Betamethasone dipropionate 0.064% / Clotrimazole 1% cream

ContextOral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease characterized by pain and burning sensation. As etiology remains unclear, the treatment of OLP is focused mainly on reducing symptoms through modulation of local immune response.AimsThe aim of this study is to evaluate and compare the clinical efficacy of Clobetasol 0.05% orabase and Betamethasone 0.05% orabase, both combined with Clotrimazole 1%, in managing symptomatic OLP.MethodologyA double-blind, randomized clinical trial was conducted on 30 patients diagnosed with OLP at a tertiary dental hospital. Patients were randomly divided into two groups: Group A (Clobetasol + Clotrimazole) and Group B (Betamethasone + Clotrimazole). Clinical response was assessed at two and four weeks using the Global Assessment Scale for lesion size and the visual analogue scale (VAS) for burning sensation. The collected data were analyzed using IBM SPSS Statistics for Windows, Version 17 (Released 2009; IBM Corp., Armonk, New York, United States).ResultsAt the end of four weeks, the change in mean size obtained was score 2.0±0.95 in Group A and 1.66±1.4 in Group B (p-value = 0.51), indicating that both the study drugs had a similar decrease in the global assessment of efficacy scores with no significant statistical difference. Mean change in the VAS score at the end of four weeks revealed a decrease in the mean score of 4.66±2.30 in Group A and a decrease by 4.00±1.80 score in Group B (p-value=0.44), indicating no statistical significance.ConclusionsBoth clobetasol and betamethasone demonstrated comparable efficacy in reducing pain and lesion size among patients with OLP. This finding suggests that either regimen can serve as a viable therapeutic option in the management of OLP. Considering their similar clinical outcomes, the choice between these corticosteroids may depend on factors such as drug availability, patient tolerance, cost, and physician preference.

Abstract licence: CC BY

IntroductionCushing syndrome (CS) is an endocrinological abnormality that results from a high level of glucocorticoids in the blood. Iatrogenic CS due to the overuse of topical corticosteroids is rarely reported. The current study aims to present a rare case of topical corticosteroid induced iatrogenic CS in an infant.Case presentationA 4-month-old female infant presented with an insidious onset of face puffiness that progressed over a 2-month period. The mother reported to have used a cream containing Betamethasone corticosteroid 5-8 times a day for a duration of 3 months to treat diaper dermatitis. Laboratory findings revealed low levels of adrenocorticotrophic hormone (ACTH) and serum. Abdominal ultrasound showed normal adrenal glands. The topical corticosteroid was halted and physiologic topical hydrocortisone doses were administered.Clinical discussionInfants are more likely to acquire topical corticosteroid induced iatrogenic CS due to their thin and absorptive skin, higher body surface area, and the high prevalence of conditions that necessitates the use of these medications. Most iatrogenic CS cases following topical steroid application have been reported in infants with diaper dermatitis that are most commonly treated with Clobetasol and Bethamethasone.ConclusionInfants are susceptible to develop CS due to topical corticosteroid overuse. Hence, physicians need to consider this in infantile CS cases, and take appropriate measures to avoid their occurrence.

Abstract licence: CC BY-NC-ND