Methylprednisolone Aceponate Research Articles

EXPERIENCE OF COMBINED APPLICATION OF METHYLPREDNISOLONE ACEPONATE AND MOLETOLO COSMETICS STEROIDSANDVIAGRAJY IN THE TREATMENT OF DERMATOSES

Skin diseases of non-infectious etiology, such as allergic contact dermatitis, atopic dermatitis, eczema and chronic actinic dermatitis have a significant impact on the quality of patient’s life, greatly reducing it. The most important place in the therapy of these diseases is found in topical glucocorticosteroids in combination with competent basic therapy.The aim of the study was to evaluate the clinical efficacy, safety profile, and tolerability of an external corticosteroid drug with a combination composition: methylprednisolone aceponate 0.1 % + urea 2 % (Komfoderm M2) in combination with dextpanthenol, allantoin and Shea butter (Dexpan plus cream) in dermatological practice in the treatment of eczematous process.Materials and methods. 48 patients, from 18 to 58 years old with mild to middle-severe eczematous process, were under observation, including 16 with allergic contact dermatitis, 14 patients with atopic dermatitis and 10 patients with eczema brushes, and 8 people with actinic dermatitis. Cream Komfoderm M2 was applied to the affected skin areas once a day in combination with cream Dexpan plus as standard therapy and emollient cosmetic. We investigated the parameters of the DLQI questionnaire “Dermatological Quality of Life Index” .Results As a result of the conducted observational study, data were obtained on the high effectiveness of therapy with the combined use of the drug Komfoderm M2 and Dexpan plus. An excellent evaluation of the efficacy of the scheme used was found in 37 (77 %) patients, a good one in 9 (18,8 %) and 2 (4.2 %) patients had a satisfactory result.Conclusions. This clinical study proves the high efficacy, safety and tolerability of the drugs — Cream with 0.1 % MPA and urea 2 % (Komfoderm M2) in combination with a cream containing dexpanthenol, allantonoin and Shea butter (Dexpan plus) in the treatment of eczematous process.

Comparison of the Efficacy of Topical Tacrolimus, Pimecrolimus, Methylprednisolone Aceponate and Narrow Band UVB in the Treatment of Vitiligo

Comparison of the Efficacy of Topical Tacrolimus, Pimecrolimus, Methylprednisolone Aceponate and Narrow Band UVB in the Treatment of Vitiligo

Dapsone for topical use in extemporaneous preparations.

The sulfone dapsone has an established role in systemic therapy. Its pharmacological and toxicological properties are well known. Topically, dapsone is used in a gel formulation for the treatment of acne vulgaris. In addition, there have been individual case reports on the efficacy of topical dapsone preparations in the treatment of various neutrophilic dermatoses. To date, no finished medicinal product for topical use has been available in Germany. Against this background, we set out to develop extemporaneous preparations containing dapsone (5%) that meet the quality requirements of the European Pharmacopoeia as well as the manufacturing requirements of the German Ordinance on the Operation of Pharmacies (ApBetrO). These formulations included the incorporation of dapsone in a hydrophobic cream base ("hydrophobe Basiscreme DAC") as well as in methylprednisolone aceponate 0.1% ointment (alternatively, in the latter's cream base without active ingredient). Tests aimed at investigating the physical, chemical, and microbiological stability of these formulations showed them to meet the aforementioned quality requirements. The extemporaneous formulations presented herein broaden the therapeutic options for topical treatment, in particular for patients with chronic inflammatory dermatoses associated with a neutrophilic pathogenesis.

Are the Spanish baseline series markers sufficient to detect contact allergy to corticosteroids in Spain? A GEIDAC prospective study.

Corticosteroids are among the most commonly used topical drugs. Contact allergy to these exists, but can be easily missed. Corticosteroid screening markers have been included in the baseline series with the aim of detecting most of the sensitized patients. To assess the prevalence of contact allergy to topical corticosteroids in Spain and examine the usefulness of corticosteroid markers to detect contact allergy to corticosteroids. In total, 3699 patients referred to 20 dermatology departments across Spain for patch testing with the baseline series, including budesonide and tixocortol pivalate, were also tested with six supplementary corticosteroids (methylprednisolone aceponate, mometasone furoate, prednicarbate, clobetasol propionate, betamethasone 17-valerate, and betamethasone 17,21-dipropionate). Additionally, 2547 (68.8%) patients were tested with hydrocortisone 17-butyrate. Fifty-four patients showed positive reactions to at least one of all tested corticosteroids (1.46%). Thirty-nine (1.05%) reacted to at least one of the additionally tested corticosteroids; among these, 24 of 39 (61.5%) did not react to any of the corticosteroid allergy screening markers tested. More than half of the patients who were allergic to the additionally tested corticosteroids were not detected with the corticosteroid allergy markers. An update of the corticosteroid allergy screening markers is encouraged, with consideration of group 3 corticosteroids.

Evaluation of medicines containing mometasone furoate or methylprednisolone aceponate with ceramides influence on the development of non-specific contact dermatitis

Topicality . High level of dermatitis diseases in the population of Ukrainian, increasing the number of severe clinical forms and low indicator of recovery make a problem of dermatitis therapy, which is the one of topical problems in dermatology. Aim . the evaluation of medicines containing mometasone furoate or methylprednisolone aceponate with ceramides influence on the development of non-specific contact dermatitis. Medicines effect investigation were on the level of proteins of the inflammation acute phase and the antioxidant system state. Materials and methods . Studies were conducted on a model non-specific contact dermatitis in rats. The effectiveness of the treatment was assessed by the intensity of skin lesions, by the level of proteins of the acute phase of inflammation (haptoglobin, CRP), and the state of the antioxidant system (AOS) – by the content of SH-groups. Results and discusssion . It was found that application of crem mometasone with ceramides and ointment methylprednisolone with ceramides reduces skin lesions (on 67.3 % and 78.5 %, respectively) and promotes normalization of antioxidant system. Therapeutic effectiveness of the study medicines were consistent with the comparator drug. Conclusions . The further pharmacological study of the proposed combinations with glucocorticosteroids and ceramides is promising in dermatology.

Structural study of polymorphism in methylprednisolone aceponate

The crystal structures of methylprednisolone aceponate were determined by X-ray diffraction analysis at temperatures 90 K and 150 K: space group P212121, a = 14.8592(2), b = 19.6844(5), c = 26.1626(4) Å, Z = 12; R = 0.0598 (T = 90 K); space group P212121, a = 6.57348(14), b = 14.8295(3), c = 26.2214(5) Å, Z = 4; R = 0.0518 (T = 150 K). Features of structural changes in the phase transition were revealed. The abrupt change in the unit cell parameters in the phase transition was shown by low-temperature X-ray powder. The methods of degree of invariance of crystal electron density and molecular Voronoi−Dirichlet polyhedra were used for the analysis of polymorphism in methylprednisolone aceponate. The atomic structure at 90 K have a translational pseudosymmetry of electron density η = 0.329(1). The decrease of number of intermolecular contacts in the high-temperature modification due to rupture of intermolecular non-valence contacts C/O was observed.

Methylprednisolone aceponate for atopic dermatitis.

The 4th generation topical corticosteroids (TCS) have demonstrated a most favorablerisk-benefit ratio. Methylprednisolone aceponate (MPA) is a non-halogenated corticosteroid with a methyl group at C6, which confers higher intrinsic activity. MPA is included in the group of potent TCS (category III/IV). A literature review is carried out of the clinical efficacy, pharmacokinetics, and adverse effects of MPA, especially for the treatment of atopic dermatitis (AD). Several clinical studies support the use of MPA in infants and children, with minimal local or systemic adverse effects reported. The pharmacokinetic profile and the low rate of adverse effects of MPA are most suitable for the treatment of atopic dermatitis (AD), a chronic disease with frequent flaring that can involve extensive areas of the skin. Most patients with AD can be easily brought into control with the use of only TCS. Achieving a complete healing of eczema is key in AD, and once the skin is clinically healthy, emollients can be used according to the physician and patient preferences. Physicians should be trained in the recognition of early or subtle manifestations of active eczema that are most suitably treated with topical TCS to achieve a most rapid and satisfactory control of the disease. If the whole area with eczema is not treated, active eczema will remain and treatment will be ineffective. Insufficient use of TCS will lead to inefficiency and frustration.

The Role of Topical Glucocorticosteroid Methylprednisolone Aceponate in External Therapy of Atopic Dermatitis in Children

The article describes the main characteristics of local glucocorticosteroids (GCS) which are the «gold standard» for external therapy of atopic dermatitis allowing to achieve control over the disease quickly and effectively. Methylprednisolone aceponate 0.1% — non-fluorinated local GCS, the drug with the most favourable therapeutic index, the efficacy and safety of which has been demonstrated in numerous randomized trials — is the optimal therapeutic option in the treatment of AtD in children from 4 months.

Thermodynamic properties of methylprednisolone aceponate

In the present work, temperature dependence of heat capacity of methylprednisolone aceponate has been measured for the first time over the range from 7K to 346K by precision adiabatic vacuum calorimetry. Based on the experimental results, the thermodynamic functions of the methylprednisolone aceponate, namely, the heat capacity, enthalpy H°(T)−H°(0), entropy S°(T)−S°(0) and Gibbs function G°(T)−H°(0) have been determined for the range from T/K→0–333. The enthalpy of combustion (−14304.4±9.1)kJ·mol−1 of the methylprednisolone aceponate was determined for the first time using high-precision combustion calorimeter. The standard molar enthalpy of formation in the crystalline state (−1465.3±9.8)kJ·mol−1 of compound at 298.15K was derived from the combustion experiments. Using a combination of the adiabatic and combustion calorimetry results the thermodynamic functions of formation of the folic acid dihydrate at T=298.15K and p=0.1MPa have been calculated.

The course and treatment of atopic erythroderma Hill (case study)

Relevance. Atopic erythroderma Hill (AEH) is a severe variant of the disease. Its occurrence depends on the examined patients and between 1.9% (young men of military age) to 42% (persons admitted to hospital). The treatment procedure is directly related to the presence of trigger factors, aggravating the disease. The purpose of this publication. To analyze the errors of physicians in the choice of Treatment for patients with AEH. Materials and methods. Use material during the examination and treatment of two patients with AEH aged 5 and 17 years in the allergological center of professor Ado A.D. The detailed analysis of the characteristics of AEH and reasons for the ineffectiveness of traditional treatment methods. Main results. Clinical, immunological, bacteriological methods have made it possible to identify trigger factors contributing to the transformation of the classical course of atopic dermatitis in AEH. Limiting their influence helped improve efficiency. Conclusion. The drug of choice for topical therapy AEH is the methylprednisolone aceponate + ceramides (Komfoderm K), which has a pronounced anti-inflammatory and moisturizing effect with the ability to handle up to 60% of the skin within 12 weeks.

Experience of application 0.1% methylprednisolone aceponatе in a complex therapy chronic dermatoses

The review describes the structure and pharmacokinetics of 0.1% methylprednisolone aceponate, world’s data practice, showing high efficiency and safety of this drug in the treatment of chronic dermatoses, presents the results of study the therapeutic efficacy of different medicinal forms.

CHRONIC ITCHING DERMATOSIS IN CHILDREN: MODERN METHODS OF TREATMENT AND EFFICIENT TERMINATION OF SUBJECTIVE COMPLAINTS

The article presents contemporary data on the peculiarities of etiology and pathogenesis of chronic itching dermatosis in children. We provide classification of various itching forms and pathophysiological mechanism of the development thereof underlying chronic skin disorders. We describe results of clinical studies of effectiveness and safety of methylprednisolone aceponate for treating itching dermatosis in children.

An experience of using methylprednisolone aceponate in the therapy of lupus erythematosus tumidus

Lupus erythematosus tumidus is a rare skin form of lupus erythematosus. About 250 cases of lupus erythematosus tumidus have been described in the world by now. A specific clinical sign of this dermatosis is the appearance of annular or arcuate urticaria-like rash. As a rule, the appearance of the rash is preceded by ultraviolet irradiation. The administration of glucocorticosteroid drugs of local action belonging to classes of potent and very potent steroids is the first-line therapy for lupus erythematosus tumidus. The authors describe a case of the successful treatment of lupus erythematosus tumidus with methylprednisolone aceponate (Advantan ointment) in a female patient aged 56.

Generalized Eosinophilic Pustular Folliculitis of Infancy Responding to Hydroxyzine.

Dear Editor: We report a case of generalized pustular folliculitis of (EPFI) involving the scalp, face, trunk, and both lower extremities that was treated with a topical corticosteroid and hydroxyzine. Interestingly, the lesions responded to hydroxyzine in a dose-dependent manner. A 3-month-old female infant presented with itchy erythematous papules and pustules on the face, trunk, and legs that had been present since birth (Fig. 1A~C). We performed a routine blood test and skin biopsy on a pustule of the trunk. Laboratory tests showed eosinophilia (eosinophil count: 5.19×109/L, normal range: 0.05~0.45×109/L), and histopathologic examination showed subcorneal pustule formation, and perivascular lymphohistiocytic and infiltration (Fig. 2). Therefore, a diagnosis of EPFI was made, and she was treated with topical methylprednisolone aceponate 0.1% ointment twice daily and oral hydroxyzine 10 mg/day. Her symptoms and lesions improved greatly within 3 weeks. However, she showed aggravation during hydroxyzine withdrawal; when hydroxyzine treatment was consequently resumed, the lesions improved dramatically (Fig. 1D~F). Eosinophil count decreased to 0.73×109/L 3 months later. Fig. 1 (A~C) Crops of papules and pustules on the face, chest, and pubic area at presentation. (D~F) After treatment with oral hydroxyzine, the skin lesions resolved almost completely without scarring. Fig. 2 Subcorneal pustule formation and perivascular lymphohistiocytic infiltration with many eosinophils (HE A: ×50, B: ×200). EPFI, a relatively rare dermatologic disease that develops in early infancy, is usually characterized by recurrent crops of papules and pustules on the scalp and other body areas1. The etiology of EPFI remains unknown but may be associated with some genetic susceptibility because of its male predilection and higher incidence in Caucasians2. Because many reported cases have not demonstrated true follicular involvement, some authors propose the term eosinophilic pustulosis of infancy is more suitable2,3. EPFI must be differentiated from other dermatological diseases characterized by recurrent grouped papules and pustules occurring in the neonatal period. However, EPFI develops most frequently in first months of life, and over 80% of patients experience spontaneous resolution by 3 years of age2. Moreover, most cases present with multiple pruritic lesions on the scalp and are associated with tissue eosinophilia or blood eosinophilia. Good response to topical corticosteroids is strongly indicative of EPFI2. Erythema toxicum neonatorum may exhibit similar cutaneous manifestations and histopathologic findings in neonates. However, EPFI may be distinguished from this disease according to its recurrent nature, predilection towards the scalp, and associated blood eosinophilia (83%) during attacks2. There are various treatment options for EPFI, including topical corticosteroids, topical calcineurin inhibitors, and oral antihistamines3. Some refractory cases can be treated with erythromycin3, dapsone3, or indomethacin4, but the effectiveness of these medications varies. EPFI usually responds well to topical corticosteroids2,4 unlike EPF in adults. The present case showed slight improvement after the topical corticosteroid was administered and an excellent response after hydroxyzine treatment was initiated. Oral antihistamines such as cetirizine2 have been successfully used by clinicians; interestingly, the present case presented with lesion fluctuation with respect to the use of hydroxyzine or lack thereof. The generalized form of EPF is reported to be associated with several medications, especially allopurinol5, whereas EPFI is not. However, in patient case, we observed disseminated papules and pustules on nearly the entire body without a previous history of medication. Although the present case is considered to belong to same disease spectrum as the localized form, generalized EPFI developing in a patient without a history of medication has never been reported.

Topical methylprednisolone aceponate and dexpanthenol in the treatment of patients with atopic dermatitis

The goals of the topical treatment of patients suffering from atopic dermatitis are suppression of the inflammatory reaction in the skin, elimination of itching, and recovery of the damaged protective lipid barrier of the epidermis. In this connection, topical glucocorticosteroids and skin moisturizers are used in the therapy of patients suffering from atopic dermatitis. Methylprednisolone aceponate (MPA, Advantan) being a topical glucocorticosteroid is characterized by high efficacy and safety. MPA is marked by the fast development of the therapeutic effect. This drug can be used for children older than 4 months and can be applied once a day. The availability of four dosage forms of MPA (emulsion, cream, ointment and fatty ointment) enables physicians to select a therapy with the use of this drug depending on the stage and localization of the skin lesion. Dexpanthenol (Bepanthen) being a tissue repair stimulator moisturizes the skin, protects the skin against an irritant effect, and restores the protective lipid barrier of the epidermis. The use of a combination of MPA being a topical glucocorticosteroid and dexpanthenol being a tissue repair stimulator can enhance the efficacy of the treatment of patients suffering from atopic dermatitis.

Особенности наружной терапии атопического дерматита у детей: роль метилпреднизолона ацепоната

The article is dedicated to the issues of external therapy of atopic dermatitis in children. Atopic dermatitis is a chronic allergic inflammatory skin disease; in most cases, it is the first manifestation of atopic march. Timely and adequate pathogenetic external therapy of this disease using topical glucocorticosteroids (TGCSs) helps to quickly and effectively terminate symptoms of the disease and allergic inflammation of the skin. Steroid phobia, which is prevalent among parents of the patients, reduced adherence to the TGCS therapy. The authors analyzed results of the original studies of effectiveness and safety of TGCSs, present general recommendations on TGCS use in children with due regard to morphofunctional peculiarities of children’s skin and clinical‑pharmacological description of the TGCSs featuring the most favorable therapeutic index of 0.1% methylprednisolone aceponate. Methylprednisolone aceponate available in 4 pharmaceutical forms is the optimal drug of choice for atopic dermatitis in children over 4 months of age.

Solitary Granuloma Annulare: The First Case of Development on a Healthy Child's Palm

Dear Editor: Granuloma annulare (GA) is a benign inflammatory skin disease that classically presents as annular, flesh-colored grouped papules. It most commonly develops on the dorsal aspect of hands, although cases of palmar involvement are very rare1. We report a rare case of GA arising on the right palm of a 2-year-old healthy boy and review the related literature. A healthy Korean boy aged 2 years came to our clinic with an asymptomatic solitary annular shaped plaque on his right palm. It had started to develop about 4 weeks ago and was later accompanied by a central depression. Physical examination revealed a solitary, coin sized, skin colored, firm, and non-tender plaque with a central concave surface (Fig. 1). His parents denied any previous history of trauma, relevant past medical history, and any other dermatosis. The punch biopsy from his right palm showed perivascular inflammatory infiltrations and palisading granulomas with collagen degenerations in the dermis (Fig. 2A). In addition, mucin infiltrations were confirmed with alcian blue stain as faint blue (Fig. 2B). Above these findings, we made a diagnosis of GA, and we then prescribed topical methylprednisolone aceponate. Fig. 1 Solitary, coin sized, mild hyperkeratotic, skin colored plaque with central depression on his palm (arrows). Fig. 2 (A) A biopsy specimen showed palisading granulomas with collagen degeneration and some inflammatory cells in the dermis (H&E, ×100). (B) Central mucinous area had a positive reaction as faint blue materials by alcian blue stain (×200). ... GA is a benign granulomatous disease in an annular shape, and can also be a self-limited disease. Clinically, it has several different subtypes, although the localized type is the most common. In addition, acral regions such as knuckles and the dorsum of the fingers are involved most frequently, and the involvement of the palm has rarely been reported1. To our knowledge, several cases of GA on the palms have been reported1-5. In 1994, Barksdale et al.2 announced 13 cases of GA associated with malignant lymphoma. In their data, uncommon locations, including the palms, sole, and face, and painful sensation (non-typical characteristic of GA), occurred in 3 of the 13 patients. Such cases were thought to explain the relevance of generalized granulomatous response associated with lymphoma, and therefore, unusual sites might be related to the systemic disease. However, because our patient had a normal development and was healthy, according to the guardians, his GA on the palm was meaningful at such an angle. While other reports have described cases of GA developed on the palms, all cases had multiple lesions2-4. Therefore, GA cases reported in the literature as solitary lesions were extremely rare. In 2008, Imamura et al.5 announced the case of long-standing solitary GA on the palm of a patient with dermatomyositis, which was the first description of solitary GA on the palm. We believe that our case is the second report of solitary GA on the palm, and this is the first report in the English literature of a healthy child. A case of GA on the palm is very rare, and is thought to be meaningful as a solitary occurrence on the palm of a healthy boy. In addition, this case should be included in the differential diagnosis of palmar papules and plaques. At the same time, in the case where GA develops in a child, the dermatologist needs to inform the child's parents about its benign clinical course.

Congenital Form of Isolated Benign Primary Cutaneous Plasmacytosis in a Child

Dear Editor: Lymphoplasmacytic proliferation in the skin can be seen in various disorders from secondary syphilis to malignancies including cutaneoues involvement of multiple myeloma1. Among various conditions, isolated benign primary cutaneous plamacytosis (PCP) is known as a rare entity and is characterized by the infiltration of plasma cells in the dermis without systemic involvement. Isolated benign PCP, a rare disease itself, in childhood or at birth is extremely rare, with only four reported cases in the literature2,3. Herein, we present a congenital form of isolated benign PCP. A 1-year-old female visited Ajou University Hospital for a skin rash on her right lower leg noted at birth. The skin rash was a small plaque at birth but became insidiously larger in size. She had been using a topical steroid on the rash before visiting us, but claimed there was no improvement. Physical examination revealed a solitary asymptomatic erythematous plaque on the right calf (Fig. 1). Her general appearance was good, and no enlarged lymph nodes were palpated. She had no previous surgicomedical history or traumatic episodes. Laboratory tests including a complete blood count and serum chemistry were within the references ranges. The result of the venereal disease research laboratory (VDRL) test was negative and serum protein and serum immunoeletrophoresis were within the normal limits. A skin biopsy revealed psoriasiform hyperplasia with dense lymphoplasma cells infiltration in the superficial and deep dermis without atypia (Fig. 2A). Through immunoperoxidase stains, dense expressions of both kappa and lambda light chains were observed (Fig. 2B, C). Based on these clinicopathologic and laboratory findings, we diagnosed her with isolated benign PCP. We prescribed methylprednisolone aceponate cream. One month later, the lesion was slightly improved showing a mild erythematous patch but was not yet fully recovered. She is now undergoing regular follow-up for 3 months, and the skin lesion remains on her leg. Primary and systemic cutaneous plasmacytosis are uncommon4. They show erythematous plaques or nodules on the head, neck, and trunk with or without lymphadenopathy. Histopathologically, they are characterized by infiltration of mature plasma cells with polyclonal hypergammaglobulinemia localized within the skin4. Among these conditions, isolated benign PCP is extremely rare, especially in children. Our case is isolated benign PCP in a child and thought to be a rare case showing a congenital form of this disorder. Although interleukin-6, human herpes virus-8 is suggested to be related to PCP, the exact pathomechanism is unknown3. Further studies will be necessary to elucidate the exact pathogenesis of PCP. The treatment of systemic cutaneous plasmacytosis is performed with steroids and cyclophosphamide1. While there is no definite treatment guideline for PCP, especially for isolated benign PCP, various trials can be carried out regarding the treatment of PCP including oral, topical corticosteroids, and intra-lesional injection of corticosteroids5. Herein, we report a case of congenital skin rash on the leg characterized by an erythematous asymptomatic plaque without systemic involvement and infiltration of mature plasma cells but with polyclonal hypergammaglobulinemia restricted to the skin. We believe this is the first time this congenital form has been reported in the literature, and thus warrants further investigation. Fig. 1 A solitary asymptomatic erythematous plaque on the right lower leg. Fig. 2 (A) Psoriasiform hyperplasia with dense lymphoplasma cells infiltration in the superficial and deep dermis without atypia (H&E, ×10). Polyclonal hypergammaglobulinemia was proven with Kappa light chain stain (B) and lambda light chain ...

Perianal Allergic Contact Dermatitis from Benzocaine – a Case Report

Abstract A large number of contact allergic reactions to benzocaine have been reported since its introduction to the pharmaceutical market as an active ingredient in different over-the-counter anesthetic ointments. Benzocaine is used as a key ingredient in many pharmaceuticals, such as products for oral ulcers, wound and burn preparations, sunburn remedies, hemorrhoidal preparations, oral and gingival products, sore throat sprays/lozenges, callous and wart remedies, creams for treatment of poison ivy dermatitis, tooth ache and denture irritation products. We present a 56-year-old Caucasian male with chronic rash, accompanied by intense itching in the perianal area. The lesions occurred two months earlier and the patient was treated with a wide range of topical antifungals, antibiotics and corticosteroids, with temporary improvement. The skin lesions were consistent with chronic allergic contact dermatitis. The patient denied using any topical preparations other than those prescribed by his dermatologist. Patch testing with the European baseline series was performed. A strongly positive reaction to benzocaine was identified on reading days 2 and 3. Targeted history showed intermittent use of benzocaine anti-hemorrhoidal cream to treat concomitant hemorrhoids. Benzocaine was discontinued and treatment with methylprednisolone aceponate 0.1% was initiated, resulting in significant improvement. No relapse was observed at 3-month follow-up. In conclusion, patients with confirmed benzocaine allergy should pay special attention to product labels and avoid products that contain benzocaine and its related substances. All products labelled as “anaesthetic” or “caine” should be suspected of containing benzocaine or related compounds. Patient education and awareness are critical to avoid further episodes and relapses.

Fast itch relief in an experimental model for methylprednisolone aceponate topical corticosteroid activity, based on allergic contact eczema to nickel sulphate

Topical corticosteroids (TC) consistently show effectiveness against itch, a paradigmatic symptom, in various eczemas. Rapid itch relief is a therapeutic goal. The early response of itch to TC has not been adequately studied. To assess the effect on itch of a TC, methylprednisolone aceponate 0.1% ointment (MPA), in induced eczema in volunteers sensitized to nickel sulphate. Sixteen volunteers with a late positive patch-test reaction to nickel sulphate entered the study. Eczema was treated once daily with ¼ fingertip unit of MPA for 5days. Pruritus intensity was assessed with a 10cm visual analogue scale (VAS). Mean time to itch relief (TR ) defined as the time to reach a 30% decrease in the highest VAS value recorded was assessed, as well as TR-baseline, colorimetry and planimetric morphometry of the reaction. Mean TR was 1.0days [standard deviation (SD)=1.1] and mean TR -baseline was 1.6days (SD=1.4). Five volunteers reached 100% decrease from itch baseline-VAS in 2.0±1.2days, whereas a 75% decrease was obtained in 1.7±1.6days by 16 volunteers. A clinical improvement of patch-test reaction was apparent at day 11, although erythema was still present. We present a valid model to assess the efficacy and speed of action of TC treatment to alleviate pruritus and the signs of eczema. The fast effect of MPA against pruritus supports the appropriateness of treating allergic contact eczema with TC.