement with betamethasone valerate appeared to be somewhat better than that with bufexamac, particularly in relation to pruritus.     

Comparative efficacy of once a day diflorasone diacetate and twice a day betamethasone valerate ointment applications in eczematous dermatitis

The efficacy of once a day applications of 0.05% diflorasone diacetate ointment and twice a day applications of 0.1% betamethasone valerate ointment was compared in 70 patients with eczematous dermatitis. Altogether 32 patients completed the 3-week study. Fourteen patients in the diflorasone group and 6 on betamethasone left the study earlier because of total (100%) improvement of lesions. Eight patients left because of unsatisfactory progress and 6 because of personal reasons. There were only two noticeable differences observed between treatment groups. At Week 2, the diflorasone diacetate group improved significantly more than the betamethasone valerate group with respect to pruritus. At Week 3, this difference in the improvement of pruritus was marginally significant in favour of diflorasone diacetate. Excluding the complications due to a secondary infection, no adverse reactions were recorded in the diflorasone diacetate-treated patients; 1 betamethasone valerate-treated patient developed telangiectasia. The once a day applications of diflorasone diacetate not only proved to be slightly more efficacious than the twice a day applications of betamethasone valerate, but also provided the advantages of patient convenience and compliance.     

Clobetasone butyrate compared with betamethasone valerate in the treatment of atopic and contact dermatitis

Summary

In a double-blind, randomized study, 0.05% clobetasone butyrate cream was found to be as effective as 0.1% betamethasone valerate in the treatment of 48 patients with atopic or contact dermatitis, after 2 weeks as well as after 4 weeks of treatment. Side-effects with both drugs were rare and mild.     

Tazarotene cream (0.1%) in combination with betamethasone valerate foam (0.12%) for plaque-type psoriasis

A combination of multiple agents is often required to achieve treatment success for plaque-type psoriasis. We report a case series of 10 patients that were treated with betamethasone valerate foam (0.12%) in the morning and topical tazarotene cream (0.1%) in the evening for a total of 12 weeks or until plaques cleared. Erythema, scale, and thickness along with an aggregate severity score were determined at weeks 4, 8, and 12. One patient was lost to follow-up. Eight of the other 9 patients experienced improvement in their disease by week 12. Two patients were clear of their psoriasis at week 4 and 4 were clear at week 8. No adverse events, including irritation were reported; the use of the corticosteroid foam may protect against potential local irritation reported with tazarotene. The combination of tazarotene cream and betamethasone valerate foam is an effective combination approach to treating localized plaque-type psoriasis.     

Efficacy of Aloe vera/olive oil cream versus betamethasone cream for chronic skin lesions following sulfur mustard exposure: a randomized double-blind clinical trial

Background: Chronic pruritic skin lesions are among the common late complications of sulfur mustard intoxication. In the present randomized double-blind clinical trial, therapeutic efficacy of Aloe vera/olive oil combination cream in the alleviation of these lesions was evaluated and compared to that of betamethasone 0.1% cream.

Methods: Sixty-seven Iranian chemical warfare-injured veterans were randomized to apply A. vera/olive oil (n?=?34, completers?=?31) or betamethasone 0.1% (n?=?33, completers?=?32) cream twice daily for 6 weeks. Evaluation of pruritus severity was performed using a pruritic score questionnaire and visual analogue scale (VAS).

Results: Both treatments were associated with significant reductions in the frequency of pruritus (p?<?0.05), burning sensation (p?<?0.01 and p?<?0.001 in A. vera/olive oil and betamethasone group, respectively), scaling (p?<?0.01 and p?<?0.05) and dry skin (p?<?0.001) at the end of trial. Fissure and excoriation were only reduced in the A. vera group (p?<?0.05). The change in the frequency of hyper- and hypopigmentation lesions, blisters, erythema and lichenification did not reach statistical significance in any of the groups (p?>?0.05). Mean pruritus (p?<?0.05) and VAS scores (p?<?0.01 and p?<?0.05) were significantly decreased by the end of trial in both groups. The rate of improvement in the pruritus severity [defined as being classified in a less severe category (mild, moderate and severe)] was found to be comparable between the groups (p?>?0.05).

Conclusion: A. vera/olive oil cream was at least as effective as betamethasone 0.1% in the treatment of sulfur mustard-induced chronic skin complications and might serve as a promising therapeutic option for the alleviation of symptoms in mustard gas-exposed patients.     

Local treatment of psoriasis with desoxymethasone and betamethasone 17,21-dipropionate: a double-blind comparison

Summary

A double-blind comparison of the effectiveness of 0.25 % desoxymethasone and 0.05 % betamethasone 17, 21-dipropionate creams was carried out in 40 patients with symmetrical, chronic psoriatic lesions. The lesions were pre-treated for 1 week with an inactive cream base and then the trial preparations were applied, without occlusion, to one or other side at random twice daily for 21 days. Overall response to treatment and the effect of the two topical steroids on scaling, induration, erythema, and pruritus were assessed at the start of and 4, 7,14, and 21 days after the start of active treatment. The results indicated a better but not statistically significant response to desoxymethasone. By the end of the trial period, the desoxymethasone-treated side was better in 22.5% of cases compared with 10% of cases in the betamethasone dipropionate-treatedside. No side-effects of treatment were observed.     

Comparative study of Unna's Boot and betamethasone cream in the treatment of sulfur mustard-related pruritus

Pruritus, as a chronic lesion caused by sulfur mustard, is a common problem among chemical weapons veterans. Numerous treatments like antihistamines, local anesthetics, and corticosteroids have been prescribed in order to control pruritus in these patients, while long- term and widespread use of each one of them has its own restrictions. Nowadays different mixtures, including Unna's Boot, are being used. They are effective and have limited adverse effects. So in this study we compared this product with corticosteroids. In this double-blind randomized clinical trial in Baqyiatallah hospital, 90 veterans were included and randomly divided into three groups. Subjects of each group received one of the Betamethasone %1 cream, Unna's Boot cream, or placebo cream for three weeks. They used their medication on an itching area of body, one finger tip unit every night. To evaluate the drugs' efficacy we used pruritus score index and Visual Analysis Score index. From 90 patients, 75 patients completely used the medication and the other 15 subjects were excluded from the study. All three drugs caused significant decrease in both pruritus score and VAS (p < .001). Betamethasone and Unna's Boot were significantly more effective than placebo and despite more efficacy of betamethasone rather than Unna's Boot, they did not have any significant differences (p > .05). Pruritus is a chronic lesion in veterans that needs long-term conservation treatment. Regarding definite side effects of local long-term therapy with corticosteroids and nearly equal efficacy of Unna's Boot and betamethasone, Unna's Boot seems to be a better choice in controlling sulfur mustard-related pruritus compared with betamethason.     

Double-blind trial comparing bufexamac infiltrations with triamcinolone acetonide infiltrations in patients with periarthritis of the shoulder

Summary

A double-blind trial was carried out in 40 patients with an acute episode of periarthritis of the shoulder to compare the effectiveness and toleration of local infiltrations of bufexamac and triamcinolone acetonide. Patients received 1 or 2 local infiltrations with either 20?mg bufexamac or 40?mg triamcinolone acetonide. The results were evaluated by objective and subjective assessments of pain, loss of function, mobility, and by doctors' and patients' opinions of relief. There was a significant, comparable reduction in pain and discomfort in both groups after the first injection. Fourteen patients in each group required a second injection, with slightly more improvement in those receiving bufexamac. Local intolerance of the injections was noted in approximately 25 %to 30% of the patients.     

A randomized controlled clinical trial assessing the effect of betamethasone valerate 0.12% foam on the short-term treatment of stasis dermatitis

BACKGROUND: There are no published studies examining either the effectiveness of topical steroids in the treatment of stasis dermatitis or indicating what steroid strength or duration of treatment is optimal to treat this common condition. OBJECTIVE: To investigate the efficacy of twice-daily application of the topical steroid betamethasone valerate 0.12% foam for the treatment of stasis dermatitis. DESIGN: 42-day randomized, double-blinded, vehicle-controlled, pilot study. SETTINGS: Outpatient dermatology clinic at a university-affiliated clinic. SUBJECTS: 19 subjects, mean age of 73, with mild to moderate bilateral stasis dermatitis. INTERVENTION: Twice-daily application of betamethasone valerate 0.12% foam versus vehicle foam to bilateral randomly assigned lower legs for 28 days with follow-up to day 42. MAIN OUTCOME MEASURES: The primary clinical endpoints were the mean change in erythema, scale, swelling, petechiae, post-inflammatory hyperpigmentation, and self-reported pruritus, assessed on a 5-point Likert scale (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe). Secondary endpoints were changes in health related quality of life (HRQL) using the EuroQol-5D (EQ-5D) utility score and visual analog scale (VAS) and the Dermatology Life Quality Index (DLQI). RESULTS: Although there was no overall difference between the foam and vehicle-treated leg at days 14 and 28, the steroid-treated leg, but not the vehicle-treated leg, showed statistical improvement over baseline. Improvement in the steroid-treated leg was statistically better than vehicle at days 14 and 28 in terms of erythema (P < .05) and petechiae (P < .05). Improvement in VAS was notable at days 14 (7.1%), 28 (9.7%), and 42 (9.6%) (P < .001). Similarly, there was a statistically significant improvement in the DLQI compared to baseline on visit days 14 (188.9%) and 28 (126.1%) (P < .001). CONCLUSIONS: This study suggests that betamethasone valerate 0.12% foam is an effective and well-tolerated short-term treatment of stasis dermatitis, but that higher potency steroids may be needed to achieve better efficacy. Furthermore, these results are the first to suggest that the application of effective topical anti-inflammatory therapy can lead to improvement in HRQL.     

Comparison of topical capsaicin and betamethasone in the treatment of chronic skin lesions due to sulfur mustard exposure

Chronic pruritic skin lesions are considered to be one of the late complications of sulfur mustard exposure. The purpose of this study was to compare the efficacy of topical capsaicin with that of betamethasone in the treatment of these lesions. In this investigator-blinded, randomized clinical trial, patients applied capsaicin cream 0.025% (n=32) or betamethasone cream 0.1% (n=32) 2 times a day for 6 weeks. Efficacy was based on a dermatologist assessment. The severity of the pruritus was assessed by pruritic score questionnaire and a visual analog scale before and after treatment. All patients complained of pruritus. Both groups showed a significant decrease in pruritus, scaling, and skin dryness (p<0.05), but burning sensation was not improved significantly in the capsaicin group. The mean (+/- standard deviation [SD]) baseline pruritic scores in the capsaicin and betamethasone groups were 29.4 (13.1) and 33.6 (7.2), respectively (p=0.1). The mean (SD) pruritus score change from baseline to after the treatment was significantly higher (p<0.001) in the betamethasone group than in the capsaicin group, 12.7 (6.4) vs. 6.9 (5.6). Fourteen (35%) patients in the capsaicin group reported a burning sensation and intolerable odor, but these effects were not serious enough to necessitate discontinuing the treatment. Topical capsaicin cream 0.025% was much less well tolerated than betamethasone and inferior to betamethasone in reducing chronic skin lesions and symptoms from sulfur mustard exposure.     

Scalp psoriasis: topical calcipotriol 50 micrograms/g/ml solution vs. betamethasone valerate 1% lotion

Forty-two patients aged between 6 and 61 years (mean: 33.5 years) with psoriasis of the scalp were enrolled in this study. Twenty-seven patients (69%) were males and 15 (31%) were females. The aim of our study was to evaluate the efficacy, safety and tolerability of topical calcipotriol 50 micrograms/g/ml solution vs. betamethasone valerate 1% lotion in the treatment of psoriasis of the scalp. The study was randomized with the twice-daily application of either calcipotriol solution or betamethasone valerate lotion for 6 weeks. Treatment evaluation was clinically based on signs of psoriasis (thickness, redness, scaliness) which were scored from 0 = absent to 4 = severest possible involvement and was performed at the start of treatment and at weeks 2 and 6 of treatment. The results showed a marked improvement and clearance at the end of treatment in 15 (72.8%) of the 24 patients in the calcipotriol group and in 13 of the 18 patients (72%) in the betamethasone group. The mean total sign score at baseline was 5.1 in the calcipotriol group and 5.4 in the betamethasone valerate group. At the end of treatment, this score was decreased to 2.1 and 1.49, respectively. No significant adverse effects were reported in either group except in two patients (8.3%) in the calcipotriol group who developed signs of irritation including itching and erythema. In conclusion, both drugs were effective and well tolerated in the treatment of scalp psoriasis but in some patients calcipotriol had to be given for more prolonged courses.     

Clobetasone butyrate compared with betamethasone valerate in the treatment of atopic and contact dermatitis

In a double-blind, randomized study, 0.05% clobetasone butyrate cream was found to be as effective as 0.1% betamethasone valerate in the treatment of 48 patients with atopic or contact dermatitis, after 2 weeks as well as after 4 weeks of treatment. Side-effects with both drugs were rare and mild.     

戊酸雌二醇片/雌二醇环丙孕酮片联合屈螺酮炔雌醇片对功能性子宫出血患者宫内内分泌环境的影响

目的 探讨戊酸雌二醇片/雌二醇环丙孕酮片联合屈螺酮炔雌醇片对功能性子宫出血（functional uterine bleeding,FUB）患者宫内内分泌环境的影响。方法 前瞻性选取2013年1月-2016年6月笔者所在医院收治的FUB患者76例,依据随机分配原则分为单优组和克优组,每组38例,单优组在诊刮术后5 d给予屈螺酮炔雌醇片口服治疗,克优组在此基础上给予戊酸雌二醇片/雌二醇环丙孕酮片口服治疗。结果 克优组治疗后血清卵泡雌激素（FSH）、黄体生成素（LH）、雌二醇（E2）水平明显低于单优组,克优组治疗显效率明显高于单优组,差异有统计学意义（P<0.05）,单优组和克优组不良反应发生率基本相同,差异无统计学意义。随访12个月期间,克优组复发率明显低于单优组,差异有统计学意义（P<0.05）。结论 戊酸雌二醇片/雌二醇环丙孕酮片联合屈螺酮炔雌醇片治疗可有效改善FUB患者的宫内内分泌环境,有利于提高患者的近远期疗效,且具有良好的安全性,值得临床作进一步推广。     

Comparison of Clinical Efficacy of Topical Pimecrolimus with Betamethasone in Chronic Skin Lesions Due to Sulfur Mustard Exposure: A Randomized,Investigator‐Blind Study

Abstract: This study compared topical pimecrolimus with betamethasone in the treatment of pruritus and chronic skin lesions due to sulfur mustard exposure. Seventy male chemical‐injured war veterans participated in this investigator‐blinded clinical trial. They were randomized to receive pimecrolimus cream 1% (n = 35) or betamethasone cream 0.1% (n = 35) two times a day for 6 weeks. Dermatological examination and assessment of pruritus severity by a pruritic score questionnaire and visual analogue scale were done before and after the treatment course. A significant decrease (P < 0.05) in pruritus, burning sensation, and skin dryness was shown in both groups after the treatment. However, the severity of hyper‐ and hypopigmentation, vesicle, erythema, fissure, lichenification and excoriation did not decrease significantly in either group (P > 0.05). Mean (± standard deviation) pruritic scores at baseline for the pimecrolimus and betamethasone groups were 30.4 (± 8.0) and 33.6 (± 7.2), respectively (P = 0.103). These scores decreased to 18.8 (± 4.8) in the pimecrolimus and 20.8 (± 4.0) in the betamethasone groups after treatment; both showed a statistically significant decrease (P < 0.001). Change of pruritus score from baseline to after the treatment course was not statistically different between the two groups (P = 0.502). No serious side‐effects were reported during the course of the treatment. Topical pimecrolimus 1% was as effective as betamethasone cream 0.1% in controlling pruritus, burning sensation and skin dryness of sulfur mustard‐exposed patients.     

Clinical investigation of halopredone acetate, a new topical steroid, in dermatology. Controlled study.

17,21-Bis(acetyloxy)-2-bromo-6beta,9-difluoro-11beta-hydroxypregna-1,4-diene-3,20-dione (halopredone acetate; Topicon) cream, a new synthetic corticosteroid for topical use, has been evaluated against betamethasone valerate by means of double-blind sequential study, where the patients, mainly affected with psoriasis, presented symmetrically located lesions which were treated with either the new drug or the reference cream so that each patient could serve as his own control. Activity and tolerability of the two preparations were equivalent. This equivalence is particularly significant when bearing in mind that the concentration of the active principle (0.01%) contained in the halopredone acetate cream is one of the lowest employed so far and 10 times lower than that of the reference steroid (betamethasone valerate 0.1%). A second open trial, made in 30 patients suffering from psoriasis, confirmed the positive anti-inflammatory properties which the new substance had already displayed during the previous pharmacological tests.     

消风止痒颗粒联合加巴喷丁治疗老年皮肤瘙痒症的疗效观察

目的探讨消风止痒颗粒联合加巴喷丁胶囊治疗老年皮肤瘙痒症的临床疗效。方法选取2016年1月—2017年1月苏州市立医院收治的老年性瘙痒症患者88例为研究对象,根据患者病例单双号分为对照组和治疗组,每组各44例。对照组口服加巴喷丁胶囊,0.3 g/次,3次/d。治疗组在对照组基础上口服消风止痒颗粒,2袋/次,3次/d。两组患者均治疗28 d。观察两组的临床疗效,比较两组的瘙痒评分情况。结果治疗后,对照组和治疗组的总有效率分别为63.63%、88.64%,两组比较差异有统计学意义(P0.05)。治疗后,两组瘙痒程度、瘙痒部位、瘙痒频率、对睡眠的影响和总评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论消风止痒颗粒联合加巴喷丁胶囊治疗老年皮肤瘙痒症具有较好的临床疗效,可改善临床症状,安全性较好,具有一定的临床推广应用价值。     

A double-blind comparison of 1 % hydrocortisone plus 10% urea (‘Alphaderm’) and 0.1 % betamethasonel7-valerate in the treatment of non-infective inflammatory dermatoses

Summary

A double-blind controlled trial was carried out over a period of 3 weeks to assess the effectiveness of 1% hydrocortisone, in a specialized carbamide drug delivery system, compared with 0.1 % betamethasone 17-valerate cream in the treatment of 21 patients with bilateral, symmetrical, non-infective inflammatory dermatoses. The trial preparations were applied topically twice daily, each to one side only during the trial. Although overall patient preference tended to favour betamethasone 17-valerate, the physician's assessment of clinical improvement, based on severity rating scores, indicated that both preparations were equally effective and there were no significant differences between the calculated mean percentage clinical improvements at the end of each week.     

The NK1 receptor antagonist serlopitant for treatment of chronic pruritus

Introduction: Pruritus is a common symptom associated with several potential underlying causes, including both dermatologic and systemic diseases; it can also occur without an identifiable cause. Current treatment options are limited and most patients experience impaired quality of life. Serlopitant is a neurokinin 1 (NK₁) receptor antagonist under development for the treatment of pruritus associated with various dermatologic conditions and chronic pruritus of unknown origin.

Areas covered: This review describes the epidemiology and unmet needs of patients with chronic pruritus, focusing specifically on patients with prurigo nodularis, psoriatic itch, and chronic pruritus of unknown origin; the rationale for targeting the NK₁ receptor for treatment of chronic pruritus; and the clinical development of serlopitant, including efficacy and safety data from completed phase II studies.

Expert opinion: There is an unmet need for novel, safe, and effective therapies to treat chronic pruritus. Serlopitant has shown promising efficacy, safety, and tolerability across different patient populations, including adolescents and elderly patients. In contrast to less convenient administration options, serlopitant is a once-daily oral tablet, which is expected to facilitate compliance.     

Local treatment of psoriasis with desoxymethasone and betamethasone 17,21-dipropionate: a double-blind comparison.

A double-blind comparison of the effectiveness of 0.25% desoxymethasone and 0.05% betamethasone 17,21-dipropionate creams was carried out in 40 patients with symmetrical, chronic psoriatic lesions. The lesions were pre-treated for 1 week with an inactive cream base and then the trial preparations were applied, without occlusion, to one or other side at random twice daily for 21 days. Overall response to treatment and the effect of the two topical steroids on scaling, induration, erythema, and pruritus were assessed at the start of and 4, 7, 14, and 21 days after the start of active treatment. The results indicated a better but not statistically significant response to desoxy-methasone. By the end of the trial period, the desoxymethasone-treated side was better in 22.5% of cases compared with 10% of cases in the betamethasone dipropionate-treated side. No side-effects of treatment were observed.     

A study in industry of clotrimazole cream in Tinea pedis and Tinea cruris

Summary

A double-blind trial was carried out in 30 industrial workers presenting either with Tinea pedis or Tinea cruris. Patients were treated at random with either 1 % clotrimazole or 1% tolnaftate creams, applied twice daily, for up to 4 weeks. Patients were assessed clinically and skin scrapings were taken for mycological examination. The results showed that Tinea cruris responded better to treatment with both agents than did Tinea pedis. Clotrimazole appeared to act faster than tolnaftate since many patients were clinically clear at 2 weeks.