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At least 19 recordsLinked to original sources
PubMed1979

Dermatoses of the scalp.

By judicious consideration of the clinical appearance, by direct examination with magnification, and by culture results, skin biopsy, and other laboratory results, the clinician is able to diagnose most pathological conditions of the scalp. The scalp participates in many systemic disorders and frequently is the chief site of involvement. Similarly, many generalized disorders limited to the skin exhibit their most typical manifestations in the scalp. Whenever a diagnosis eludes the investigator, more than likely he or she has not considered all of the etiological possibilities or has not pursued an adequate laboratory investigation. A few scalp diseases initially present nonspecific clinical pictures. By utilizing follow-up examinations at appropriate intervals, the diagnosis can eventually be made. Once a diagnosis is made, appropriate treatment will generally produce satisfactory improvement or cure. Nevertheless, a few generally rare conditions will defy the physician's most enlightened and aggressive therapy.

Acne Keloid↗
PubMed2003

Efficacy of betamethasone valerate mousse in comparison with standard therapies on scalp psoriasis: an open, multicentre, randomized, controlled, cross-over study on 241 patients.

BACKGROUND: The scalp is a common area for plaque psoriasis. Corticosteroid-based lotions are the most widely used therapy in this clinical setting. A new formulation of betamethasone valerate 0.12% in a thermophobic, low-residue foam vehicle (Bettamousse trade mark, Mipharm, Italy; BVM) is available for the treatment of scalp dermatoses. OBJECTIVES: In an open, investigator-blinded, multicentre (28 dermatology clinics), randomized, cross-over study, the efficacy, safety and patient acceptability of BVM in scalp psoriasis were evaluated in comparison with standard therapies (ST, i.e. corticosteroids or vitamin D analogues). ST were chosen by each centre according to its usual therapeutic protocols. METHODS: In total, 241 patients with moderate to severe scalp psoriasis participated in the trial. After a 2-week run-in period, each active treatment (BVM or ST) was applied for 4 weeks, with a wash-out period between the two active treatment phases of at least 4 weeks. Efficacy was evaluated by investigators unaware of treatment sequence analysing a 'target' lesion for erythema, scaling, itching and burning using a five-point grading score. Patient treatment acceptability and assessment of the influence on Psoriasis Disability Index were evaluated using an eight-item modified Finlay-Khan questionnaire at baseline and at the end of each treatment period. Safety was evaluated by recording any adverse event occurring during the study duration. BVM was applied twice daily, and ST were applied once or twice daily, according to the approved scheduled regimens. RESULTS: Analyses were by intention-to-treat. Two hundred and ten patients concluded the study. Fifteen patients withdrew from the study during BVM treatment, and 16 during ST (not significantly different). Both treatments were well tolerated. At baseline, the mean +/- SD clinical global score (the 'Sum' score = erythema + scaling + itching + burning) was 7.6 +/- 2.6. The ST chosen were topical corticosteroids (55% of cases; mainly mometasone and betamethasone dipropionate) or calcipotriol lotion (45% of cases). At the end of active treatments, BVM was significantly superior to ST (P < 0.001) in reducing, as compared with baseline, the mean +/- SD Sum score (1.5 +/- 1.9 with BVM and 3.1 +/- 2.7 with ST). During BVM treatment, 88% (95% confidence interval, CI 82-94%) of patients had a complete or nearly complete resolution of scaling in comparison with 66% (95% CI 58-74%) during ST therapy (P < 0.001). BVM was also considered an easier and more convenient formulation to use in comparison with ST (P < 0.01). CONCLUSIONS: BVM is more effective than lotion-based ST commonly used in the treatment of scalp psoriasis, and has higher patient acceptability.

Administration, Topical↗
PubMed1999

Experience in treating recalcitrant scalp psoriasis with automated shampooing and debridement.

We report the cumulative clinical experience and financial implications of treating severe scalp psoriasis in an outpatient phototherapy center by means of an automated scalp debridement unit. Benefits of this approach included increased patient and staff satisfaction, enhanced response of recalcitrant scalp psoriasis, and detection of scalp dermatoses mimicking psoriasis.

Adolescent↗
PubMed2002

Scalpdex: a quality-of-life instrument for scalp dermatitis.

OBJECTIVE: To develop a scalp dermatitis-specific quality-of-life instrument. METHODS: Based on the results of directed focus sessions with 8 patients with scalp psoriasis or seborrheic dermatitis, we conceptualized 3 major constructs that explain the way scalp dermatoses affect patient quality of life: symptoms, functioning, and emotions. We constructed a 23-item instrument, Scalpdex, and tested its reliability, responsiveness, and validity. RESULTS: Fifty-two dermatology patients completed the study. We demonstrated construct validity by confirming that the factors derived by principal axes factor analyses with orthogonal rotation correlated to our hypothesized scales (r = 0.76-0.84) and that differences in symptom, functioning, and emotion scores differed among the varying levels of self-reported scalp severity more than would be expected by chance (P<.05 by analysis of variance). The instrument demonstrated reliability with internal consistency (Cronbach alpha, 0.62-0.80) and reproducibility (intraclass correlation coefficient, 0.90-0.97). The quality-of-life scores changed in the expected direction in our test for responsiveness (P<or=.05, by paired t test for functioning and emotion for those who improved). We ascertained the discriminant capability of Scalpdex compared with a dermatological generic quality-of-life tool, Skindex, by demonstrating superior responsiveness (P<or=.005 by paired t test in functioning and emotion) and improved overall sensitivity in individual items. CONCLUSIONS: Scalpdex is, to our knowledge, the first quality-of-life instrument specifically for patients with scalp dermatitis that is reliable, valid, and responsive. Clinicians can use the instrument to determine which aspect of the disease most bothers the patient and to evaluate quality of life as one variable of responsiveness to the therapeutic intervention.

Adult↗
PubMed2000

Topical corticosteroid in foam vehicle offers comparable coverage compared with traditional vehicles.

BACKGROUND: A new preparation of betamethasone valerate in a novel foam vehicle is available for treatment of scalp dermatoses. The vehicle spreads between hair until it reaches the scalp, where it melts and delivers the active drug. Solids make up only a tiny fraction of the foam vehicle, leaving no apparent residue on the skin or hair. The uniqueness of this vehicle raises the question of how to compare it with other topical corticosteroid preparations. OBJECTIVE: The purpose of this study was to determine the equivalency of a given quantity of the foam product to quantities of drugs in conventional vehicles. METHODS: The number of fingertip units (FTUs) per gram and the area of coverage of an FTU of betamethasone valerate foam vehicle were determined and compared with those of cream, lotion, gel, and solution psoriasis treatments. RESULTS: The weight of an FTU of foam vehicle was 52.5 +/- 5.7 microg. There were 9 to 12 times as many FTUs in 100 g of vehicle foam as in 100 g of cream or gel and 2.3 to 2.8 times as many as in 100 g of lotion or solution. The area covered by an FTU of foam vehicle was less than the area covered by an FTU of cream or gel. CONCLUSION: The characteristics of foam vehicle are different from those of other vehicles. The greater number of FTUs in 100 g of foam vehicle made up for the lower coverage per FTU, such that total coverage area for 100 g of foam vehicle was comparable to the coverage area for 100 g of the drugs in traditional vehicles.

Administration, Topical↗
PubMed2003

Efficacy of betamethasone valerate 0.1% thermophobic foam in seborrhoeic dermatitis of the scalp: an open-label, multicentre, prospective trial on 180 patients.

BACKGROUND: Seborrhoeic dermatitis (SD) is a common chronic inflammatory disease of the skin. Topical steroid creams and/or antifungal agents are commonly used in SD, but no resolutive therapies have been available up to now. Furthermore, little data have been available regarding clinical outcomes after cessation of topical treatments. A new formulation of betamethasone valerate 0.1% in a thermophobic, low-residue, foam vehicle (Bettamousse) (BVM) has become available for the topical treatment of scalp dermatoses. No data have been published hitherto regarding efficacy, safety and patient acceptability of this new formulation for the treatment of SD of the scalp. STUDY AIM: To assess in an open-label, prospective, multicentre trial, the efficacy, safety and patient acceptability of BVM, as compared to baseline, in SD subjects with scalp involvement. PATIENTS AND METHODS: A total of 180 patients with moderate-to-severe SD of the scalp were enrolled in the trial. Efficacy was evaluated by analysing SD lesions for erythema, scaling and itching using a five-point grading score (0 = lesion completely cured; 1 = mild; 2 = moderate; 3 = severe and 4 = very severe lesion). The clinical global (sum) score was obtained adding the score of each item. Efficacy and safety were assessed at baseline, after 4 weeks of active treatment, followed by an 8-week follow-up period with no treatment. RESULTS: In comparison with baseline, BVM significantly improved SD lesions. The sum score was reduced from 6.3 +/- 1.8 to 1.4 +/- 1.4 at the end of the active treatment period, (p < 0.0001) and to 1.7 +/- 1.8 at the end of the 8-week follow-up period (p < 0.0001). After active treatment, 93% of the patients had a sum score of </=3). At the end of 8-week of follow-up, 88% of patients maintained a sum score </=3. In addition, 85% of patients considered BVM foam to be a better topical formulation both in terms of efficacy and acceptability compared with previous treatments used. CONCLUSION: BVM is an effective and well-tolerated topical treatment of scalp SD. Its clinical effect is also maintained after a 2-month wash-out period.

Anti-Inflammatory Agents↗
PubMedDate not supplied

The efficacy and tolerability of clobetasol propionate foam 0.05% in the treatment of mild to moderate plaque-type psoriasis of nonscalp regions.

BACKGROUND: Clobetasol propionate foam 0.05% (Connetics Corporation, Palo Alto, CA) is approved by the United States Food and Drug Administration for the treatment of corticosteroid-responsive scalp dermatoses, but there is only limited data available for its efficacy and tolerability in treating dermatoses which affect nonscalp sites. OBJECTIVE: The efficacy and tolerability of clobetasol propionate foam (clobetasol foam) in treating psoriatic lesions at nonscalp sites was evaluated in a multicenter, randomized, double-blinded, placebo-controlled study of 279 patients with mild to moderate plaque-type psoriasis. METHODS: The patients applied clobetasol foam or placebo to the psoriatic lesions twice daily for two weeks. In addition to receiving clinical evaluations, the study patients completed a questionnaire evaluating various characteristics of the foam formulation, including their preference for its use and their projected likelihood to comply with similar therapy in a nonstudy environment. RESULTS: At Week 2 (or end of treatment), 68% (94/139) of patients who received clobetasol foam had a Physician's Static Global Assessment score of 0 (clear, except for minor residual discoloration) or 1 (majority of lesions have individual scores for plaque thickness, erythema, and scaling that averages 1). This was significantly more than the 21% (30/140) observed in the placebo group (P < 0.0001). Similar results were obtained for the Patient's Global Assessment score at Week 2 and in changes (from Baseline to Week 2) in the scores for the signs of psoriasis at a target lesion and for pruritus. Adverse effects were generally limited to mild and transient burning or other application site reactions in only a few patients in each treatment group. In the patient's poststudy questionnaire (completed at Week 2, or end of treatment) a majority of patients rated the characteristics of the foam formulation very highly. The patients ranked the foam formulation as superior to other topical formulations based on factors impacting their quality of life and indicated they would be more likely to comply with a recommended course of therapy with the foam formulation than with other topical formulations. CONCLUSION: Clobetasol propionate foam 0.05% is safe and effective for the treatment of plaque-type psoriasis on scalp and nonscalp areas, when applied twice daily for two weeks. As it is understood that patient dissatisfaction with select topical formulations affects their compliance with therapy, which necessarily affects the effectiveness of the therapy, the results of the patient's poststudy questionnaire suggest that there are multiple and integrated benefits for the use of clobetasol foam in the treatment of psoriasis of nonscalp sites.

Administration, Topical↗
PubMed2001

Betamethasone valerate foam for treatment of nonscalp psoriasis.

BACKGROUND: Although betamethasone valerate (BMV) foam, 0.12% (Luxiq, Connectics Corporation, Palo Alto, CA) is approved by the Food and Drug Administration for the treatment of corticosteroid-responsive scalp dermatoses, no data are available for its use on nonscalp psoriasis. OBJECTIVE: We evaluated the safety and efficacy of BMV foam in treating psoriatic lesions at nonscalp sites. METHODS: We conducted a randomized, double-blind, placebo-controlled, paired-comparison, split-body study of 40 patients with mild to moderate plaque-type psoriasis. Patients applied BMV foam and placebo foam twice daily for 12 weeks. RESULTS: At the end of the treatment period, 70% of patients had greater than 50% improvement of lesions on their active foam-treated side compared with 24% of patients with similar improvement on their placebo foam-treated side. Adverse effects were limited to temporary stinging, burning, or itching in several patients. Three patients (7.5%) withdrew because of stinging or itching. CONCLUSIONS: The results indicate that BMV foam is effective against nonscalp psoriasis. Twice-daily applications are well tolerated, compliance exceeds 90%, cosmetic characteristics are acceptable, and the medication may reduce the need for multiple prescriptions.

Administration, Topical↗