Topical clobetasol propionate compared with placebo in the treatment of unretractable foreskin.

OBJECTIVE

To assess whether it is the steroid alone or the gentle physical retraction combined with ointment that is responsible for the excellent results observed with topical steroid treatment of unretractable foreskin.

DESIGN

Prospective, randomised, double-blind study.

SETTING

University hospital, Sweden.

SUBJECTS

30 Boys randomised to be treated with clobetasol propionate (n = 15) or placebo (n = 15).

INTERVENTIONS

The boys were examined 1, 2 and 6 months, respectively, after treatment.

MAIN OUTCOME MEASURES

Comparison between the effects of clobetasol propionate and placebo.

RESULTS

Two patients in the steroid group and one in the placebo group withdrew from the study. 10 Boys in the steroid group showed an improvement within 2 months. The remaining 3 boys had no effect and were circumcised. Histopathological examination showed lichen sclerosus et atrophicus. Seven boys in the placebo group improved. The 7 non-responders were prescribed clobetasol propionate ointment, and all 7 improved.

CONCLUSION

17 of 27 boys referred with "phimosis" were successfully treated with an ointment and gentle traction. When clobetasol propionate was given the non-responders success rate was increased to 24/27 (89%).