Pels Ragna, Sterry Wolfram, Lademann Jürgen
Department of Dermatology, Polikum Friedenau, Berlin, Germany.
Drugs Today (Barc). 2008 Jul;44(7):547-57. doi: 10.1358/dot.2008.44.7.1122221.
Clobetasol propionate is the most potent of all topical steroids. It is successfully applied in the treatment of various skin diseases such as atopic dermatitis, psoriasis and vulvar lichen sclerosus. The therapy is, however, mainly symptomatic. A preventive effect is only reported in the treatment of the latter. Clobetasol propionate exerts antiinflammatory, immunosuppressive and antimitotic effects influencing the growth, differentiation and function of various cells and inhibiting cytokine production. Seven different dosage forms are available to deliver the drug to the living cells of the skin. Their choice might additionally affect patient compliance. The potency of clobetasol propionate, however, is accompanied by local and systemic side effects, such as skin atrophy and hypothalamic-pituitary-adrenal axis suppression. Patients applying clobetasol propionate must be well instructed in how to use it. Physicians prescribing clobetasol propionate should consider a diversity of factors and be able to answer the questions where, when and why.
丙酸氯倍他索是所有外用类固醇中效力最强的。它成功应用于治疗各种皮肤病，如特应性皮炎、银屑病和外阴硬化性苔藓。然而，该疗法主要是对症治疗。仅在治疗后者时报道有预防作用。丙酸氯倍他索具有抗炎、免疫抑制和抗有丝分裂作用，可影响各种细胞的生长、分化和功能，并抑制细胞因子的产生。有七种不同剂型可将药物递送至皮肤活细胞。剂型的选择可能还会影响患者的依从性。然而，丙酸氯倍他索的效力伴随着局部和全身副作用，如皮肤萎缩和下丘脑 - 垂体 - 肾上腺轴抑制。使用丙酸氯倍他索的患者必须得到关于如何使用它的充分指导。开具丙酸氯倍他索处方的医生应考虑多种因素，并能够回答在何处、何时以及为何使用的问题。
