Triamcinolone Acetonide Cream Research Articles

Triamcinolone Acetonide Injection and Topical as an Alternative Method for Mucocel Therapy

Introduction: Mucocele is a swelling caused by the collection of saliva from the ducts of minor salivary glands that are cut off or blocked. This is a salivary gland cyst that contains mucus and generally founded in the oral cavity. Surgery is the most popular therapy in the treatment of mucocele. There are various alternative therapeutic modalities that can be used including laser ablation, cryosurgery, sclerotherapy, micromarsupialization, laser surgery, injection of sclerosis agents, and corticosteroid injection. Case and management: This paper describes the treatment of mucoceles using triamcinolone acetonide that is quite often used in the oral cavity. The therapy carried out is intradermal injection of 0.2 ml of triamcinolone acetonide IA/ID (10 mg/ml) and topical application of triamcinolone acetonide ointment in orabase 0.1% 6x/day. One week later it was seen that the mucocele lesion had almost disappeared. Discussion: Corticosteroids act as potent anti-inflammatory agents and also act like sclerosing agents causing shrinkage of the dilated salivary ducts. Conclusion: Triamcinolone acetonide can be an alternative therapy besides surgery in the management of mucocele cases. The application can be done by intradermal injection and topical ointment. No side effects were found at the end of treatment.

Comparison of Effectiveness of Hiora SG Gel With Triamcinolone Acetonide Gel in Recurrent Aphthous Stomatitis.

Background The oral condition known as recurrent aphthous ulceration (RAU) or recurrent aphthous stomatitis (RAS) is very prevalent. Its etiopathogenesis is unknown; hence, symptomatic therapy is all that can be offered if it manifests clinically. Lesion care aims to minimize discomfort and the frequency of relapses by bringing active illness under local control in the affected area. The current treatment options that may have negative side effects include the use of topical and systemic steroids, antibiotics, cauterization, and laser therapy. Objectives and Importance This study aimed to compare the efficiency of HiOra SG gel with triamcinolone acetonide gel in the management of RAS. Materials and Methods Fifty individuals with RAS were recruited for the trial and randomly assigned to either group I (HiOra SG gel) or group II (0.1% triamcinolone acetonide ointment; Oraways). After each meal for a total of 10 days, those with mouth ulcers were instructed to topically administer the drugs. The clinical data were analyzed by comparing the ulcer severity scores from the first, fifth, and 10th days. Results There was a statistically significant (p = 0.001) reduction in reported pain, pain duration, and overall ulcer severity across all groups. After therapy, however, neither the HiOra gel group nor the triamcinolone group showed any discernible improvement over the other. Conclusion The present study's findings corroborate the efficacy of HiOra SG gel in the treatment of RAS when compared to triamcinolone acetonide gel (0.1%). In this trial, no patients had any negative reactions to HiOra SG gel. In the future, further studies are needed with larger samples to prove its benefits.

Efficacy and Safety of Cream Containing Dipotassium Glycyrrhizinate, Vaccinium myrtillius, Epigallocatechin Gallatyl Glucoside, and Tamarindus indica Compared with Triamcinolone Acetonide Cream in Eczema and Psoriasis

Background: Topical corticosteroids are the main treatment in eczema and psoriasis. However, long-term use of corticosteroids causes unwanted adverse effects. Dipotassium glycyrrhizinate (DPG) HERB cream, containing DPG, Vaccinium myrtillius, epigallocatechin gallatyl glucoside, and Tamarindus indica, has an anti-inflammatory and antioxidant effect by inhibiting histamine release and proinflammatory cytokine production so a natural herbal cream is required for alternative treatment. Objective: To evaluate the efficacy and safety of DPG-HERB. Materials and Methods: The present study was a right-left, double-blinded, randomized clinical trial in participants with eczema or plaque psoriasis on both sides of the body. DPG-HERB was applied to the lesion on one side of the body, while 0.1% triamcinolone acetonide (TA) cream was applied to the lesion on the other side, twice daily for four weeks. Disease severity as eczema area and severity index (EASI) in eczema, and psoriasis area and severity index (PASI) in psoriasis, skin biophysics as corneometry and transepidermal water loss (TEWL), and clinical assessments as erythema, scale or excoriation, and lichenification or thickness, were evaluated at baseline, week 2 and week 4 after treatment. The dermatology life quality index (DLQI) was performed at baseline and week 4. Adverse effects were recorded during each visit. Results: The evaluation of the 75 patients with 150 lesions in the present study, DPG-HERB and TA cream showed significant improvement in all the evaluated characteristics of eczema (p<0.05), however, in psoriasis, both creams showed significant improvement in skin biophysics, PASI, scale, and thickness (p<0.05), but DPG-HERB was less effective in decreasing erythema (DPG-HERB, p=0.31 and TA, p<0.05) and less improving TEWL compared with 0.1% TA cream (DPG-HERB, p=0.051 and TA, p<0.05). No side effects in the short-term period were reported in either group. Conclusion: DPG-HERB is safe and efficacious in eczema, but less effective in psoriasis comparing to TA cream. Keywords: Eczema; Plaque psoriasis; Dipotassium glycyrrhizinate acid

Post-circumcision penile skin loss: reporting the outcome of one-stage anterolateral scrotal based flaps in children

ABSTRACT Introduction Improper penile assessment, together with carrying out circumcision by an inexperienced person, results in major complications. One of the complex complications is the complete or sub-complete penile skin loss, which in many cases, necessitates one or staged repair. Purpose To evaluate modified one-stage bilateral anterolateral scrotal-based flaps to compensate for penile skin loss after circumcision. Methods This study was performed on patients with almost penile skin loss after circumcision from February 2013 to July 2021. In all cases, one-stage modified bilateral anterolateral scrotal skin flaps were used to compensate for penile skin loss. The modification includes scrotal skin flap fashioning in a novel way, in addition to the use of penodermal fixation sutures at the penoscrotal junction, to create a stable penoscrotal junction and new penile skin coverage. Patients were discharged from the hospital on the same day of surgery. The dressing was left for 5 days. Follow-up visits were scheduled weekly in the first month, 3 and 6 months later, then annually. Results Forty-six children were included in this study. Their mean age was 4.5 ± 1.5 years. The mean operative time was 139.6 ± 11.5 min. No flap ischemia or necrosis was reported. One case (2.2%) developed a scrotal hematoma managed conservatively. Three (6.5%) cases presented with wound dehiscence at the penoscrotal angle. Three (6.5%) cases had self-limited penile edema. Two (4.3%) cases had dorsal midline hypertrophic scar; one improved after treatment with triamcinolone acetonide ointment, and the other needed scar revision. The mean follows up was 23.33 ± 9.13 months. Conclusion The modified scrotal skin flap technique provides a good substitution for stable penile skin coverage and a one-stage reconstruction of penile skin loss. It results in good parents’ satisfaction with acceptable complications.

Disseminated tinea incognito due to Trichophyton violaceum in a healthy child

A 13-year-old boy living in a village presented to our clinic with a 1-year history of pruritus involving the face, scalp, trunk, and extremities with nonresponse to topical corticosteroid, including triamcinolone acetonide cream and lotion. Physical examination revealed wide-spread erythematosus, sharply demarcated plaques with scales, and central clearing on the face (Figure 1, 2a), scalp (Figure 3), trunk (Figure 1b and c), and extremities (Figure 1d, e, and f). Posterior cervical and postauricular lymphadenopathy could not be found.

Topical Tacrolimus vs Topical Triamcinolone equally effective in the Treatment of Oral Lichen Planus

Background: Lichen planus is a disease that can involve either skin, mucosa or both. Although there is no definite treatment but many medications are available for the relieving the symptoms of this autoimmune disease and recent literature has brought into light the use of an immunosuppressant such as Tacrolimus that may be effectively used as topical application in treatment of Oral Lichen Planus (OLP). Methods: We conducted a study on 80 patients to determine the use of results of topical Tacrolimus (0.1%) versus Triamcinolone acetonide (0.1%) ointment for the treatment of Oral Lichen Planus over a period of six months at Oral & Maxillofacial Surgery Department, HITEC Dental College Taxila. Results: Outcome of the study was determined in terms of ‘Improvement in pain’. Conclusion: This study showed an insignificant difference in improvement in pain of patients of lichen planus treated with tacrolimus and triamcinolone. Keywords: Oral lichenplanus, treatment outcome, symptomatic management, improvement in pain,

18407 Improvement of short-term outcome of mild to moderate atopic dermatitis using a combination treatment of crisaborole ointment 2% and a concomitant topical cortiscosteroid over a 8 week period

Background: Atopic dermatitis (AD) also known as atopic eczema is a chronic inflammatory skin disease that is characterized by intense itching and recurrent eczematous lesions. Although it most often starts in infancy and affects two of ten children, it is also highly prevalent in adults. Current topical treatments for AD have not changed in over 15 years and are associated with safety concerns. In AD, overactivity of phosphodiesterase 4 (PDE4), leads to inflammation and disease exacerbation. Combination therapy is known to be superior to monotherapy and is commonly used in other skin diseases. It has been shown that the addition of a corticosteroid (triamcinolone acetonide ointment, 0.1%) to other therapies have been shown to improve the efficacy and decrease the skin irritation normally associated with other therapies alone. By combining medications with a different mechanism of action and safety profile, efficacy can be enhanced and/or safety improved. This study (n = 16) is of the efficacy and safety of crisaborole ointment 2% when combined with a topical steroid (triamcinolone acetonide ointment, 0.1%) for the treatment of mild to moderate atopic dermatitis in subjects 2–79 years of age. Subjects were randomized to crisaborole alone versus combination treatment.

Comparison between uses of topical tacrolimus and triamcinolone ointment for the treatment of oral lichen planus.

Background: Lichen planus is a chronic mucocutaneous disease with primary or secondary involve- ment of the oral mucosa. In particular in case of erosive lichen planus most of the patients experience no long term symptoms relief of conventional topical treatment such as corticosteroid ointment. Topical tacrolimus applications to mucosal lesions seem to be an alternative treatment approach.Objective: The aim of this study was to compare the efficacy of topical tacrolimus ointment with that of triamcinolone acetonide ointment on patients suffering from oral lichen planus.Study design: This was a clinical trial. Study setting and period: This study was conducted in outpatient department of Oral and Maxillofacial Surgery, Dhaka Dental College in the period between June 2013 to May 2014.Subjects: A total of sixty patients were enrolled. Out of sixty patients thirty patients used topical tacroli- mus 0.03% (Group A) and another thirty patients used topical triamcinolone acetonide( Group B) for the treatment of oral lichen planus.Methods: A total of sixty patients were asked to answer a questionnaire regarding the degree of pain and burning sensation in every two weeks according to visual analogue scale (VAS). In every two weeks change of colour and size and also any side effects of these drugs were assessed. Data were analyzed using Statistical Package for Social Science (SPSS), version 15.0 for windows.Results: At the end of 12th week follow up periods complete relief of pain and burning sensation in group A patients were 100% and in group B it was 30%. There was no side effect in two study group patients.Update Dent. Coll. j: 2018; 8 (1): 17-21

Comparative Effect of Ablative Fractional CO2 Laser Plus Triamcinolone Acetonide Cream Versus Intralesional Injection of Triamcinolone Acetonide in Keloid and Hypertrophic Scars: A Randomized Clinical Trial

Background: The current study was performed to compare the effects of ablative fractional CO2 laser plus triamcinolone acetonide cream versus intralesional injection of triamcinolone acetonide in the treatment of hypertrophic and keloid scars. Methods: This quasi-experimental study was performed among 33 patients visiting dermatology clinics of two referral teaching hospitals during 2013 - 2014.A lesion of these patients was divided in to two equal parts, one half was injected with triamcinolone acetonide at a dose of 10 - 20 mg/mL, and in the combination treatment, we administered ablative fractional CO2 laser treatment (level: 15, point of shot: 5, PW: 5, pitch: 0.5; Unixel, Korea) with topical triamcinolone acetonide in the other half. The settings of the laser device for each session were set according to the thickness of the scar. Immediately after laser treatment (in the first two seconds) and up to one week later, the triamcinolone acetonide 0.1% cream was applied twice a day. Each patient underwent 3 - 5 treatment sessions of laser treatment at 4-week intervals for one lesion. One hour before each session, the local anesthetic, lidocaine-p gel, was administered around the lesion. Results: The general appearance of the wound was better in the intralesional triamcinolone group (1.53 vs. 2.15, P < 0.0001). Dyschromia showed more improvement in the combination treatment (1.13 vs. 1.47, P < 0.0001), while hypertrophy improved more as a result of intralesional triamcinolone acetonide injection (2.19 vs. 1.52, P < 0.0001). Additionally, combination treatment was more effective on texture (1.61 vs. 2.11, P < 0.0001). The improvement of symptoms scores was 2.73 out of a total of three. Conclusions: It can be concluded that topical corticosteroids plus fractional laser therapy is more effective than intralesional injection of corticosteroids for the amelioration of dyschromia and texture of hypertrophic and keloid scars. However, general appearance and hypertrophy showed a better response to intralesional injection of triamcinolone. Accordingly, in non-homogenous lesions with dyschromia, the use of local corticosteroids plus fractional laser is recommended.

Fabrication of Triamcinolone Acetonide Cream and Ointment: Optimization, Evaluation and Pharmacodynamic Assessments

The present investigation describes the optimization and evaluation of topical triamcinolone acetonide (TA) cream and ointment along with their sensory test on healthy human volunteers. TA cream and ointment were prepared by fusion followed by high-speed homogenization technique. The prepared creams and ointments were subjected to evaluation for physical parameters like pH, Fourier transform infrared spectroscopy, viscosity, assay, drug content, in vitro diffusion studies and accelerated stability study. Further, sensory test was performed with 30 healthy human volunteers. Based on physicochemical characterizations, we found that batch FC6 was the optimized batch for TA cream and batch F3 was the optimized batch for TA ointment formulations. Results of both the optimized formulations showed favorable viscosity as compared to reference drug (Fougera). In vitro diffusion study demonstrated increased drug release with optimized batch of both cream and ointment. The optimized TA cream and ointment showed good stability when storage at accelerated conditions for three months. Finally, sensory test results indicated ‘good feel’ when both optimized formulations applied on the human skin. In conclusion, TA cream and ointment offers great potential for topical drug delivery system in the treatment of anti-inflammatory disease, which reduces the inflammation of skin. &#x0D;

Fabrication of Triamcinolone Acetonide Cream and Ointment: Optimization, Evaluation and Pharmacodynamic Assessment

The present investigation highlights, optimization and evaluation of topical Triamcinolone Acetonide (TA) cream and ointment along with their sensory test on healthy human volunteers. TA cream and ointment were prepared by fusion followed by high speed homogenization technique. The prepared creams and ointments were subjected to evaluated for physical parameters like pH, Fourier transform infrared spectroscopy, viscosity, assay, drug content, in vitro diffusion studies and accelerated stability study. Further, sensory test was performed with 30 healthy human volunteers. On the basis of physicochemical characterizations, we found that batch FC6 was the optimized batch for TA cream and batch F3 was the optimized batch for TA ointment formulations. Results of both the optimized formulations showed favorable viscosity as compared to reference listed drug (Fougera). In vitro diffusion study demonstrated increased drug release with optimized batch of both cream and ointment. The optimized TA cream and ointment showed good stability when stored at accelerated conditions for three months. Finally, sensory test results indicated ‘good feel’ when both optimized formulations applied on the human skin. In conclusion, TA cream and ointment offers great potential for topical drug delivery system in the treatment of anti-inflammatory disease which reduces the inflammation of skin.

A mild topical steroid leads to progressive anti-inflammatory effects in the skin of patients with moderate-to-severe atopic dermatitis

Topical glucocorticosteroids are considered an efficient treatment option for atopic dermatitis (AD), but a global assessment of glucocorticosteroid responses on key disease circuits upon weeks to months of treatment is currently lacking. We sought to assess short (4weeks) and long-term (16weeks) application of topical glucocorticosteroids on AD skin and define response biomarkers. The effects of triamcinolone acetonide cream 0.025% were assessed based on gene expression and immunohistochemistry studies at baseline, 4weeks, and 16weeks in biopsy specimens from 15 patients with moderate-to-severe AD. At 16weeks, only 3 patients were clinical responders (by using SCORAD50 criteria), but 6 patients qualified as responders based on histologic criteria. Baseline characteristics indicated more severe disease in nonresponders. While 3 of 15 patients experienced only transient benefit after 4weeks, others showed progressive improvements toward 16weeks. Topical glucocorticosteroid use in patients with AD resulted in improvements of the AD genomic signature of 25.6% at 4weeks and 71.8% at 16weeks, respectively, and even 123.9% in the histologic responder group. Cytokines (IL-12p40, IL-13, IL-22, CCL17, CCL18, peptidase inhibitor 3 [PI3]/elafin, and S100As) showed consistent decreases from baseline toward 16weeks with corresponding improvements in epidermal disease hallmarks (keratin 16 and loricrin) in lesional skin from responders (P<.05). Nonresponders largely showed lesser/nonsignificant reductions in key inflammatory and barrier markers (keratin 16, IL-13, IL-22, CCL17, CCL18, PI3/elafin, S100As, and loricrin). The combination of IL-21 and IFN-γ baseline expression closely predicted individual clinical glucocorticosteroid responses at 16weeks of treatment. Our study indicates that even low-potency glucocorticosteroids can broadly affect immune and barrier responses in patients with moderate-to-severe AD, associating higher baseline severity with increased steroid resistance in patients with AD.

Anti-angiogenic therapy (bevacizumab) in the management of oral lichen planus.

Oral lichen planus (OLP), a mucocutaneous chronic inflammatory disease, is conventionally managed using topical corticosteroid therapy. Given the fact that OLP is strongly linked to angiogenesis, anti-angiogenic drugs, such as bevacizumab, might be introduced as an alternative treatment for contraindicated, non-responsive patients. The aim of the present study was to report the short-term effectiveness and safety of intralesional bevacizumab injection in the management of atrophic/erosive OLP. A case series study was conducted in patients with atrophic/erosive OLP in the buccal mucosa, assigned to receive either 2.5 mg of bevacizumab, by intralesional injection (n = 20, test), or topical 0.1% triamcinolone acetonide ointment (n = 20, control). The size, score, and pain intensity of the lesions were assessed pre- and post-treatment. Tissue biopsies were collected for histopathologic, immunohistochemical, and ultrastructural examination. After 1 wk, the test group had significant reductions both in lesion seize and in pain scores compared with controls. A marked decrease in vascular endothelial growth factor (VEGF) and interleukin-8 immunoexpression was noted in tissue biopsies from bevacizumab-treated lesions compared with control lesions. Furthermore, ultrastructural examination of OLP tissue specimens revealed significant healing signs associated with bevacizumab treatment. Short-term data suggest that intralesional bevacizumab injection effectively and safely achieved resolution of atrophic/erosive OLP lesions without disease exacerbations during a 3-month follow-up period.

Determination of ketoconazole in ketoconazole and triamcinolone acetonide cream by HPLC

Objective To establish a method for determining the ketoconazole in ketoconazole and triamcinolone acetonide cream.Methods HPLC was adopted.The determination was performed on Shimpack VP-ODS C18 under the following conditions:the mobile phase was methanol and pH 6.8 phosphate buffer (80:20) ; the flow rate was 1.0 ml · min-1; and the detection wavelength was 254 nm.Results The calibration curve of ketoconazole was linear within the concentration range of 19.34 ～ 116.10 μg · ml-1 (r=0.9999),with an average recovery rate of 100.29％(RSD=0.26％).Conclusions This method is specific,accurate,and sensitive and can be used to control the quality of ketoconazole and triamcinolone acetonide cream. Key words: Ketoconazole and triamcinolone cream; Content determination of ketoconazole; HPLC

Generalized orf superinfection in a child with atopic dermatitis

A 15-year-old boy presented with an exacerbation of early-onset atopic dermatitis (AD), an overall slump feeling without fever and newly developed skin lesions. Occipital examination showed a 4 × 5 cm, painful, erythematous, multilobular node with purulent exudate on a red-to-purple base, surrounded by multiple papulonodules (figure 1A). A bacterial infection was suspected and treated with amoxicillin, with triamcinolone acetonide ointment for his eczema. Five days later he presented with multiple [...]

Effects of Pimecrolimus Compared with Triamcinolone Acetonide Cream on Skin Barrier Structure in Atopic Dermatitis: a Randomized, Double-blind, Right–Left Arm Trial

Patients with atopic dermatitis (AD) have an epidermal barrier dysfunction, which allows invasion of allergens to occur. Stratum corneum skin barrier is formed by corneocytes and extracellular lipids extruded from the epidermal lamellar bodies. In a controlled, randomized, double-blinded, right-left comparison study we investigated the effect of pimecrolimus (PIM) cream compared with triamcinolone acetonide cream (TA) on the skin barrier in 15 patients with symmetrical elbow lesions of AD. In punch biopsies, before and after treatment, skin lipid bilayer and lamellar body structure were examined by transmission electron microscopy (TEM). Partial Eczema Area and Severity Index (pEASi), stratum corneum hydration, and transepidermal water loss (TEWL) were monitored on days 1, 8 and 22. The pEASi was significantly more improved with TA compared with PIM, whereas stratum corneum hydration was slightly more improved after treatment with PIM. The TEM revealed a strong reduction in lamellar bodies in lesional skin of AD; only 32% of the lamellar bodies were normal. A significantly higher number of normal lamellar bodies was found after 3 weeks of treatment with PIM (58%; p < 0.005). An increase in lamellar bodies also occurred with TA treatment (46%; p < 0.05); however, significantly less than with PIM (p < 0.05). Clinical score and TEWL were more improved after treatment with TA, whereas the lamellar bodies were more normal after treatment with PIM.

Enhanced transdermal delivery of 18β-glycyrrhetic acid via elastic vesicles: in vitro and in vivo evaluation

Objective: The aim of this work was to develop an elastic vesicular formulation to enhance the skin permeation of a poorly water-soluble 18β-glycyrrhetic acid (GA) and treat dermatitis.Methods: Elastic vesicles of GA were prepared by the film method with high pressure homogenizer and characterized by storage stability. In vitro permeation studies were carried on rat skin using Franz diffusion cell. In vivo skin deposition of GA was studied using HPLC assay. Chronic allergic contact dermatitis model was built to evaluate pharmacodynamic of GA elastic vesicles.Results: The GA elastic vesicles developed have high flexibility and the storage stability was at least for 6 months at 4°C and for 4 months at 25°C. In vitro cumulative penetration of GA from elastic vesicles within 8 hours was 5.3-fold and 23.2-fold higher than that of conventional liposomes and saturated solution, respectively. After non-occlusive application to mice ears in vivo, skin deposition of GA increased immediately and reached the Cmax at 3 h (1.95 ± 0.32 µg/cm2) and still detected, even after 16 hours GA removed. In vivo anti-inflammatory activity study, GA elastic vesicles showed significant reduction in ear thickness and mass (25.52% and 49.23%) (P < 0.05). The suppressive activity was comparable to that of positive control group (Triamcinolone Acetonide and Econazole Nitrate cream in market), while few side effects were observed in present model.Conclusion: The results suggested that of GA elastic vesicular was safe and effective in treatment of contact dermatitis by transdermal administration.

A Comparative Evaluation of Efficacy of Tacrolimus and Triamcinolone Acetonide in the Management of Symptomatic Oral Lichen Planus

Background and objectives: Oral lichen planus (OLP) is a relatively common, chronic inflammatory condition, which frequently present with burning sensation. Only symptomatic OLP requires treatment and efforts are made in a continued searching for novel therapies for symptomatic OLP. Therefore, this study was aimed to compare the efficacy of treatment with topical tacrolimus ointment with that of triamcinolone acetonide ointment in subjects with symptomatic OLP. Materials and methods: This prospective randomized comparative study, included 30 symptomatic OLP subjects, divided into two groups as group A and group B to receive topical tacrolimus 0.03% ointment and triamcinolone acetonide 0.1 % ointment application respectively, twice daily for four consecutive weeks. Burning sensation using visual analog scale (VAS), overall treatment response using Tel Aviv-San Francisco scale was recorded at every visit. The data obtained was analyzed statistically using Wilcoxson Rank Test, Mann Whitney and Fischer's Exact Test. Results: Subjects in both the groups showed a significant reduction in burning sensation; however, it was higher (98%) in tacrolimus group than in the triamcinolone acetonide group (72%). The overall treatment response was significantly better in tacrolimus group. Interpretation and conclusion Topical tacrolimus 0.03% ointment induced better initial therapeutic response than triamcinolone acetonide 0.1 % ointment. However, relapses occurred in two subjects in group 'A' and three subjects in group 'B' after the cessation of the respective treatments. Nevertheless, at present topical tacrolimus may be a valuable addition to the already existing therapeutic modalities for treating subjects with OLP.

Long-term intermittent treatment of localized chronic eczema with triamcinolone acetonide and econazole nitrate cream.

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical corticosteroids in localized chronic eczema.Methods A total of 129 patients with localized chronic eczema were treated with triamcinolone acetonide and econazole nitrate cream (Pevisone (R)).Those who achieved a clinical cure within 4-week treatment were recruited into the following long-term study and classifled into 2 groups to be intermittently treated with triamcinolone acetonide and econazole nitrate cream or a moisturizing cream for 8 weeks.The cream was applied topically twice a day for 2 days every week.Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment.The severity of eczema in patients was rated according to SCORAD (SCORing atopic dermatitis) score.Results The SCORAD score was significantly lower in patients treated with triamcinolone acetonide and econazole nitrate cream than in those with moisturizing cream on week 8 in the treatment and week 12 after the discontinuation (t=3.076,2.367,both P<0.05).A statistical decrease was also observed in the recurrence rate of eczema in patients treated with triamcinolone acetonide and econazole nitrate cream compared with moisturizing cream.treated patients at the 3 follow-up time points (x2=4.426,7.683,8.199,all P<0.05).The incidence of adverse events was 3.1% during the treatment with triamcinolone acetonide and econazole nitrate cream.No severe adverse reactions were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and postponement of recurrence,of eczema. Key words: Eczema; Long-term intermittent treatment; Topical corticosteroids

A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis

Topical aloe vera (AV) has been used to treat various skin conditions, including psoriasis, with good results. This study aims to compare the efficacy of AV and 0.1% triamcinolone acetonide (TA) in mild to moderate plaque psoriasis. A randomized, comparative, double-blind, 8-week study was designed. Eighty patients randomly received AV or 0.1% TA cream and their clinical response were evaluated using the Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI). After 8 weeks of treatment, the mean PASI score decreased from 11.6 to 3.9 (-7.7) in the AV group and from 10.9 to 4.3 (-6.6) in the TA group. Between-group difference was 1.1 (95% confidence interval -2.13, -0.16, P = 0.0237). The mean DLQI score decreased from 8.6 to 2.5 (-6.1) in the AV group and from 8.1 to 2.3 (-5.8) in the TA group. Between-group difference was 0.3 (95% confidence interval -1.18, -0.64, P = 0.5497). There was no follow-up period after the 8-week treatment. AV cream may be more effective than 0.1% TA cream in reducing the clinical symptoms of psoriasis; however, both treatments have similar efficacy in improving the quality of life of patients with mild to moderate psoriasis.