EXPERIENCE OF COMBINED APPLICATION OF METHYLPREDNISOLONE ACEPONATE AND MOLETOLO COSMETICS STEROIDSANDVIAGRAJY IN THE TREATMENT OF DERMATOSES

Cover Page


Cite item

Full Text

Abstract

Skin diseases of non-infectious etiology, such as allergic contact dermatitis, atopic dermatitis, eczema  and chronic actinic dermatitis have a significant impact on the quality of patient’s life, greatly reducing it. The most important place in the therapy of these diseases is found in topical glucocorticosteroids in combination with competent basic therapy.

The aim of the study was to evaluate the clinical efficacy, safety profile, and tolerability of an external corticosteroid drug with a combination composition: methylprednisolone aceponate 0.1 % + urea 2 % (Komfoderm M2) in combination with dextpanthenol, allantoin and Shea butter (Dexpan plus cream) in dermatological practice in the treatment of eczematous process.

Materials and methods. 48 patients, from 18 to 58 years old with mild to middle-severe eczematous process, were under observation, including 16 with allergic contact dermatitis, 14 patients with atopic dermatitis and 10 patients with eczema brushes, and 8 people with actinic dermatitis. Cream Komfoderm M2 was applied to the affected skin areas once a day in combination with cream Dexpan plus as standard therapy and emollient cosmetic. We investigated the parameters of the DLQI questionnaire “Dermatological Quality of Life Index” .

Results As a result of the conducted observational study, data were obtained on the high effectiveness of therapy with the combined use of the drug Komfoderm M2 and Dexpan plus. An excellent evaluation of the efficacy of the scheme used was found in 37 (77 %) patients, a good one in 9 (18,8 %) and 2 (4.2 %) patients had a satisfactory result.

Conclusions. This clinical study proves the high efficacy, safety and tolerability of the drugs — Cream with 0.1 % MPA and urea 2 % (Komfoderm M2) in combination with a cream containing dexpanthenol, allantonoin and Shea butter (Dexpan plus) in the treatment of eczematous process.

About the authors

Evgeny V. Orlov

Samara State Medical University, Ministry of Health of the Russian Federation

Author for correspondence.
Email: fake@neicon.ru

Evgeny V. Orlov — Dr. Sci. (Med.), Prof., Departmental Head, Department of Skin and Sexually Transmitted Diseases.

Chapaevskaya str., 89, Samara, 443099

Россия

Pavel E. Konnov

Samara State Medical University, Ministry of Health of the Russian Federation

Email: konnoff@yandex.ru

Pavel E. Konnov — Cand. Sci. (Med.), Ass. Prof., Department of Skin and Sexually Transmitted Diseases.

Chapaevskaya str., 89, Samara, 443099

Россия

Antonina A. Arsenieva

Samara State Medical University, Ministry of Health of the Russian Federation

Email: fake@neicon.ru

Antonina A. Arsenieva — Cand. Sci. (Med.), Research Assistant, Department of Skin and Sexually Transmitted Diseases.

Chapaevskaya str., 89, Samara, 443099

Россия

References

  1. European Task Force on Atopic Dermatitis Position paper on diagnosis and treatment of atopic dermatitis. 2005.
  2. Федеральные клинические рекомендации. Дерматовенерология. 2015: Болезни кожи. Инфекции, передаваемые половым путем. 5-е изд., перераб. и доп. М.: Деловой экспресс, 2016. С. 28–39, 187–192, 616– 628.
  3. Saraswat A., Lahiri K., Chatterjee H. et al. Topical corticosteroid abuse on the face: a prospective, multicenter study of dermatology out patients. Indian J Dermatol Venerol Leproe. 2011;77(2):160–166. doi: 10.4103/0378-6323.77455
  4. Leung D. Y. New insights into atopic dermatitis: role of skin barrier and immune dysregulation. AllergolInt. 2013;62(2):151–161. doi: 10.2332/allergolint.13-RAI-0564
  5. Клеменова И.А., Есенин С. А. Эволюция применения кортикостероидных препаратов для местного лечения в дерматологической практике. Клин. дерматолвенерол. 2011;(5):46–50.
  6. Батыршина С. В. Глюкокортикостероиды для местного применения в современной стратегии терапии воспалительных дерматозов в педиатрической практике. Практическая медицина 2014;(9):94–102.
  7. Шимановский Н. Л. Прогресс в облати создания препаратов топических глюкокортикостероидов, применяемых в дерматологии. Международный медицинский журнал. 2005;(2);144–147.
  8. Макарова И. В. Подходы к наружной терапии атопического дерматита у детей. Вопр. соврем. пед. 2003;(6);33–36.
  9. Nowak D. A., Yeung J. Steroid-Induced Osteonecrosis in Dermatology: A Review. J Cutan Med Surg. 2015;19(4):358–360.
  10. Ortonne J. P. Skin atrophogenicpotencial of methylprednisolone aceponate (MPA). J Eur Acad Dermatol Venerol. 1994;3:13–18.
  11. Hoffmann K., Auer N., Stucker M. et al. Comparison of skin atrophy and vasoconstriction due to mometasonefuroate, methylprednisolone and hydrocortisone. J Eur Acad Dermatol Venerol. 1998;10:137–142.
  12. Haneke E. The treatment of atopic dermatitis with methylprednisolone aceponate (MPA), a new topical corticosteroid. J Dermatol Treat. 1992;3:13–15.
  13. Fritsch P. Clinical experience with methylprednisolone aceponate (MPA) in eczema. J Dermatol Treat. 1992;3:17–19.
  14. Haneke E. Long-term treatment wich 6-methylprednisolone aceponate. J Eur Acad Dermatol Venerol. 1994;3:17–19.
  15. Bieber T., Vick K., Folster-Holst R., Belloni-Fortina A., Stadtler G., Worm M., Arcangeli F. Efficacy and safety of methylprednisolone aceponate 0,1 % compared to tacrolimus 0,03 % in children and adolescents with an acute flare of severe atopic dermatitis. Allergy. 2007;62:184–189.
  16. Перламутров Ю. Н., Ольховская К.Б. и группа исследователей. Результаты всероссийского многоцентрового открытого наблюдательного исследования «Аккорд» по определению эффективности, безопасности и переносимости различных форм адвантана при лечении больных контактными дерматитами. Клин дерматолвенерол. 2009;(4):72–79.
  17. Ноздрин В. И., Белоусова Т. А., Лаврик А. И. и др. Морфологические изменения кожи у экспериментальных животных под воздействием мочевины. Российский журнал кожных и венерических болезней. 2008;3:63–68.
  18. Scheinfeld N. S. A review of scientific and clinical data. Skinmed. 2010;8:2:102–106.
  19. Loden M. Barrier recovery and influence of irritant stimuli in skin treated with a moisturizing cream. Contact Dermatitis. 1997;36:256–260.
  20. Loden M. Urea-containing moisturizers influence barrier properties of normal skin. Arch Dermatol Res. 1996;288:103–107.
  21. Сазыкина Л.Н., Белоусова Т. А., и др. Комплексная терапия избыточного ороговения и грибковых поражений кожи и ногтей. Клиническая дерматология и венерология. 2013;1:19–23.
  22. Hagemann I., Proksch E. Topical treatment by urea reduces epidermal hyperproliferation and induces differentiation in psoriasis. Acta Derm Venereol. 1996;76:353–356.
  23. Bissonnette R., Maari C., Provost N. et al. A double-blind study of tolerance and efficacy of a new urea-containing moisturizer in patients with atopic dermatitis. J CosmetDermatol. March 2010;9(1):16–21. doi: 10.1111/j.1473-2165.2010.00476.x
  24. Peserico A., Stаdtler G., Sebastian M. et al. Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study. Br J Dermatol. April 2008;158(4):801–807. doi: 10.1111/j.1365-2133.2008.08436.x Epub 2008 Feb 16.
  25. Wohlrab W. Die DNS-Synthese in der Epidermis nach Kontaktmit Harnstoff. Dermatologica. 1974;149:144–148.
  26. Swanbeck G. A. New treatment of ichthyosis and other hyperkeratotic conditions. Acta Derm Venerol. 1968;48:123–127.
  27. Fredriksson T., Gip L. Urea creams in the treatment of dry skin and hand dermatitis. Int J Dermatol. 1975;14:442–444.
  28. Grimalt R. et al. The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology. 2007;214(1):61–67.
  29. Szczepanowska J., Reich A., Szepietowski J. C. Emollients improve treatment results with topical corticosteroids in childhood atopic dermatitis: a randomized comparative study. Pediatr. Allergy. Immunol. 2008;19(7):614–618.
  30. Akdis C. A. Akdis M., Bieber T. Diagnosis and treatment of atopic dermatitis in childrend and adults: Evropean Academy of Allergology and clinical Immunology / American Academy of Allergy, Asthma and Immunology / PRECTALL Concencus Report. Allergy. 2006;61:969–987.
  31. Goujon C., Alleaume B., De Bony R., Girard P. Randomised singleblind pilot comparison study of the efficacy and tolerability of Bepanthen ointment in subjects with bilateral dryness of the hands. Realitees Therapeutiquesen DermatoVenerologie. 1997;66:47–33.
  32. Gehring W., Gloor M. Effect of topically applied dexpanthenol on epidermal barrier function and stratum corneum hydration. Results of humaninvivo study. Arzneimittelforsch. 2000;50:659–663.
  33. Camargo F. B. Jr., Gaspar L. R., Maia Campos P. M. Skin moisturizing effects of panthenol-based formulations. J Cosmet Sci. 2011;62:361–370.
  34. Proksch E., Nissen H. P. Dexpanthenol enhances skin barrier repair and redusec inflammation after sodiom lauryl sulphate-induced irritation. J Dermatolog Treat. 2002;13:173–178.
  35. Biro K., Thaci I. D., Ochsendorf F. R. et al. Efficacy of dexpanthenol in skin protection against irritation: a double-blind, placebo-controlled study. Contact Dermatitis. 2003;49:80–84.
  36. Ebner F., Heller A., Rippke F., Tausch I. Topical use of dexpanthenol in skin disorders. Am J Clin Dermatol. 2002;3:427–433.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2018 Orlov E.V., Konnov P.E., Arsenieva A.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 60448 от 30.12.2014.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies