Effects Of Topical Steroids Research Articles

Effect of topical steroid on soft tissue swelling following anterior cervical discectomy and fusion.

Anterior cervical discectomy and fusion is the most commonly used surgical approach for treating cervical spine conditions, but it can often lead to postoperative swallowing difficulties. To retrospectively assess the effects of topical triamcinolone acetonide in the anterior cervical surgery on swallowing function. In this study, a retrospective design was used to select patients aged 18 years and older who were diagnosed with cervical spondylosis and required anterior cervical discectomy and fusion. Among them, the patients in the experimental group used triamcinolone acetonide topically in front of the plate during surgery, and the control group was the patients who did not use triamcinolone acetonide. The sex, age, operation time, operation segment, and preoperative soft tissue area were compared between the two groups. There were no significant differences in gender, age, operation time, and segment between the two groups. For the preoperative soft tissue area, triamcinolone acetonide was significantly lower than in the control group (P < 0.05). The retrospective results of this study support that topical triamcinolone acetonide as a treatment in anterior cervical surgery can significantly reduce soft tissue swelling, and no effect was found on the operation time, postoperative blood loss, and segment. These findings provide an important basis for clinical care teams to make treatment decisions and confirm the effectiveness of triamcinolone acetonide in improving swallowing function. However, there was a possibility of information collection and selection bias due to the limitations of retrospective studies. To confirm and further advance the use of this treatment, more rigorous prospective randomized controlled trials are recommended to validate these preliminary results.

The effect of topical steroids and non-steroidal anti inflammatory drugs on epiphora of unknown cause: Optical coherence tomography study.

The aim of this study is to evaluate using topical non-steroidal antiinflammatory and low-potency steroid drugs for the treatment of epiphora without an underlying cause using anterior segment-optical coherence tomography (AS-OCT) and Munk epiphora grading system. Thirty patients with epiphora who had no underlying cause were evaluated prospectively.A detailed ophthalmological examination, tear meniscus height on slit-lamp, fluorescein tear break-up time, schirmer test, lisamin green conjonctival staining, lacrimal syringing of the upper and lower canaliculus were done in all patients. The patients with contact lens wear,punctal stenosis, lacrimal system disorders, dry eye disease, eyelid malpositions, pterygium, conjunctivochalasis, conjunctivitis, blepharitis, ocular infection, and corneal disease, used topical anti-glaucomatous drugs were excluded. All patients were treated with a combination of topical low-potency drug (loteprednol etabonate 0.5%) twice daily for ten days and topical non-steroidal anti-inflammatory drug (nepafenac 0.3%)once a day for 1 month. Before and after the medical treatment protocol, tear meniscus area (TMA) and tear meniscus height (TMH) were measured by AS-OCT and patients were asked to subjectively rate their epiphora according to the Munk epiphora grading system. The effectiveness of treatment were evaluated by AS-OCT measurements and the Munk epiphora grading system. Fourteen males and sixteen females were included. The mean age at presentation was 60.1±7.35 years and duration of symptoms was 10.03±5.08 months. The mean duration of follow-up was 8.7±3.2 months. Munk epiphora grading system was significantly decreased from 2.5 to 1.6 after treatment (p: 0.004). TMH and TMA were significantly decreased on AS-OCT (TMH:402vs 309µm, p:0.001, TMA:0.797vs 0.347 mm2, p=0.006).Six of thirty patients subjectively reported that their symptoms had not improved but TMH and TMA were significantly decreased on AS-OCT. The combined use of topical non-steroidal anti-inflammatory and low-potency steroid drops may be a good option in patients with epiphora who does not have an underlying cause.

Comparative study between topical steroid alone versus combined fractional Erbium:YAG laser with topical steroid in treatment of alopecia areata.

AA is a common autoimmune skin disease that causes hair loss on the scalp and sometimes other areas of the body. New therapy approaches for alopecia areata are emerging, with the goal of improving clinical outcomes. In this study, the effects of topical steroids against fractional Er:YAG laser followed by topical steroids in the treatment of alopecia areata will be compared. A total of 30 participants with alopecia areata were included in the study. Each patient's lesions were treated with one of two methods: topical clobetasol propionate or fractional Er:YAG laser followed by topical clobetasol propionate. SALT score, patient satisfaction, and dermoscopic imaging were used to evaluate therapeutic response. Both treatment modalities showed a significant clinical improvement in alopecia areata with a statistically significant reduction in the SALT score. The SALT score was more evident in the laser-steroid group. On comparing the dermoscopy findings in both treated areas before and after treatment, a significant reduction was found regarding all dermoscopic findings of alopecia areata in both modalities. Combining fractional Er:YAG laser with topical steroids is found to be a safe treatment modality and more effective than topical steroids in alopecia areata.

The Long-Term Effects of 12-Week Intranasal Steroid Therapy on Adenoid Size, Its Mucus Coverage and Otitis Media with Effusion: A Cohort Study in Preschool Children.

Background: The purpose of this study is to analyse the long-term effects of a 12-week course of topical steroids on adenoid size and its mucus using endoscopy and on middle ear effusion measured by tympanometry. Methods: The study presents an endoscopic choanal assessment of the change in adenoid size (adenoid to choanae ratio, A/C ratio) and its mucus coverage in 165 children with Grade II and III adenoid hypertrophy three to six months after finishing a 12-week course of intranasal steroid treatment with mometasone furoate. Additionally, tympanometry was performed to measure middle ear effusion. Changes in the tympanograms were analysed. Results: The mean A/C ratio before treatment was 65.73%. Three to six months after finishing a 12-week course of intranasal steroid treatment, the mean A/C ratio decreased to 65.52%, although the change was not statistically significant (p = 0.743). There was no change in adenoid mucus according to the MASNA scale before and three to six months after the end of the steroid treatment (p = 0.894). Long-term observations of tympanograms before and three to six months after the end of the treatment did not show improvement (p = 0.428). Conclusions: The results indicate that there was no effect of topical steroids on adenoid size, its mucus and otitis media with effusion (OME) three to six months after finishing a 12-week course of treatment. In the light of performed study, decision of adenoidectomy and tympanostomy should not be procrastinated.

Nasal function and CPAP use in patients with obstructive sleep apnoea: a systematic review.

This systematic review was conducted to answer the following 3 questions: 'Does nasal pathology affect CPAP use?', 'What is the effect of CPAP on the nose?'and 'Does treatment of nasal pathology affect CPAP use?'. Pubmed and Scopus databases were searched for articles relevant to the study questions up to October 2020. Sixty-three articles were selected, of which a majority were observational studies. Most studies identified a correlation between larger nasal cross-sectional area or lower nasal resistance and higher CPAP compliance or lower CPAP pressures; however, nasal symptoms at baseline did not appear to affect CPAP use. The effect of CPAP on the nose remains uncertain: while most studies suggested increased mucosal inflammation with CPAP, those investigating symptoms presented contradictory results, with some reporting an increase and others an improvement in nasal symptoms. Evidence is clearer for nasal surgery leading to an increase in CPAP compliance and a decrease in CPAP pressures, whereas there is little evidence available for the use of topical nasal steroids. There appears to be a link between nasal volumes or nasal resistance and CPAP compliance, an increase in nasal inflammation caused by CPAP and a beneficial effect of nasal surgery on CPAP usage, but no significant effect of CPAP on nasal patency or effect of topical steroids on CPAP compliance. Results are more mitigated with regard to the effect of nasal symptoms on CPAP use and vice versa, and further research in this area would help identify patients who may benefit from additional support or treatment alongside CPAP.

Effect of Topical Steroid on Swallowing Following ACDF

Study Design. Randomized, double-blinded, controlled trial. Objective. To investigate the effectiveness of local intraoperative corticosteroids at decreasing the severity of swallowing difficulty following multilevel anterior cervical discectomy and fusion (ACDF). Summary of Background Data. Dysphagia is a common complication after ACDF, and while for most patients the symptoms are mild and transient, some patients can suffer from severe dysphagia resulting in significant postoperative morbidity. Previous studies investigating the local application of corticosteroids are limited. Methods. This was a prospective, randomized, double-blinded, controlled trial of patients undergoing 2, 3, or 4 level ACDF for radiculopathy and/or myelopathy. Patients undergoing multilevel ACDF were randomized to receive local corticosteroid in the retropharyngeal space or placebo (no steroid). Dysphagia was assessed using validated outcomes including the Eating Assessment Tool-10 (Eat-10) and Swallowing Quality of Life (SWAL-QOL) Questionnaire both preoperatively and at 1 day (POD1), 2 days (POD2), and 1-month postoperatively. Results. One-hundred nine patients had a complete dataset available for analysis. Eat-10 scores were significantly lower in the Steroid group on POD2 (8 vs. 16, P = 0.03) and 1-month postoperatively (2 vs. 5, P = 0.03). A comparison of the individual SWAL-QOL subscale scores demonstrated that patients in the Steroid group had better scores than the Control group in various subscales at all postoperative time points. Significant differences were noted (always in favor of the Steroid group) in 40% of subscales on POD1, 60% of subscales on POD2, and 50% of subscales at 1-month postoperatively. The Control group never had a better SWAL-QOL subscale score at any time point postoperatively. Conclusion. Local administration of corticosteroid after multilevel ACDF can decrease postoperative severity and symptomatology of dysphagia during the immediate postoperative period to 1-month postoperatively. The long-term effects of local steroid administration on fusion and other complications will need to be established in future studies. Level of Evidence: 1

Effectiveness of Topical Steroids in Treating Herpes-Associated Erythema Multiforme and Review of Topical Steroids Erythema Multiforme and Review of Topical St

50-year-old female presented at the Oral Medicine clinic at the Faculty of Dentistry, Chulalongkorn University, Bangkok with a chief complaint of severe pain in her oral cavity and lips for 1 week. She had no systemic diseases, except for vertigo, and was currently taking cetirizine hydrochloride. An oral examination revealed a hemorrhagic crust on her lips, scaly, large ulcerations on the upper labial mucosa, and multiple oral ulcerations on the right and left buccal mucosa. She had limited mouth opening and difficult in eating. She was treated with benzydamine hydrochloride mouthwash, triamcinolone acetonide 0.1% mouthwash, and fluocinolone acetonide 0.1% solution. The patient’s pain and severe oral lesions gradually reduced after treatment for one week. At the one month follow-up, all lesions had completely disappeared and the laboratory investigation report showed that she was Herpes simplex virus Ab IgG type I and Type II positive; therefore, the diagnosis in this case was Herpes associated erythema multiforme (HAEM). The aim of this case report is to show the effectiveness of various potent topical steroids in treating severe oral ulcerations without any side-effects. Potent topical steroids are recommended as an alternative treatment for severe oral ulcerations in HAEM patients.

37. Effect of topical steroid on swallowing following ACDF: results of a prospective randomized double blind control trial

BACKGROUND CONTEXT Dysphagia is a common complication in the setting of ACDF surgery. There is controversy in the literature regarding the effectiveness of Local Intraoperative Corticosteroids (LIC) in reducing postoperative dysphagia. This study aims to evaluate the effectiveness of LIC in decreasing the severity of swallowing difficulty following ACDF. PURPOSE To determine if the application of local intraoperative corticosteroids (LIC) during multilevels ACDF surgery impacts early postoperative dysphagia severity STUDY DESIGN/SETTING Double blinded randomized clinical trial early postoperative results. PATIENT SAMPLE A total of 106 adult patients undergoing primary multilevel ACDF (2-4 levels) at a single institution. OUTCOME MEASURES SWAL-QOL, Eat-10 (standard and modified). METHODS Patients who sustained a multilevel ACDF were enrolled and randomized in a double blinded fashion. Arm S (steroid) received 1ml (40mg) of methylprednisolone delivered with an absorbable hemostatic matrix (vehicle) to the retro-esophageal space prior to closure. The control arm (C) only received the vehicle prior to closure. Dysphagia specific instruments (EAT-10 and the SWAL-QOL) were collected preoperatively, and at day 1 (POD1), day 2 (POD2), and 1 month (M1) postoperatively. Potential randomization biases were assessed by comparing the preoperative characteristics and surgical treatment of the 2 arms. A Friedman test was used to investigate change over time in patient-reported outcomes (PRO); a Mann-Whitney U test was performed to compare the median PRO scores (S vs C) at each time points. RESULTS Out of the 106 enrolled patients, 95 (90%) had complete dataset and were included in the analysis. The overall mean age was 57.6 year-old, for a BMI of 29.4kg/m2, and 48.4% of female patients. The most common diagnoses were cervical spondylosis (63.2%), radiculopathy (48.4%), myeloradiculopathy (30.5%) and myelopathy (24.2%). The comparison of the C arm (n=47) and S arm (n=48) revealed no significant difference in demographics, diagnosis, or surgical information in terms of number of levels fused (1.5±0.6 vs 1.4±0.6, p = 0.521), Op time (150min±37 vs 136min±33 p = 0.065), or EBL (100cc±43 vs 91cc±52 p = 0.358). Preoperatively, there was also no significant difference in PRO, with the exception of the Eat-Desire domain (p=0.049, but similar median, 25th and 75th percentile). Overall and for each randomized arm, significant change in dysphagia scores were observed from pre- to postop. The comparison of postoperative PRO across the study arms revealed that the S arm had significantly better dysphagia scores than the control arm. At POD1, the S arm had better SWALL-QOL in ood selection (p=0.049, 87.5 [50-100] vs 75 [37.5-100]), and Fear (p=0.027, 100 [89-100] vs 93.7 [75-100]); at POD2 the S arm had better dysphagia scores in Burden (p=0.02), Eat Duration (p=0.008), Fear (p = 0.017), Fatigue (p=0.047), and modified Eat-10 (p=0.013). Finally, better dysphagia scores were maintained at M1 in terms of Eat Desire (p = 0.015), East duration (p=0.046), Fear Swallow (p=0.016), and Fatigue (p=0.003) CONCLUSIONS Both arms demonstrated similar preoperative characteristics and underwent similar surgical procedure. Our study demonstrated the benefit of LIC with this delivery method to prophylactically reduce dysphagia following ACDFs. Early postop results were superior for treatment group, especially postop days 2, and maintained at 1 month. FDA DEVICE/DRUG STATUS Unavailable from authors at time of publication.

Effect of Topical Steroids on Skin Prick Test: A Randomized Controlled Trial

IntroductionTopically applied corticosteroids on the skin can significantly inhibit the wheal response to allergens in skin prick test (SPT). The duration of this effect is unknown. The aim of this study is to investigate the duration of the inhibitory effect of topical corticosteroids on SPT.MethodsTwenty-two healthy subjects were included in a single-blinded randomized study. All subjects were skin prick tested using a standard inhalant allergen panel. The subjects were randomized to treat either the left or right forearm with Betnovat® cream (group III steroid) once a day for 10 days. Subsequently, the subjects were skin prick tested the following 5 days and at day 8 on both forearms.ResultsAt baseline, the 22 individuals had positive SPT for a total of 72 allergens. Compared with the untreated arm, the mean size of the wheals was significantly reduced on day 1 (12 h after end of treatment) by 0.56 mm (95 % confidence interval (CI) [0.06; 1.06], p = 0.03) for allergens and 0.70 mm [0.32; 1.09] (p = 0.001) for histamine. On day 2 (36 h after end of treatment), the mean difference between treated and untreated arm was 0.47 mm [−0.08; 0.85] (p = 0.02) for allergen-induced wheals and 0.22 mm [−0.21; 0.64] (p = 0.31) for histamine-induced wheal. On day 3, 4, 5, and 8, there was no significant difference.ConclusionsTreatment with topical steroid significantly inhibited the response to SPT for 36 h but for less than 3 days. In addition, we demonstrated that topical applied corticosteroids inhibit the mean wheal size of the positive histamine control for a shorter time than for the allergens. Consequently, positive response to histamine control is not a valid marker for reliable skin prick test in steroid-treated patients.Plain Language SummaryPlain language summary available for this article.

Effect of topical steroid on the str atum corneum compositions by using confocal Raman microscopy

Effect of topical steroid on the str atum corneum compositions by using confocal Raman microscopy

Topical Steroids Are Effective in the Treatment of Idiopathic Granulomatous Mastitis.

Idiopathic granulomatous mastitis (IGM) is a rare, benign, and chronic disease of the breast. Despite the various treatment approaches described for this disease, a gold standard treatment modality has not yet been defined. In this study, the effect of topical steroids was reviewed and assessed in patients with IGM. The records of patients with IGM who were treated only with topical steroids were retrospectively reviewed. Patients were grouped as "completely healed," "inadequately healed," "stable," "worsened," or "recurred" if they had once healed but their symptoms returned. Patients whose skin changes were completely ameliorated were considered "completely healed." All of the patients were women, and the average patient age was 35.7 years (range 24-48 years). During the average follow-up of 37.2 months (range 12-72 months) in patients who received only topical steroid treatment, recurrence was observed in three patients (3/28, 10.7 %), and no side effects or steroid-related complications occurred. Topical steroids seem to be effective in the treatment of IGM characterized by skin changes. Prospective clinical studies would be useful in determining the clinical efficacy of topical steroids in the treatment of IGM.

Effect of topical dexamethasone in reducing dysfunction after facial nerve crush injury in the rat

ObjectiveTo date, the effect of topical steroid after a crush injury to rat facial nerve has rarely been reported on. The aim of this study was to investigate the effects of topical dexamethasone on recovery after a crush injury to the rat facial nerve, by functional, electrophysiological, and morphological evaluation. Materials and methodsWe investigated the effects of topical dexamethasone on recovery after a crush injury to rat facial nerve by functional, electrophysiological and morphological evaluation. ResultsThe functional recovery using vibrissae movement was significantly high scores in the experimental group than control group at two and three weeks post-crush. The recovery of the threshold of muscle action potential was significantly lowered in the experimental group compared to the control (p<0.05). However, there was no statistical significance in the nerve conduction velocity. The dexamethasone treatment groups showed a larger axon diameter and thicker myelin sheath than the control group. ConclusionFrom our results, topical dexamethasone accelerates recovery of the crush-injured facial nerve.

Effects of Topical Steroids on Tight Junction Proteins and Spongiosis in Esophageal Epithelia of Patients With Eosinophilic Esophagitis

The allergic response associated with eosinophilic esophagitis (EoE) occurs when food antigens permeate tight junction-mediated epithelial dilated intercellular spaces. We assessed whether levels of tight junction proteins correlate with the dilation of intercellular spaces (spongiosis) and the effects of topical steroids on these parameters. We assessed esophageal biopsy samples from 10 patients with active EoE treated with topical fluticasone, 10 untreated patients, and 10 patients without esophageal disease (controls) for degree of spongiosis. Immunohistochemical assays were used to determine the levels of the tight junction proteins filaggrin, zonula occludens (ZO)-1, ZO-2, ZO-3, and claudin-1. Histology and immunohistochemistry results were assessed blindly, with levels of tight junction proteins and degree of spongiosis rated on scales of 0 to3. The mean degrees of spongiosis in untreated and treated patients with EoE were 1.3 and 0.4, respectively (P= .016). Esophageal epithelia did not stain significantly for ZO-1 or ZO-2. Filaggrin was observed in a predominant cytoplasmic pattern, compared with the cytoplasmic and membranous patterns of ZO-3 and claudin-1. In biopsy specimens from patients with active EoE, the mean staining intensities for filaggrin, ZO-3, and claudin-1 were 1.6, 1.4, and 0.7, respectively. In biopsy specimens from patients treated with fluticasone, levels of filaggrin, ZO-3, and claudin-1 were 2.8 (P= .002 compared with untreated patients), 1.7 (P=.46 compared with untreated patients), and 1.3 (P= .25 compared with untreated patients), respectively. The correlation between the level of filaggrin and the degree of spongiosis was r= 0.23, and between ZO-3 staining and the degree of spongiosis was r= .016 (P= .001 for filaggrin vs ZO-3 staining). Filaggrin, ZO-3, and claudin-1 (but not ZO-1 or ZO-2) are detected in the esophageal mucosa of patients with EoE treated with steroids and individuals without esophageal disease. Without treatment, spongiosis increases, corresponding with reduced levels of filaggrin, ZO-3, and claudin-1. Loss of tight junction regulators and dilation of intercellular spaces appear to be involved in the pathophysiology of EoE and could be targets for treatment.

Steroid Phobia in the Ward

Topical steroid phobia is a recognised phenomenon and may be exhibited by patients, parents of patients, relatives, GPs, dermatologists, pharmacists, Internet sites and patient blogs [1-3]. Unhelpful and overvalued beliefs about side effects of topical steroids exist, resulting in a reluctance to use topical steroids as recommended. Adherence to the suggested treatment regimen is reduced which can result in suboptimum outcomes. The reasons for steroid phobia are complex and have been explored recently [4].

Sinus Surgery and Delivery Method Influence the Effectiveness of Topical Corticosteroids for Chronic Rhinosinusitis: Systematic Review and Meta-Analysis

Published randomized controlled trials (RCTs) on the efficacy of intranasal corticosteroid (INCS) in chronic rhinosinusitis (CRS) use either nasal delivery (nasal drop or nasal spray) or sinus delivery (sinus catheter or sinus irrigation) in patients with or without sinus surgery. This influences topical drug delivery and distribution. The effect of these factors on the published results of RCTs is assessed. This systematic review explores the strength of evidence supporting the influence of sinus surgery and delivery methods on the effectiveness of topical steroids in studies for CRS with meta-analyses. A systematic review was conducted of RCTs comparing INCS with either placebo or no intervention for treating CRS. Data were extracted for meta-analysis and subgroup analyses by sinus surgery status and topical delivery methods. Forty-eight studies (3961 patients) met the inclusion criteria. INCS improved overall symptoms (standardized mean difference [SMD], -0.49; p < 0.00001) and the proportion of responders (risk ratio [RR], 0.59; p < 0.00001) compared with placebo. It decreased nasal polyp size with a greater proportion of responders (RR, 0.48; p < 0.00001) and prevented polyp recurrence (RR, 0.59; p = 0.0004) compared with placebo. Reduction of polyp size was greater in patients with sinus surgery (RR, 0.31; 95% confidence interval [CI], 0.20, 0.48) than those without (RR, 0.61; 95% CI, 0.46, 0.81; p = 0.009). Greater symptom improvement occurred when sinus delivery methods (SMD, -1.32; 95% CI, -2.26, -0.38) were compared with nasal delivery methods (SMD, -0.38; 95% CI, -0.55, -0.22; p < 0.00001). INCS is effective for CRS. Prior sinus surgery and direct sinus delivery enhance the effectiveness of INCS in CRS.

Effect of Topical Steroid (0.05% Clobetasol Propionate) Treatment in Children With Severe Phimosis

PurposeWe report our experience with the use of a topical steroid, 0.05% clobetasol propionate, for the treatment of phimosis with clinical complications.Materials and MethodsThis was a retrospective analysis of the clinical outcomes of all patients presenting with phimosis to a single institution during the time period from October 2008 to May 2012. A total of 88 patients who had a Kikiros retractability grade of 4 or 5 and phimosis-associated clinical complications, such as ballooning of the prepuce, balanoposthitis, or a history of urinary tract infection (UTI), were instructed to apply 0.05% clobetasol propionate cream to the slightly retracted foreskin and to massage gently while retracting the foreskin. The efficacy of treatment was evaluated at 4 weeks from the initiation of therapy.ResultsA total of 60 of the 88 patients (68.2%) showed a complete response (i.e., full retraction of the foreskin) to the therapy. The phimotic ring disappeared in 25 of the 88 patients (28.4%) after treatment. Patients who had a history of balanoposthitis, smegma, ballooning of the prepuce, or UTI showed significantly poorer improvement in preputial retraction (p<0.001, p<0.001, p<0.001, and p=0.02, respectively) and phimotic ring disappearance (p<0.001, p=0.001, p<0.001, and p=0.001, respectively) after treatment. No significant local or systemic side effects were associated with the administration of topical steroids.ConclusionsTopical application of 0.05% clobetasol propionate cream and skin stretching is a safe, simple, and effective procedure with no significant side effects for severe phimosis in prepubertal boys.

Clinical observation of topical steroid for the treatment of chronic rhinosinusitis in Chinese adults

This study was focused on the clinical effects of topical steroid for chronic rhinosinusitis (CRS) in Chinese adults. The CRS patients were randomly selected in the department of otorhinolaryngology, first affiliated hospital of Sun Yat-sen university between november 2010 and December 2011. Thirty-four CRS patients with polyps (CRSwNP) or CRS without polyps (CRSsNP), no prior surgeries were included. These patients were prescribed to use budesonide nasal spay for three months. Evaluation included visual analog score (VAS), sino-nasal outcome test-20(SNOT-20), CT scan (Lund-Mackay score). SPSS 16.0 software was used to analyze the data. Four patients were lost to follow up, while the other 30 patients finished the 3-months' follow up. Except for smelling disturbance which was not statistically changed (t = 0.902, P > 0.05), VAS for nasal blockage (baseline: 4.84 ± 3.15, after treatment: 2.26 ± 2.27), rhinorrhea (baseline: 6.03 ± 2.93, after treatment: 1.96 ± 2.23), headache (baseline: 1.68 ± 2.66, after treatment: 0.42 ± 0.95), facial pressure (baseline: 2.04 ± 2.97, after treatment: 0.58 ± 1.42) and general symptom (baseline: 6.00 ± 2.75, after treatment: 2.71 ± 1.90) were statistically decreased (t value was 4.386, 6.740, 2.445, 2.980, 6.989, respectively, all P < 0.05). VAS of nasal blockage, rhinorrhea and general symptom were statistically decreased after one-month's treatment (all P < 0.05), but no statistical improvements were observed between first, second and the third month (all P > 0.05). SNOT-20 was significantly decreased after treatment (t = 3.687, P < 0.01). 22.2% patients were cured on CT scan. Topical steroid improves objective symptoms and quality of life in CRS patients. Some of the patients can be cured in CT scores. The symptoms improvements begin from the first month, but do not change during the latter two months.

Su1122 The Effect of Topical Steroids on Tight Junction Proteins and Spongiosis in Esophageal Epithelia in Patients With Eosinophilic Esophagitis

Su1122 The Effect of Topical Steroids on Tight Junction Proteins and Spongiosis in Esophageal Epithelia in Patients With Eosinophilic Esophagitis

Effect of Topical Steroids (0.05% Clobetasol Propionate) in Children with Phimosis

Purpose: We evaluated the effect of a topical steroid(0.05% clobetasol propionate[DermovateⓇ]) on phimosis. Materials and Methods: Between May 2005 and May 2007, 30 boys with phimosis were assigned to receive topical application of DermovateⓇ. Of the 30 boys, 19 boys had concealed penises. The parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroid over the stenotic opening of the prepuce twice daily for 4 weeks then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 1-6. Response to treatment was arbitrarily defined as improvement in the retractibility score(complete response, score 5 and 6; partial response, score 3 and 4; no response, score 1 and 2). The effect of treatment was studied with respect to the duration of treatment, age, and an associated concealed penis. Results: The pretreatment grade in all patients was a retractibility score of 1. The mean age of the patients was 48.5±27.6 months(range, 7-108 months). The complete response rates in boys treated for 4 and 8 weeks were 50% and 73.3%, respectively. In boys younger than 3 years of age (n=12) and older than 3 years of age(n=18), the complete response rates were 75% and 72.2%, respectively(p=0.866). In boys with or without an associated concealed penis(n=19 and n=11, respectively), the complete response rates were 63.1% and 90.9%, respectively(p=0.199). No adverse effect was encountered in all patients. Conclusions: Our data suggest that the application of topical steroids for 8 weeks as a first line treatment of phimosis may be effective, although further studies are needed to establish the definite efficacy and safety of this procedure

Evaluation of the effects of topical clobetasol propionate by visual score, electrical impedance and laser Doppler flowmetry

The intensity of steroid-induced skin blanching is usually evaluated subjectively by a trained observer using a visual score although a few methods have been described for doing this objectively. In this study we wished to establish whether the effects of topical steroids can be detected by measuring the electrical impedance of the skin. Ten healthy volunteers were treated with three concentrations of clobetasol propionate (0.005, 0.05, and 0.5 mg/mL) on the forearm covered by a dressing overnight. On the following morning, we assessed dermal blanching using a visual score, laser Doppler flowmetry and electrical impedance. Using the visual score, we found dose-response blanching at all concentrations of clobetasol propionate. The laser Doppler flow values declined significantly after the application of clobetasol propionate (0.005 mg/mL (P<0.01) and 0.5 mg/mL (P<0.05)), as compared with the test site treated with the vehicle alone. Electrical impedance showed a significant increase in phase index after the application of 0.05 mg (P<0.01) and 0.5 mg (P<0.01) of clobetasol propionate, and a significant reduction in real part index after of 0.05 mg/mL (P<0.05) and 0.5 mg/mL (P<0.05) compared with the test site treated with the vehicle alone. The magnitude index and imaginary part index were not affected by this steroid. Our findings indicate that the dermal blanching induced by topical corticosteroids can be evaluated with a skin impedance spectrometer.