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SAGE Open Medical Case Reports 2021The article description and significance to dermatologists: bleomycin flagellate dermatitis is a rare cutaneous manifestation, believed to be due to the lack of...
The article description and significance to dermatologists: bleomycin flagellate dermatitis is a rare cutaneous manifestation, believed to be due to the lack of bleomycin hydrolase enzyme in the skin, which inactivates bleomycin, resulting in its accumulation. This is thought to be a dose-dependent reaction, and doses over 200 U and higher may increase risk. This case describes a male developing a pruritic, erythematous linear flagellated dermatitis to the lower back after his third cycle of bleomycin, etoposide and cisplatin for a stage 3 seminoma. Pruritis resolved and erythema improved with the treatment of bilastine and desoximetasone cream. It is important to recognize this condition because untreated pruritis may lead to increased impairment of the skin barrier in already immunocompromised patient populations. This may also give further evidence to having ongoing and continuing collaboration between Dermatology and Medical Oncology for any patients presenting with a new rash undergoing chemotherapy treatments.
PubMed: 34484791
DOI: 10.1177/2050313X211039476 -
The Journal of Dermatological Treatment Mar 2020Topical corticosteroids, available in an array of vehicles are used to control a variety of inflammatory skin diseases. Patients preferences for different vehicles may...
Topical corticosteroids, available in an array of vehicles are used to control a variety of inflammatory skin diseases. Patients preferences for different vehicles may affect their willingness to use treatment. We assess corticosteroid vehicle preference and potential impact of topical characteristics on adherence and quality of life in patients with psoriasis. Subjects with psoriasis were recruited from Wake Forest University Dermatology Clinic. Subjects sampled desoximetasone 0.25% spray, betamethasone valerate 0.1% cream, triamcinolone acetonide 0.1% ointment, fluocinonide 0.05% gel, betamethasone valerate 0.1% lotion, clobetasol propionate 0.05% foam, and fluocinonide 0.05% solution in a predetermined randomized order. Subjects completed a Vehicle Preference Measure, Determinants of Adherence Measure, and a Determinants of Quality of Life Measure. Patients preferences for the various products were highly variable. Regarding Determinants of Adherence, patients perception of absorption of the medication was ranked as 'quite important/extremely important' by 85% of total subjects. A majority of patients rated medication side effects as 'quite important/extremely important' when asked to consider topical characteristics effect on quality of life. There was wide variation in patient preference for topical medication vehicles used for treating psoriasis. Several vehicle characteristics were considered important to adherence. Given the marked variation in vehicle preference, topical treatment should be individualized according to patients preferences.
Topics: Administration, Topical; Betamethasone Valerate; Clobetasol; Desoximetasone; Drug Compounding; Female; Fluocinonide; Glucocorticoids; Humans; Male; Middle Aged; Patient Preference; Pharmaceutical Vehicles; Psoriasis; Quality of Life
PubMed: 29770722
DOI: 10.1080/09546634.2018.1473837 -
Journal of Drugs in Dermatology : JDD Jul 2013Topical corticosteroids are the standard-of-care treatment for dermatitis, mild psoriasis, and other inflammatory skin diseases. Prescribing practices rely on knowledge...
BACKGROUND
Topical corticosteroids are the standard-of-care treatment for dermatitis, mild psoriasis, and other inflammatory skin diseases. Prescribing practices rely on knowledge of topical corticosteroid potency, as well as potential side effects including steroid allergies.
PURPOSE
The primary aim of this study is to determine how dermatologists classify particular topical corticosteroids according to potency, and which products they prefer in cases when allergenicity is a concern,
METHODS
The data were collected and analyzed from 105 US-based dermatologists surveyed at the 2011 Summer American Academy of Dermatology meeting.
RESULTS
The majority of dermatologists were in agreement on the potency ranking of many commonly prescribed topical corticosteroids. Two thirds of the surveyed dermatologists expressed concern about allergy to topical corticosteroids. In cases of a suspected allergy, desoximetasone was the leading product dermatologists would choose to prescribe.
LIMITATIONS
The survey was limited to attendees of an educational conference, possibly leading to an overestimation of dermatologist knowledge of topical steroids.
CONCLUSIONS
This study shows that dermatologists are generally knowledgeable about group classifications of corticosteroids in terms of potency and that they can appropriately select a topical product with low potential for allergy
Topics: Administration, Cutaneous; Dermatologic Agents; Dermatology; Glucocorticoids; Health Care Surveys; Health Knowledge, Attitudes, Practice; Humans; Practice Patterns, Physicians'; Skin Diseases; United States
PubMed: 23884491
DOI: No ID Found -
Der Hautarzt; Zeitschrift Fur... Aug 1974
Clinical Trial Comparative Study
Topics: Adult; Child; Clinical Trials as Topic; Dermatitis, Contact; Dexamethasone; Female; Foot Dermatoses; Hand Dermatoses; Humans; Keratosis; Male; Psoriasis; Skin Diseases; Skin Diseases, Infectious
PubMed: 4608661
DOI: No ID Found -
Analytical and Bioanalytical Chemistry Nov 2023Over the last decade, applications of ion mobility-mass spectrometry (IM-MS) have exploded due primarily to the widespread commercialization of robust instrumentation...
Over the last decade, applications of ion mobility-mass spectrometry (IM-MS) have exploded due primarily to the widespread commercialization of robust instrumentation from several vendors. Unfortunately, the modest resolving power of many of these platforms (~40-60) has precluded routine separation of constitutional and stereochemical isomers. While instrumentation advances have pushed resolving power to >150 in some cases, chemical approaches offer an alternative for increasing resolution with existing IM-MS instrumentation. Herein we explore the utility of two reactions, derivatization by Girard's reagents and 1,1-carbonyldiimidazole (CDI), for improving IM separation of steroid hormone isomers. These reactions are fast (≤30 min), simple (requiring only basic lab equipment/expertise), and low-cost. Notably, these reactions are structurally selective in that they target carbonyl and hydroxyl groups, respectively, which are found in all naturally occurring steroids. Many steroid hormone isomers differ only in the number, location, and/or stereochemistry of these functional groups, allowing these reactions to "amplify" subtle structural differences and improve IM resolution. Our results show that resolution was significantly improved amongst CDI-derivatized isomer groups of hydroxyprogesterone (two-peak resolution of R = 1.10 between 21-OHP and 11B-OHP), deoxycortisone (R = 1.47 between 11-DHC and 21-DOC), and desoximetasone (R = 1.98 between desoximetasone and fluocortolone). Moreover, characteristic collision cross section (CCS) measurements can be used to increase confidence in the identification of these compounds in complex biological mixtures. To demonstrate the feasibility of analyzing the derivatized steroids in complex biological matrixes, the reactions were performed following steroid extraction from urine and yielded similar results. Additionally, we applied a software-based approach (high-resolution demultiplexing) that further improved the resolving power (>150). Overall, our results suggest that targeted derivatization reactions coupled with IM-MS can significantly improve the resolution of challenging isomer groups, allowing for more accurate and efficient analysis of complex mixtures.
PubMed: 37740752
DOI: 10.1007/s00216-023-04953-8 -
Medicina Cutanea Ibero-latino-americana 1981In a double-blind study on 22 patients affected by neurodermitis the action of two ointmes was studied. Both possess an activity in controlling the clinical and... (Clinical Trial)
Clinical Trial Comparative Study
In a double-blind study on 22 patients affected by neurodermitis the action of two ointmes was studied. Both possess an activity in controlling the clinical and histological manifestations of the disease. Desoximethasone (red labelled tubes) is very usefull in controlling pruritus and, histologically, the epidermal component of the lesions. Bazalin (yellow labeled tubes containing fluocinolone acetonide 0.025%, leucobitupal 5% an salicylic acid 3%), has a higher antiscaling action a more intense activity on the dermal component of the lesions.
Topics: 17-Ketosteroids; Adolescent; Adult; Aged; Child; Desoximetasone; Dexamethasone; Double-Blind Method; Female; Fluocinolone Acetonide; Humans; Leukocyte Count; Male; Middle Aged; Neurodermatitis; Skin
PubMed: 7038354
DOI: No ID Found -
Medicina Cutanea Ibero-latino-americana 1978Effectiveness of two creams, one containing desoxymethasone 0.25%, the other betamethasone dipropionate 0.05% was compared double blind, intraindividually. The... (Comparative Study)
Comparative Study
Effectiveness of two creams, one containing desoxymethasone 0.25%, the other betamethasone dipropionate 0.05% was compared double blind, intraindividually. The preparations were used in symmetric areas of psoriasis. Final evaluation shows desoxymethasone cream to be significantly more active concerning reduction of erythema and overall improvement of lesions.
Topics: Administration, Topical; Adult; Aged; Betamethasone; Desoximetasone; Dexamethasone; Double-Blind Method; Female; Humans; Male; Middle Aged; Psoriasis
PubMed: 398919
DOI: No ID Found -
Pediatric Dermatology Jan 2021Atopic dermatitis (AD) affects up to 20% of the pediatric population, with a growing prevalence over the past 30 years. Topical corticosteroids (TCS) are commonly used...
BACKGROUND/OBJECTIVES
Atopic dermatitis (AD) affects up to 20% of the pediatric population, with a growing prevalence over the past 30 years. Topical corticosteroids (TCS) are commonly used as a first-line topical therapy for AD and are prescribed in 59% of all AD visits. However, some topical corticosteroids are prescribed outside of their age range indications. This paper aims to explore the frequency with which topical corticosteroids are prescribed for AD outside of their FDA-approved age range.
METHODS
Data on prescribing patterns for AD were obtained from the National Ambulatory Medical Care Survey (NAMCS). We assessed the frequency of off-label use of topical corticosteroids with respect to age indications in four specific age-groups, as delineated in the data (0-1, 2-7, 8-18, and 19+ years).
RESULTS
All prescribed topical corticosteroids found in the NAMCS database have an indication for AD or other inflammatory dermatoses or pruritic dermatoses. However, some medications were prescribed outside of their FDA-approved age indications. These off-label prescription rates ranged from 52% for desoximetasone to 0% for halobetasol and alclometasone, or rates lower than could be detected by our study.
CONCLUSIONS
Much like other medications for AD treatment, TCS are sometimes used off-label. The off-label use of topical corticosteroids to treat pediatric AD highlights a gap between clinical practice and regulating guidelines. Additional pediatric studies would offer a greater body of evidence to maintain or expand label indications for the use of TCS in younger patients.
Topics: Child; Dermatitis, Atopic; Dermatologic Agents; Health Care Surveys; Humans; Infant; Infant, Newborn; Mometasone Furoate; Off-Label Use; Practice Patterns, Physicians'
PubMed: 33170543
DOI: 10.1111/pde.14442 -
Fortschritte Der Medizin Apr 1982
Clinical Trial
Topics: Chemical Phenomena; Chemistry; Clinical Trials as Topic; Desoximetasone; Dexamethasone; Humans; Ointments; Skin Diseases
PubMed: 7044929
DOI: No ID Found -
Frontiers in Pharmacology 2022Physiologically based pharmacokinetic (PBPK) models are widely accepted tools utilised to describe and predict drug pharmacokinetics (PK). This includes the use of...
A mechanistic physiologically based model to assess the effect of study design and modified physiology on formulation safe space for virtual bioequivalence of dermatological drug products.
Physiologically based pharmacokinetic (PBPK) models are widely accepted tools utilised to describe and predict drug pharmacokinetics (PK). This includes the use of dermal PBPK models at the regulatory level including virtual bioequivalence (VBE) studies. The current work considers the Topicort Spray formulation, which contains 0.25% desoximetasone (DSM), as an example formulation. Quantitative formulation composition and permeation testing (IVPT) data were obtained from the public literature to develop a mechanistic model using the multi-phase, multi-layer (MPML) MechDermA IVPT module in the Simcyp Simulator. - extrapolation functionality was used to simulate PK for various scenarios and predict a 'safe space' for formulation bioequivalence using the VBE module. The potential effect of vasoconstriction, impaired barrier function, and various dosing scenarios on the formulation safe space was also assessed. The model predicted 'safe space' for formulation solubility suggesting that a 50% change in solubility may cause bio-in-equivalence, whereas viscosity could deviate by orders of magnitude and the formulation may still remain bioequivalent. Evaporation rate and fraction of volatile components showed some sensitivity, suggesting that large changes in the volume or composition of the volatile fraction could cause bio-in-equivalence. The tested dosing scenarios showed decreased sensitivity for all formulation parameters with a decreased dose. The relative formulation bioequivalence was insensitive to vasoconstriction, but the safe space became wider with decreased barrier function for all parameters, except viscosity that was unaffected.
PubMed: 36532731
DOI: 10.3389/fphar.2022.1007496