A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus t

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Hello

having read lots of various reports on the use of both creams have just read about a trial with 58 women half using clobetasol and half using tacrolimus or protopic. The trial was published by the American Academy of Dermatology (07.07.2014) the research was carried out in Montreal in 4 different hospitals.

After 3 months of treatment the clobetasol showed a significantly more effective result than the protopic in terms of the disease itself.

It's really good that there are Doctors out there trying to improve the treatment.

After 3 months of Protopic I had a really bad bladder infection which I have never had before which I am sure was due to the immunsuppressant action of the cream.

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9 Replies

  • Posted

    I have only used the Cobetasol for 10 years. Drs. Never brought up any other treatment options. Good to know that though.
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  • Posted

    Thanks for passing this info on. It is good to know I am doing the best I can for now. i know things change as the more research is done but for now that confirms my belief that Clobetasol is the best for me at the moment. thanksfor sharing.
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  • Posted

    Thanks, Marie. Just confirms what I had settled on. It sounds from what I've seen that Drs try Tacrolimus if Clobetasol causes a bad reaction, not so much because it might work better. What I wonder is how often bad reactions are from using too much. I'd been on it for a year (constantly wondering if I was using it right) before I came across the info that we should use between 30 and 60 grams a year. I breathed a sigh of relief that I hadn't over- or under-applied. I used 50g. Should be less in the second year without the heavy startup. 
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  • Posted

    I think that the immune suppressant part of the glob. is the negative.  But at present the small amount I use may just not be enough to have a serious effect.  Even though I already have an issue in the immune department - adrenal glands.  Experience by now tells me that LS needs a continuous maintenance amount of glob.  It's the one and only that keep it somewhat under control. 
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  • Posted

    Thanks Marie. 58 women is not a very big survey so the results would really have to be very significantly different to be credible. Do you know how they measured the significance and how many women in  each section showed the good effects?

    thanks.

    And yes, I agree it is good somebody is doing something, no matter how small, to look at this.

     

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    • Posted

      Hello Joodie,

      it was an extract printed from the American Dermatology Department but the trial was actually carried out in Canada.If you google on google scholar maybe you can find out more. I know 58 is not a large number but when you think how appantly this disease is so rare I imagine it was difficult to find enough women willing to participate.

      Reading through the jargon significant is only used when the benefits greatly outweigh those of the opposing group.

       

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  • Posted

    New to this - wondering what diagnosis you were given.  i was just diagnosed and

    prescribed Clobetasol Propionate.  Is that what  you all are using?  The instructions 

    state to use on small areas, not large areas.  However, I have this over 2/3 of my

    trunk.   What do you think.

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    • Posted

      That's what we're all using, except the few who have Protopic, or who are refusing clob. You have lichen sclerosus over tht big an area? I looked 'extragenital LS' up and found this bit on The British Skin Foundation (as information for any LS sufferer who may see your post):

      What is lichen sclerosus?

      Lichen sclerosus is a relatively uncommon condition in which thin white crinkly patches appear on the skin. It can appear anywhere, but is most troublesome in the genital areas.  

      What are the symptoms of lichen sclerosus?

      Many patients have none, but the most common symptom of lichen sclerosus is itch. As a rule the spots on the general skin surface seldom itch much, but those in the genital area do, and can also be sore if the skin breaks down or cracks. In the genital area, the scar-like process can tighten the skin, and this can interfere with sexual intercourse in affected men or women. In men, lichen sclerosus can make the foreskin tight and difficult to retract, and can even partly block the flow of urine.

      What does lichen sclerosus look like?

      On the main areas of the skin, the spots of lichen sclerosus look like small ivory-coloured slightly raised areas, which can join up to form white patches.  Some have tiny yellowish horny plugs within the pale areas. After a while the surface of the spots can look like wrinkled tissue paper. The most common sites are the bends of the wrists, the upper trunk, around the breasts, the neck and armpits.

      Most of us are willing to use Clobetasol, which is thousands of times stronger than over-the-counter steroid creams, because we're afraid of our vulva shutting right over the urethra and because having chronic open lesions in a location that constantly gets doused in urine – there's a larger than average chance of developing squamous cell cancer of the vulva. I have psoriasis, sometimes on large areas, and stopped using steroic creams on it over a decade ago, because it usually just goes away when the stress in my life calms down.

      Does your dermatologist know you're using clobetasol over large areas? If you were using way too much you might get symptoms like cushings syndrome – puffiness that causes moon face.

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    • Posted

      Hi, I presume you mean you have LS over 2/3 of your trunk.  If this is the case I would insist on a biopsy if you haven't already had one as you really need to be 100% sure that it is LS that you have.  That seems a very large area to be affected and unuaual.  You would also have to be very careful how you treat such a large area.  Clobetasol Prorionate that we are issued is usually advised to be treating with a pea size amount.  I do not think this would be sufficient to treat such a large area.  There are other conditions that could look like this.  I really feel for you to have this much of your torso affected.  Are you seeing a dermatologist for this condition or is it your GP that is treating you?  It must be awful to have this much of your body affected by any skin condition. 
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