Sommer Anja, Lucassen Gerald W, Houben Alfons J H M, Neumann Martino H A
Department of Dermatology, University Hospital Maastricht, The Netherlands.
Microvasc Res. 2003 May;65(3):152-9. doi: 10.1016/s0026-2862(03)00011-6.
Topical application of corticosteroids induces blanching of the skin, based on changes of the underlying microcirculation of the skin. Usually the intensity of blanching after topical application of corticosteroids is measured subjectively by a trained observer using a visual score. In order to obtain an objective determination of the blanching effect and to assess the underlying effect of the skin perfusion, it is necessary to use noninvasive bioengineering techniques. The aim of this study was to compare changes in the vascular plexus during 72 h after topical application of corticosteroids of different potencies with control sites by two noninvasive techniques: laser Doppler imaging (LDI) and diffuse reflectance spectroscopy (DRS). We used the most potent vasoconstrictor, Clobetasol-di-propionate. After 8 h (1.49 Rm (mean reflectance) +/- 0.6 SEM) and after 30 h (0.52 Rm +/- 0.36) DRS showed significant changes in blood flow (during blanching and reactive hyperemia). LDI showed a slight change after 8 h (-0.04 aU (arbitrary units) +/- 0.02 blanching) and a second, significant reaction after 30 h (LDI: 0.18 aU +/- 0.04 reactive hyperemia). In LDI after 30 h higher values were found in men than in women (clobetasol-17-propionate under occlusion Deltat(30)-t(0) men: 0.47 aU +/- 0.18; n = 7; Deltat(30)-t(0) women: 0.14 aU +/- 0.02; n = 10; P = 0.025). This leads to the conclusion that DRS is of more value for the detection of blanching than LDI, which has its sensitivity in the hyperperfused skin. Measurement with both devices showed clear differences in men and women, which means that sex differences should be taken into account.
基于皮肤深层微循环的变化，局部应用皮质类固醇会导致皮肤变白。通常，局部应用皮质类固醇后的皮肤变白强度由经过培训的观察者通过视觉评分进行主观测量。为了客观确定皮肤变白效果并评估皮肤灌注的潜在影响，有必要使用非侵入性生物工程技术。本研究的目的是通过激光多普勒成像（LDI）和漫反射光谱（DRS）这两种非侵入性技术，比较不同效力的皮质类固醇局部应用72小时后血管丛与对照部位的变化。我们使用了最强效的血管收缩剂丙酸氯倍他索。8小时后（平均反射率1.49 Rm±0.6 SEM）和30小时后（0.52 Rm±0.36），DRS显示血流量有显著变化（在皮肤变白和反应性充血期间）。LDI在8小时后显示出轻微变化（-0.04任意单位±0.02皮肤变白），30小时后出现第二次显著反应（LDI：0.18任意单位±0.04反应性充血）。30小时后，LDI显示男性的值高于女性（闭塞下丙酸氯倍他索，男性Δt(30)-t(0)：0.47任意单位±0.18；n = 7；女性Δt(30)-t(0)：0.14任意单位±0.02；n = 10；P = 0.025）。由此得出结论，对于检测皮肤变白，DRS比LDI更有价值，LDI在皮肤高灌注时更具敏感性。两种设备的测量结果显示男女之间存在明显差异，这意味着应考虑性别差异。
