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Clinical comparison of desonide cream with fluocinonide cream in steroid-responsive dermatologic disorders.

Desonide, a nonfluorinated topical corticosteriod, was compared with fluocinonide, a potent fluorinated steroid, in identical concentrations, in the treatment of various steroid-responsive dermatologic disorders. In treatment comparisons, the group treated with desonide showed significantly (p less than 0.05) better erythema and scaling scores after the first week than did those in the fluocinonide group, but the two week scores were not significantly different. Although 5 percent of patients treated with fluocinonide had adverse reactions, no such reactions were observed in the desonide-treated group.

Adolescent

The identification of related substances in triamcinolone acetonide by means of high-performance liquid chromatography with diode array detector and mass spectrometry.

A study of an HPLC method for the analysis of related substances in triamcinolone acetonide is described. Several systems of solvents and samples of different lots and preparative origins were examined and a rapid-scanning diode array UV detector (DAD) was particularly useful. With the proposed technique it was possible to identify 9 alpha-bromo desonide as a principal impurity, which was present in all examined samples of triamcinolone acetonide. This identification was rendered possible by the investigation of the second derivative of the UV spectra and by means of study of the mass spectrum. Furthermore, it was possible, primarily on the basis of the spectrophotometric data, to formulate reliable hypotheses on the possible identification of 9 beta, 11 beta-epoxide of the desonide which was present at very low levels and to exclude the presence of 11-deoxy-9(11)-unsaturated desonide. The presence of the above-mentioned related substances was explained considering the scheme of synthesis described in the literature. The spectrophotometric characteristics of the studied compounds and the limits of applicability of the present procedure are discussed.

Chromatography, High Pressure Liquid

Corticosteroid-induced dermal atrophy in the rat.

Corticosteroid-induced dermal atrophy has been studied in the rat using daily application of ethanolic solutions to small areas of flank skin. After 12 days of treatment, the degree of atrophy was determined by comparing the weights of skin plugs (16 mm diameter) taken from the treated areas with contralaterally paired control areas. Doses can be adjusted so that systemic effects are minimized and only local effects are observed. Hydrocortisone, hydrocortisone butyrate, dexamethasone, betamethasone, desonide and triamcinolone acetonide all produce atrophy in the rat, and the degree of thinning is dose dependent. Potencies in the dermal atrophy assay compare directly with topical anti-inflammatory potencies in the rat, and the presence of fluorine in the steroid molecule is not a determining factor in the production of atrophy.

Administration, Topical

Action of various drugs with anti-inflammatory or anti-rheumatic properties on pleurisy due to Bordetella pertussis hypersensitivity in the rat.

The authors studied various drugs with anti-inflammatory or antirheumatic properties on pleurisy due to Bordetella pertussis hypersensitivity in the rat. The following compounds were studies according to various methods of treatment: indomethacin, phenylbutazone, cyclophosphamide, desonide, chloroquine, levamisole, D-penicillamine and sodium aurothiopropanol sulphonate. The action on the volume of pleural exudate and on cell events depended on the compounds and the conditions of treatment. Only gold salt produced no reduction in the pleural volume under all methods of treatment. All the compounds studied produced various degrees of significant modifications at the level of the cell events.

Animals

Comparison of the effects of a non-steroidal anti-inflammatory agent, an immunosuppressive, a corticosteroid and an immunomodulator on various immunological and non-immunological inflammatory experimental models.

The effects of a non-steroidal anti-inflammatory agent, phenylbutazone, a corticosteroid, desonide, an immunosuppressive, cyclophosphamide and an immunomodulator, levamisole on a number of experimental inflammatory models were compared. Compounds were first tested in carrageenin-induced pleurisy as a non-immune acute inflammation, then in passive skin anaphylaxis and reversed passive Arthus oedema in the rat as models of humoral immunity. Finally the compounds were investigated in various delayed hypersensitivity tests: reaction to sheep red cells and to oxazolone in the mouse, skin reaction to purified protein derivative (P.P.D.) in the rat and guinea-pig, P.P.D. induced pleurisy in the guinea-pig.

Animals

Bioavailability and activity of topical corticosteroids from a novel drug delivery system, the aerosol quick-break foam.

Experiments were conducted to: (a) compare the bioavailability of betamethasone benzoate in a quick-break aerosol foam and semisolid dosage forms, (b) compare the activity of betamethasone benzoate, betamethasone valerate, clobetasol propionate, triamcinolone acetonide, desonide, flumethasoid reservoir formation in skin, and (d) assess the effect of a natural moisturizer. Efficacy was determined by a graded response 6-hr occluded vasoconstriction test with subsequent reocclusion for reservoir demonstration. Moisturizer effect was assessed by a nonoccluded vasoconstriction test using "plain" and sodium 2-pyrrolidone-5-carboxylate-containing concentrates on arms pretreated with water or moisturizer. The activities of betamethasone benzoate concentrate, collapsed foam, ointment, and gel were similar and significantly better than the activity of the cream. Clobetasol propionate was significantly better than the other medicated concentrates, which were equivalent. Steroid-induced blanching decreased in the presence of a moisturizer.

Administration, Topical

Comparative effects of two topical antiseptics (chlorhexidine vs KMn04) on bacterial skin flora in atopic dermatitis.

In order to determine the efficacy and tolerance of two topical antiseptics, chlorhexidine vs KMn04 (diluted at 1:20,000), we compared their bacteriological and clinical effects in a randomized trial on 20 children with Atopic Dermatitis (AD) treated with topical steroids (desonide). After treatment, a clinical improvement was noted in the two groups, though without statistical differences. In vivo: Before treatment, Staphylococcus aureus (S.A.) density was high and predominant in both groups. After treatment, the decrease in S.A. was greater in the chlorhexidine group than in the KMn04 group, without significant difference. In vitro: At the clinical dilution used, there was a statistical difference (p < 0.05) between the number of killed bacteria in the chlorhexidine group (-3 log) and the number in the KMn04 group (-1 log). This study confirms the role and importance of the choice of a topical antiseptic in the treatment of AD.

Administration, Cutaneous

Contact dermatitis due to multiple corticosteroid creams.

A patient was allergic to the corticosteroids halcinonide, fluocinonide, desonide, and triamcinolone acetonide. She also was allergic to ethylendiamine hydrochloride, neomycin, thimerosal, formaldehyde solution, and nystatin.

Adolescent

Growth rate of cultured human fibroblasts increased by glucocorticoids.

Selected glucocorticoids have been demonstrated to increase the growth rate of human skin fibroblasts in culture, over a physiologically significant concentration range. At the same concentrations and identical conditions, the glucocorticoid compounds tested inhibited the growth rate of mouse L-929 cells. We have discussed currently acceptable theories of glucocorticoid mechanism of action that permit this dichotomous effect, the main point being that inhibition can no longer be regarded as the only response of fibroblasts to glucocorticoids. Conclusions drawn from observations of cell cultures affected by addition of glucocorticoids must have considered the source of the cells, as response may vary with source and biologic state of the cells in culture.

Adult

Dose titration of steroidal and non-steroidal topical anti-inflammatory agents.

Although there is a variety of animal models available, neither a single assay system nor the results of the various assays permit absolute protection of relative anti-inflammatory potency. Equally, current clinical dose titration studies, although more reliable, provide only gross estimates of therapeutic potency when conducted in certain clinical situations in a double-blind randomized fashion. This paper delineated clinical means to titrate more objectively and accurately therapeutic potency in the patient. Moreover, it has submitted considerations as to how to assess therapeutic anti-inflammatory activity in the complex multi-component process of inflammation accompanying most dermatologic diseases that eventually may permit titration of specific anti-inflammatory compounds on certain tissue components of the inflammatory process.

Administration, Topical

Action of phenylbutazone, cyclophosphamide and prednacinolone on pleurisy due to Bordetella pertussis hypersensitivity in the rat.

Phenylbutazone, cyclophosphamide and prednacinolone acetonide, administered around the period of challenge reduced the exudate of pleurisy due to Bordetella pertussis hypersensitivity in the rat. The results on the leukocytes of the exudate are different depending on the class of product studied. Phenylbutazone only slightly reduced the number of mononuclears cells. Both the immunosuppressive and the corticoid induced a clear decrease in the total leukocyte number. But, while prednacinolone effects were nearly equally distributed among mononuclears and polynuclears, cyclophosphamide was mainly active on mononuclears.

Animals

[Clinical study of a new preparation in the treatment of anorectal varices].

Sterectal is a new antihemorrhoidal drug which contains prednacinolone, lidocaine hidrochloride and ephedrine hidrochloride. The results of the double blind, between patient, clinical study carried out in order to detect effectiveness of Sterectal compared with placebo show that the new drug owns a more rapid onset of therapeutic activity and exhibits a greater reduction in symptom severity than placebo. Both treatments were well tolerated.

Adult