BACKGROUND/AIMS: Atrophy is a distressing side effect of potent corticosteroids. After open application of a high potency steroid, we monitored atrophogenicity by a variety of non-invasive methods. METHODS: Volar forearms were treated twice daily for 3 or 4 weeks, with clobetasol propionate cream (Temovate). The following methods were used: 1) confocal microscopy, 2) transepidermal water loss (TEWL), 3) dimethyl sulfoxide whealing, 4) sodium hydroxide erosions, 5) analysis of stratum corneum lipids, and 6) B-scan ultrasound. RESULTS: Confocal microscopy revealed thinning of the epidermis, decreased microvasculature and decreased size of keratinocytes. Evaporimetry demonstrated transepidermal water loss. Whealing to dimethyl sulfoxide was enhanced. Sodium hydroxide erosions formed more quickly. The amount of ceramides, cholesterol, and free fatty acids was reduced. Ultrasound showed thinning of the dermis. CONCLUSION: Non-invasive methods are very useful for quantifying the atrophogenicity of topical corticosteroids.
BACKGROUND/AIMS: Atrophy is a distressing side effect of potent corticosteroids. After open application of a high potency steroid, we monitored atrophogenicity by a variety of non-invasive methods. METHODS: Volar forearms were treated twice daily for 3 or 4 weeks, with clobetasol propionate cream (Temovate). The following methods were used: 1) confocal microscopy, 2) transepidermal water loss (TEWL), 3) dimethyl sulfoxide whealing, 4) sodium hydroxide erosions, 5) analysis of stratum corneum lipids, and 6) B-scan ultrasound. RESULTS: Confocal microscopy revealed thinning of the epidermis, decreased microvasculature and decreased size of keratinocytes. Evaporimetry demonstrated transepidermal water loss. Whealing to dimethyl sulfoxide was enhanced. Sodium hydroxide erosions formed more quickly. The amount of ceramides, cholesterol, and free fatty acids was reduced. Ultrasound showed thinning of the dermis. CONCLUSION: Non-invasive methods are very useful for quantifying the atrophogenicity of topical corticosteroids.
Authors: Moyses Costa Lemos; Wagner Rafael Correr; Lucimar Retto da Silva de Avó; Carla Maria Ramos Germano; Cristina Kurachi; Igor Polikarpov; Débora Gusmão Melo Journal: Lasers Med Sci Date: 2012-01-17 Impact factor: 3.161
Authors: George Man; Theodora M Mauro; Peggy L Kim; Melanie Hupe; Yongjiao Zhai; Richard Sun; Debbie Crumrine; Carolyn Cheung; Almudena Nuno-Gonzalez; Peter M Elias; Mao-Qiang Man Journal: Exp Dermatol Date: 2014-07-31 Impact factor: 3.960