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Biomedical subjects

R S Medansky

Publications and source records attributed to R S Medansky.

At least 19 recordsLinked to original sources

A double-blind, vehicle-controlled study of clobetasol propionate 0.05% (Temovate) scalp application in the treatment of moderate to severe scalp psoriasis.

The efficacy and safety of clobetasol propionate 0.05% scalp application was evaluated in 378 patients with moderate to severe scalp psoriasis in a double-blind vehicle-controlled parallel group study. After 2 weeks of twice-daily applications, 81% receiving active drug versus 22% receiving vehicle had clearing of 50% or greater. Complete clearing was seen in 26% with active drug and 1% with vehicle. Local side effects were primarily burning or stinging in 11% and 10% of patients treated on an active or a vehicle regimen, respectively. The morning cortisol levels of 168 patients were checked at baseline and again after 2 weeks of drug therapy. Subnormal morning plasma cortisol values were seen in 5% of the patients receiving active drug and in 5% receiving vehicle; 13% of those taking active drug versus 5% taking vehicle had a 50% or greater decrease in morning cortisol at the 2-week visit compared with baseline values. Clobetasol propionate 0.05% scalp application appears to be a safe and an effective treatment for scalp psoriasis.

Administration, Topical

Intermittent corticosteroid maintenance treatment of psoriasis: a double-blind multicenter trial of augmented betamethasone dipropionate ointment in a pulse dose treatment regimen.

Ninety psoriasis patients, who were either completely cleared of or manifested only a minimal presence of disease signs following 3-4 weeks of twice daily treatment with augmented betamethasone dipropionate (ABD) ointment 0.05%, were enrolled in this multicenter, double-blind, placebo-controlled study. The study was designed to determine if an intermittent pulse dose regimen of ABD ointment could safely and effectively maintain a remission disease status when treatment was applied in three consecutive applications 12 h apart, once a week for a maximum treatment period of 6 months. The disease of 60% of the patients in the active treatment group was successfully controlled for 6 months, while 80% of the placebo-treated patients experienced exacerbation of disease signs. No serious local or systemic treatment-related adverse experiences were reported. ABD ointment 0.05%, when applied using the intermittent treatment regimen described here, was shown to be a clinically beneficial and well-tolerated method of long-term (up to 6 months) maintenance therapy for psoriasis patients.

Administration, Topical

Mometasone furoate ointment and cream 0.1 percent in treatment of psoriasis: comparison with ointment and cream formulations of fluocinolone acetonide 0.025 percent and triamcinolone acetonide 0.1 percent.

Mometasone furoate (Elocon) is a newly formulated and unique medium-potency synthetic 17-heterocyclic corticosteroid. The efficacy and safety of the ointment and cream formulations (0.1 percent) of the corticosteroid, administered once daily, were compared with those of the ointment and cream formulations of fluocinolone acetonide 0.025 percent administered three times daily and triamcinolone acetonide 0.1 percent administered twice daily in four multicenter clinical studies. They were conducted involving psoriasis patients with chronic and moderate to severe disease. Evaluation of change in disease sign scores indicated that mometasone ointment, applied once daily, was significantly more effective (P less than 0.01) than fluocinolone ointment, applied three times daily, and triamcinolone ointment, applied twice daily. The cream formulation of mometasone was significantly more effective (p less than 0.001) than fluocinolone cream, applied three times daily, and equivalent to triamcinolone cream, applied twice daily. The incidence of local adverse experiences following treatment with the ointment or cream formulations of mometasone was minimal. Mometasone ointment and cream provide a highly effective once-a-day treatment for moderate to severe psoriasis with minimal risk of side effects.

Administration, Topical

SCH 370 (clotrimazole-betamethasone dipropionate) cream in patients with tinea cruris or tinea corporis.

The safety and efficacy of SCH 370 (1 percent clotrimazole/0.05 percent betamethasone dipropionate) cream was compared with each of its individual components in 331 patients with tinea cruris or tinea corporis. The study was a multicentered, randomized, double-blind, parallel-groups design. The patients received one of three treatments applied twice a day for two weeks and returned for a follow-up visit two weeks after the last application. Total signs and symptoms scores of infections were evaluated at baseline, once between days three to five, and after weeks one, two, and four. Culture and potassium hydroxide preparations were done at baseline and weeks two and four. SCH 370 cream demonstrated more rapid therapeutic activity than the antifungal agent alone, resulting in significantly better clinical results in early treatment and in midtreatment. As expected with a steroid, betamethasone dipropionate achieved relief of inflammatory signs and symptoms early in the course of treatment, but SCH 370 was superior from one week on in the patients with tinea cruris and at post-treatment in the patients with tinea corporis. Mycologically, SCH 370 cream and clotrimazole were comparable at the end of the study and results were significantly better than those for betamethasone dipropionate. All three treatments were safe with no reports of unexpected or serious adverse experiences.

Adult

Dermatopsychosomatics: classification, physiology, and therapeutic approaches.

Psychosomatic dermatology is practiced in some manner by every dermatologist. In spite of this, there has been a virtual void in the literature from the middle 1950s until the present time. The relationship to physiologic phenomena, as well as a classification of psychosomatic dermatology, is reviewed. Dermatologic patients are divided into three groups: the primary group in which the emotional disorder is the primary disease and the cutaneous disorder merely part of its expression; the secondary group in which the basic cause is organic but does not affect the person emotionally in various degrees; and the collaborative group in which the organic causes and emotional disorders combine in different degrees to cause the skin disorder. This paper discusses anxiety and depression along with methods of dermatologic psychosomatic therapy consisting of antianxiety drugs, especially the benzodiazepines, antidepressants, hypnosis, behavior therapy, and the doctor/patient rapport. We conclude that one of the objectives for every dermatologist is to treat the entire patient-the psyche along with the soma.

Anxiety

Treatment of psoriasis with topical nitrogen mustard.

With the advent of various new methods of treating psoriasis, it is necessary to remind physicians to consider an agent that is easy to administer, locally effective, relatively inexpensive, not time-consuming and without systemic toxic effects. Nineteen patients were treated with topical nitrogen mustard between 1972 and 1976, and only five developed sufficient contact sensitization to warrant stopping medication.

Administration, Topical

Analysis of a new corticosteroid aerosol in treatment of contact dermatitis.

In multicentric clinical trial involving twelve investigators and 271 patients, betamethasone dipropionate (0.1 percent) aerosol was found to be significantly more effective than its vehicle in the treatment of moderate to severe contact dermatitis. Statistical tests determined this significance at a value of less than 0.0001. Betamethasone dipropionate was favored numerically not only in the combined results but also in ten of the twelve individual centers.

Aerosols

A trial with fluocinonide in recalcitrant dermatoses.

The effectiveness and safety of fluocinonide 0.05% in a cream base (FAPG cream: fatty acid propylene glycol) were evaluated in 105 patients with recalcitrant corticosteroid-responsive dermatoses that had failed to respond adequately to at least two weeks' previous treatment with one of 21 other topical corticosteroid preparations. At the end of the three weeks, 66 (71.0%) of the 93 patients who qualified for analysis showed excellent to moderate improvement with fluocinonide. Side effects were rare and of a minor nature. The general effectiveness of fluocinonide is indicated in this single-blind trail in which excellent or moderate results predominated in 8 of the 12 different diagnosis.

Drug Evaluation