| CLINICAL PHARMACOLOGY
Like other topical corticosteroids, clobetasol propionate
has anti- inflammatory, antipruritic, and vasoconstrictive
properties. The mechanism of the anti-inflammatory activity
of the topical steroids, in general, is unclear. However,
corticosteroids are thought to act by the induction of
phospholipase A2 inhibitory proteins, collectively called
lipocortins. It is postulated that these proteins control
the biosynthesis of potent mediators of inflammation such
as prostaglandins and leukotrienes by inhibiting the release
of their common precursor, arachidonic acid. Arachidonic
acid is released from membrane phospholipids by phospholipase
A2.
Pharmacokinetics
The extent of percutaneous absorption of topical corticosteroids
is determined by many factors, including the vehicle and
the integrity of the epidermal barrier. Occlusive dressings
with hydrocortisone for up to 24 hours has not been demonstrated
to increase penetration; however, occlusion of hydrocortisone
for 96 hours markedly enhances penetration. Topical corticosteroids
can be absorbed from normal intact skin. Inflammation
and/or other disease processes in the skin may increase
percutaneous absorption.
Studies performed with clobetasol propionate ointment
and emollient cream indicate that they are in the super-high
range of potency as compared with other topical corticosteroids.
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