clobetasol
Sources réglementaires consultées
Indications approuvées
- Traitement à court terme des dermatoses du cuir chevelu sensibles aux corticoïdes, comme le psoriasis répondant insuffisamment à des corticoïdes moins puissants, chez l’adulte et l’adolescent à partir de 12 ans.
Contre-indications
Absolues
- Hypersensibilité à le clobétasol ou aux autres corticoïdes ou à l’un des composants.
- Lésions ulcérées, brûlures, rosacée, acné, dermatite périorale, prurit périanal ou génital, lésions infectées, visage, paupières ou âge inférieur à 2 ans.
Mises en garde cliniques
- Mise en garde majeure · Utiliser la plus petite quantité efficace pendant la durée la plus courte possible. Les grandes surfaces, l’usage prolongé, l’altération de la barrière cutanée et l’occlusion augmentent l’absorption et peuvent provoquer une suppression réversible de l’axe HHS, un syndrome de Cushing, une hyperglycémie ou une glycosurie ; les enfants sont plus sensibles. — CIMA/AEMPS, ficha técnica 66071
- Éviter le contact avec les yeux. Arrêter en cas d’irritation ou de sensibilisation. Traiter toute infection cutanée ; en l’absence de réponse rapide, arrêter le corticoïde jusqu’à son contrôle. — CIMA/AEMPS, ficha técnica 66071
- Mise en garde majeure · L’utilisation au-delà de la dose ou de la durée recommandée a été associée à une ostéonécrose, à des infections graves — dont la fasciite nécrosante — et à une immunosuppression systémique. Réduire progressivement en cas de suppression surrénalienne. — CIMA/AEMPS, ficha técnica 66071
- Le récipient est pressurisé et inflammable : ne pas utiliser près d’une flamme et éviter les yeux, le nez et la bouche. — CIMA/AEMPS, ficha técnica 66071
Effets indésirables
Communs (≥1%)
Picotement au site d’application · Autres réactions au site d’application
Grossesse et allaitement
Les données sont insuffisantes pour établir une recommandation spécifique pendant la grossesse ou l’allaitement ; l’équipe soignante doit individualiser l’utilisation.
Bibliographie récente (PubMed)
Alopecia areata (AA) is a kind of alopecia that affects hair follicles and nails. It typically comes with round patches and is a type of nonscarring hair loss. Various therapies are accessible for the management and treatment of AA, including topical, systemic and injectable modalities. It is a very complex type of autoimmune disease and is identified as round patches of hair loss and may occur at any age. This review paper highlights the epidemiology, clinical features, pathogenesis and new treatment options for AA, with a specific emphasis on nanoparticulate drug-delivery systems. By exploring these innovative treatment approaches, researchers aim to enhance the effectiveness and targeted delivery of therapeutic agents, ultimately improving outcomes for individuals living with AA.
To compare the reported efficacy and costs of available interventions used for the management of oral lichen planus (OLP). A systematic literature search was performed from database inception until March 2021 in MEDLINE via PubMed and the Cochrane library following PRISMA guidelines. Only randomized controlled trials (RCT) comparing an active intervention with placebo or different active interventions for OLP management were considered. Seventy (70) RCTs were included. The majority of evidence suggested efficacy of topical steroids (dexamethasone, clobetasol, fluocinonide, triamcinolone), topical calcineurin inhibitors (tacrolimus, pimecrolimus, cyclosporine), topical retinoids, intra-lesional triamcinolone, aloe-vera gel, photodynamic therapy, and low-level laser therapies for OLP management. Based on the estimated cost per month and evidence for efficacy and side-effects, topical steroids (fluocinonide > dexamethasone > clobetasol > triamcinolone) appear to be more cost-effective than topical calcineurin inhibitors (tacrolimus > pimecrolimus > cyclosporine) followed by intra-lesional triamcinolone. Of common treatment regimens for OLP, topical steroids appear to be the most economical and efficacious option followed by topical calcineurin inhibitors. Large-scale multi-modality, prospective trials in which head-to-head comparisons interventions are compared are required to definitely assess the cost-effectiveness of OLP treatments.
Bullous pemphigoid (BP) is the most common autoimmune blistering disease. Oral steroids are the standard treatment. We have updated this review, which was first published in 2002, because several new treatments have since been tried. To assess the effects of treatments for bullous pemphigoid. We updated searches of the following databases to November 2021: Cochrane Skin Specialised Register, CENTRAL, MEDLINE, and Embase. We searched five trial databases to January 2022, and checked the reference lists of included studies for further references to relevant randomised controlled trials (RCTs). RCTs of treatments for immunofluorescence-confirmed bullous pemphigoid. At least two review authors, working independently, evaluated the studies against the review's inclusion criteria and extracted data from included studies. Using GRADE methodology, we assessed the certainty of the evidence for each outcome in each comparison. Our primary outcomes were healing of skin lesions and mortality. We identified 14 RCTs (1442 participants). The main treatment modalities assessed were oral steroids, topical steroids, and the oral anti-inflammatory antibiotic doxycycline. Most studies reported mortality but adverse events and quality of life were not well reported. We decided to look at the primary outcomes 'disease control' and 'mortality'. Almost all studies investigated different comparisons; two studies were placebo-controlled. The results are therefore based on a single study for each comparison except azathioprine. Most studies involved only small numbers of participants. We assessed the risk of bias for all key outcomes as having 'some concerns' or high risk, due to missing data, inappropriate analysis, or insufficient information. Clobetasol propionate cream versus oral prednisone Compared to oral prednisone, clobetasol propionate cream applied over the whole body probably increases skin healing at day 21 (risk ratio (RR 1.08, 95% confidence interval (CI) 1.03 to 1.13; 1 study,
Allergic contact dermatitis (ACD) may occur secondary to topical corticosteroids. This may be due to topical corticosteroids containing potential allergens in their vehicles. Variation of allergenic ingredients among various brands of a product has not been well characterized. This study aimed to assess the frequency of allergenic ingredients in various brands and manufacturers of clobetasol propionate. Common brands of clobetasol propionate were identified online on GoodRx website. Then, ingredient lists for these products were obtained from the US Food & Drug Administration’s Online Label Repository via a proprietary name search. A systematic literature review was performed using the ingredient name on Medline (PubMed) database to find reports of ACD confirmed by patch testing. Forty-nine different ingredients were identified among all 18 products included, with an average of 8.4 ingredients per product; 19 of these ingredients have allergenic potential, while one has protective effects. Two branded foam formulations contained the greatest number of potential allergens (5), while a shampoo formulation contained no potential allergens. Knowing which allergens are present in different products may be helpful when treating a patient with an allergy or suspected allergy to one of these ingredients. J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.4651.
The various cutaneous manifestations have lately appeared in the setting of COVID-19. Psoriasis flare-ups have been reported during a COVID-19 infection. We present a case of a 32-year-old woman with COVID-19 who presented with generalized pustular psoriasis. She received oral prednisolone, hydroxyzine, and topical clobetasol. The patient received follow-up two weeks later and found that her lesions were favorably desquamating. The PubMed, SCOPUS, and ISI Web of Science databases were thoroughly searched for English studies reporting psoriasis flare-ups following SARS-CoV-2 infection. Ten case reports/series were included after screening. Our case report brings awareness to clinicians for the possible cutaneous manifestation of COVID-19, which should be considered part of the differential diagnoses.