EVALUATION OF THE EFFICACY AND SAFETY OF 0.05% HALOBETASOL PROPIONATE OINTMENT AND 0.05% CLOBETASOL PROPIONATE OINTMENT IN CHRONIC, LOCALIZED PLAQUE PSORIASIS

Psoriasis is a common, chronic, inflammatory, multisystem disease involving the skin and joints. It accounts for 2.3% of the total dermatology outpatients in India.  Corticosteroids have an important role in skin diseases because of their anti-inflammatory, immunosuppressive, and anti-proliferative effects on the keratinocytes.Topical corticosteroids are commonly used in the management of psoriasis and other inflammatory skin disorders. Clobetasol 0.05% ointment and halobetasol 0.05% ointment are synthetic class I super-potent topical corticosteroids with anti-inflammatory, anti-pruritic and vasoconstrictive properties commonly prescribed for the treatment of psoriasis. The current study conducted in 202 patients from 6 centers showed a significant reduction in LPSI scores at end of treatment. The physician's global evaluation rating at end of treatment of almost total clearing of lesion (Grade 4) was reported in 19.2% and 32% patients, marked improvement (Grade 3) in 47.5% and 50.5%, moderate improvement (Grade 2) in 30.3% and 17.5% and mild improvement (Grade 1) in 3% and 0% for Clobetasol and Halobetasol groups respectively. The difference between the two groups for physicians' global evaluation was found to be statistically significant (p=0.019). 19.2% and 27.2% patients in Clobetasol and Halobetasol respectively, showed >75% improvement in photographic assessment (p=0.521).  There was a significant difference in the cosmetic acceptability (p=0.042) & in the ease of application (p=0.019) between the two groups.  No significant difference was found in serum cortisol levels, in both groups (p=0.074).Therefore this study reaffirms that halobetasol has better efficacy and good tolerability profile compared to clobetasol

Role of clobetasol propionate 0.025% topical therapy in various dermatoses

The anti-inflammatory and vasoconstrictive properties of topical corticosteroids (TCs) contribute in providing therapeutic benefits in several skin conditions, including atopic eczema, localized vitiligo, psoriasis, and chronic hand eczema. Clobetasol propionate (CP) is the most common topical agent used for psoriasis management and demonstrates an efficacy superior to other TCs. A new CP 0.025% cream formulation has demonstrated hypoallergenic effects due to the absence of known contact allergens, such as propylene glycol, short-chain alcohols, and sorbitol-based emulsifiers. Lower CP serum levels and less hypothalamic–pituitary–adrenal axis suppression with CP 0.025% cream formulation than with CP 0.05% ensure better safety. The present case series discusses the clinical experience of using CP 0.025% cream in various dermatological conditions

Case Report - Aleukemic leukemia cutis

Aleukemic leukemia cutis has always been a dermatological curiosity. It is a rare condition characterized by the infiltration of skin by leukemic cells before their appearance in the peripheral blood or bone marrow. A 20 year old man had presented with nodular swelling on the scalp of 6 months duration along with cervical lymphadenopathy. Biopsy and immunohistochemistry revealed myeloid sarcoma. The initial presentation was aleukemic and repeated peripheral blood counts and marrow examinations were normal. However, the outcome was fatal within 3 months of diagnosis of cutaneous lesions