Which is better, Clobetasol propionate lotion or cream for moderate to severe plaque-type psoriasis?

What is Clobetasol propionate?

Clobetasol propionate is a topical steroid drug with anti-inflammatory, antipruritic, vasoconstrictive and immunomodulatory properties. It is currently used to treat a variety of skin conditions including psoriasis, eczema, vulvar scleroderma and atopic dermatitis. It is an excellent treatment for relieving itching, redness, dryness, crusting, flaking, inflammation and discomfort in a variety of scalp and skin conditions.

Mechanisms of action

Clobetasol propionate exerts its effects by binding to the glucocorticoid receptor in the cytoplasm and subsequently activating glucocorticoid receptor-mediated gene expression. This leads to the synthesis of certain anti-inflammatory proteins while inhibiting the synthesis of certain inflammatory mediators. Specifically, clobetasol propionate appears to induce the phospholipase A2 inhibitory protein, which controls the release of the inflammatory precursor arachidonic acid from membrane phospholipids by phospholipase A2.

Clobetasol propionate Lotion and Cream

Clobetasol propionate Lotion and Cream are two dosage forms of Clobetasol propionate and both can be used to treat atopic dermatitis (AD) and psoriasis. And clinical studies have shown that clobetasol propionate lotion is significantly more effective than its lotion vehicle and comparable to the cream formulation. After a two-week treatment-free follow-up period, the clinical success rate was higher in the clobetasol propionate lotion group than in the cream group. Clobetasol propionate lotion was effective, safe, well tolerated, and provided better remission than clobetasol propionate cream in the treatment of moderate to severe AD.

Another multicentre, randomised clinical study also showed that in the treatment of moderate to severe plaque psoriasis, clobetasol propionate lotion was significantly more effective than the carrier lotion and comparable to the emollient cream. After a 4-week treatment-free follow-up period, the treatment success rate was higher in the clobetasol propionate lotion group than in the emollient cream group. Clobetasol propionate lotion was safe and well tolerated.

References:

[1] Clobetasol Propionate[J]. Definitions, 2020. DOI:10.32388/w898ak.

[2] DEBRA BRENEMAN. Clobetasol propionate 0.05% lotion in the treatment of moderate to severe atopic dermatitis: a randomized evaluation versus clobetasol propionate emollient cream.[J]. Journal of Drugs in Dermatology, 2005.

[3] JACQUES DECROIX. Clobetasol propionate lotion in the treatment of moderate to severe plaque-type psoriasis.[J]. Cutis, 2004.

[4] NICHOLAS LOWE. Clobetasol propionate lotion, an efficient and safe alternative to clobetasol propionate emollient cream in subjects with moderate to severe plaque-type psoriasis.[J]. Journal of Dermatological Treatment, 2005. DOI:10.1080/09546630510041060.

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