A case of lichen planopilaris associated with lichen planus following Blaschko lines successfully treated with topical corticosteroid

Lichen planopilaris (LPP) is characterized by erythematous, keratotic follicular papules and cicatricial alopecia. LPP, the most common cause of cicatricial alopecia, is usually seen in women and causes significant psychosocial morbidity. We describe here a 42-year-old woman with a 6-month history of hair loss accompanied by itching on the scalp. Dermatological examination revealed patchy cicatricial alopecia in the vertex and band-like purple flat patches and plaques following the Blaschko lines on the right half of the body, together with post-inflammatory hyperpigmentation. Histopathological examination of the scalp biopsy was consistent with LPP, while thigh biopsy was consistent with lichen planus. With the histopathological and clinical evidence, our patient was evaluated as LPP associated with LP and successfully treated with topical corticosteroid. A few LPP and LP cases following the Blaschko lines have previously been reported separately. However, LPP, together with LP following Blaschko lines, have not been reported in the same patient.

Topical corticosteroid for treatment of hand osteoarthritis: study protocol for a randomised controlled trial

Background Hand osteoarthritis is a common and disabling chronic joint disease with a lack of effective therapies. Emerging evidence suggests the role of local inflammation in causing pain in hand osteoarthritis. Corticosteroids are potent anti-inflammatory drugs used in many rheumatic diseases. The aim of this randomised, double-blind, placebo-controlled trial is to determine whether topical corticosteroid reduces pain over 6 weeks in patients with hand osteoarthritis. Methods One hundred participants with hand osteoarthritis will be recruited from the community in Melbourne, Australia, and randomly allocated in a 1:1 ratio to receive either topical Diprosone OV or placebo ointment administered 3 times daily on the painful hand joints for 6 weeks. The primary outcome is pain reduction (assessed by 100 mm visual analogue scale) at 6 weeks. The secondary outcomes include changes in pain and function assessed using Functional Index for Hand Osteoarthritis, Australian Canadian Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and tender and swollen joint count at 6 weeks. Adverse events will be recorded. The primary analysis will be by intention to treat, including all participants in their randomised groups. Discussion This study will provide high-quality evidence to determine whether topical corticosteroid reduces pain over 6 weeks in patients with hand osteoarthritis, with major clinical and public health importance by informing clinical practice guidelines for the management of hand osteoarthritis and reducing the burden of the disabling disease. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12620000599976. Registered 22 May 2020.

Topical corticosteroid withdrawal reactions

Overview of: Medicines and Healthcare products Regulatory Agency. Topical corticosteroids: information on the risk of topical steroid withdrawal reactions. Drug Safety Update 2021;15(2):1.

The role of bacteriotherapy in the restoration of the nasal mucosa in patients with chronic rhinosinusitis

Topicality: Chronic rhinosinusitis is an polyetiological disease with shch basic complaints as nasal obstruction, nasal discharge, headache or facial pain and reduction of smell. The SNOT-22 questionnaire is widely used to detail patient complaints in various fields. Chronic rhinosinusitis is most often divided into chronic rhinosinusitis with polyps and without nasal polyps. Given the large number of phenotypes and endotypes of the disease, it is important to study further the mechanisms of pathogenesis and selec- tion of individualized treatment. Aim: to determine the role of topical application of Streptococcus salivarius 24SMBc and Streptococcus orals 89a in the form of nasal spray in improving the condition of the nasal mucosa in chronic rhinosinusitis and reducing the recurrence rate. Materials and methods: The study was conducted at the Department of Otolaryngology of National Medical University on the basis of KNP "Oleksandrivs’ka Clinical Hospital of Kyiv". It was attended by 82 patients (38 women and 44 men) aged 18 to 60 years, who were randomly divided into two groups. The 1st group (main, 43 patients) received treatment: irrigation therapy with isotonic saline, topical corticosteroid mometasone furoate in combination with a nasal spray, which contains autochthonous saprophytes (AC) – Streptococcus salivarius 89SMBc and Streptococcus orals 89a nasal mucus. The 2nd group (control, 39 patients) received nasal saline irrigation therapy, topical corticosteroid mometasone furoate in combination with topical antibiotic framicetin sulfate. Assessment was performed according to the VAS scale, SNOT-22 questionnaire (before treatment, on the 10th day of treatment and one month after the end of therapy) and determining the frequency of relapses in patients of both groups. Results: According to the obtained results, the indicators of patients of both groups before treatment and on the 10th day had no statistically significant difference (p>0.05). However a month later patients in the main group had better results (p<0.05) on the scale of VAS and the SNOT-22 questionnaire. So, topical use of Streptococcus salivarius 24SMBc and Streptococcus orals 89a as a nasal spray is effective and can be recommended for the treatment of patients with chronic rhinosinusitis in the acute stage.