Clinical observation frequently shows a paradoxical effect of topical corticosteroids in charge of a sudden melting of edema in the first days of treatment, which could be due to mobilization of extracellular. No study has shown the value of this measure in patients treated with topical steroids. This uncertainty, coupled with the observation of the paradoxical effects of topical steroids on edema are some patients that despite the systemic absorption of clobetasol propionate, a salt-free diet is not currently recommended practice.
The main objective of the study is to evaluate whether there is fluid retention after introduction of clobetasol propionate treatment from 10 g/day dosage to 40 g / day in patients with bullous pemphigoid. Bio-impedance is a noninvasive device for measuring with an electric current of low intensity the different volumes of the human body. A preliminary experiment of impedance measurements in some patients with bullous pemphigoid (examination requested as part of a nutritional assessment) showed that these patients had mostly a total water loss without dehydration, corresponding to a significant undernutrition during 1 month of treatment, possibly related to muscle wasting and protein loss by skin erosions without obvious argument for fluid retention, justifying reproduce these measures on a larger number of patients and the other to accurately assess the evolution of nutritional parameters during the first month of treatment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Enrollment
30
Impedance analysis in patient with Bullous pemphigoid disease treated with clobetasol propionate. impedance analysis includes : fat measures, lean body mass, total body water, extracellular water phase angle
clobetasol propionate treatment initiated following French recommendations
Rouen University Hospital
Rouen, France
Change from Baseline in fluid retention at day 30
Change from Baseline in extra-cellular water volume at day 30 measured by bioimpedance analysis
Time frame: Day 30
Change from Baseline in fluid retention at day 7
Change from Baseline in extra-cellular water volume at day 7 measured by bioimpedance analysis
Time frame: Day 7
Weight variation between day 1 and day 30
Time frame: Day 30
Urinary Sodium level variation between day 1 and day 30
Time frame: Day 30
Urinary creatinin level variation between day 1 and day 30
Time frame: Day 30
Brain Natriuretic Peptide level variation between day 1 and day 30
Time frame: Day 30
Change from Baseline in nutritional parameters at day 30
bioimpedance analysis, C Reactive Protein level, albumin level, daily diet diary, Buzby index
Time frame: Day 30
Change from Baseline in bullous pemphigoid disease severity index at day 30
BPDAI questionary assessment
Time frame: Day 30
Change from Baseline in bullous pemphigoid disease severity index at day 7
BPDAI questionary assessment
Time frame: Day 7
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Change from Baseline in corticoid administration dosage at days 30
Evaluation of corticoid dosage between day 1 and day 30
Time frame: Day 30