Application Of Clobetasol Propionate Research Articles

Corticosteroid Atrophy in Human Skin. A Study by Light, Scanning, and Transmission Electron Microscopy

Steroid atrophy was induced in 3 volunteers by the continuous, occlusive application of clobetasol propionate to the forearms for 6 weeks. The changes were followed sequentially by light, scanning, and transmission electron microscopy. a 59% decrease in viable epidermal thickness was noted after the sixth week of treatment, as well as a flattening of the dermal-epidermal junction. The 3-dimensional architecture of the dermis was strikingly reorganized. This was largely brought about by resorption of the ground substance as revealed by a progressive diminution of Hale's stain for acid mucopolysaccharides. Loss of ground substance resulted in decreased spaces between collagen and elastic fibers as shown by scanning and transmission electron microscopy. The fibrous network consequently collapsed, yielding a more compact papillary and reticular dermis. This compression caused the reorientation of both collagen and elastic fibers. However, no differences in collagen and elastin fine structure were noted. Fibroblasts were shrunken but not reduced in density. A marked decrease in number of mast cells was noted in 3-week specimens and virtually no mast cells were observed after 6 weeks. We found that the primary effect of short-term steroid use was a rearrangement of the geometry of the dermal fibrous network. This was not due to alterations in the fibers themselves but a secondary consequence of the loss of ground substance.

Cushing's syndrome and pituitary-adrenal suppression due to clobetasol propionate.

Widespread application of clobetasol propionate resulted in suppression of the hypothalamic pituitary axis in four patients. Three patients showed Cushigoid features and developed symptoms of adrenocortical insufficiency on withdrawal of clobetasol.

The measurement of corticosteroid induced dermal atrophy by a radiological method.

Dermal atrophy due to the application of Clobetasolpropionate has been detected and measured by an X-ray method after four weeks topical application to the forearm. This effect was found to have recovered when the subjects were re X-rayed eight weeks after they had stopped using the steroid preparation.

The effect on plasma corticosteroid levels of the short term topical application of clobetasol propionate.

Thirty-four patients with skin diseases which necessitated treatment with potent topical steroids at a hospital clinic were studied. All the patients received clobetasol propionate ointment (Dermovate) for a period of 2 weeks and sixteen of the patients continued with their treatment for 4 weeks, during which time their plasma corticosteroid levels were measured. Thirty patients had normal levels throughout the whole period of study (≥ 6 μg/100 ml) and five patients showed a depressed level at some stage during the investigation. Of six patients who were using a large amount of clobetasol ointment (more than 100 g/week) and who had a significant proportion of their body affected by disease (20-80%), two had lowered plasma corticosteroid levels and in four there was no evidence of adrenal suppression.