Microscopy Services Dähnhardt GmbH, Flintbek, Germany.
J Dtsch Dermatol Ges. 2013 May;11(5):437-43. doi: 10.1111/ddg.12074. Epub 2013 Apr 2.
The skin barrier plays a crucial role in the pathophysiology of atopic dermatitis. The quality of the skin barrier can be assessed using a new semi-quantitative method to measure intercellular lipid lamellae. This procedure was used to evaluate the influence of the topical application of the calcineurin inhibitor tacrolimus 0.1% ointment (Protopic®) versus mometasone furoate cream (Ecural®) on the quality of the skin barrier.
20 adult patients with active atopic dermatitis (SCORAD 10-63) were included in an open, non-interventional study. Lesions on their forearms were treated twice daily over 10 days with either tacrolimus 0.1% ointment or mometasone furoate cream. At the beginning and the end of the treatment period, SCORAD, TEWL and skin hydration were determined and the intercellular lipids were measured using transmission electron microscopy.
The SCORAD improved in both groups nearly to the same extent, whereas TEWL and skin hydration improved significantly only in the tacrolimus group. Using the semi-quantitative analysis of intercellular lipid length per 1,000 nm(2) intercellular space, a twofold increase for mometasone furoate cream and a fourfold increase for tacrolimus 0.1% ointment were determined.
In addition to its known antiinflammatory effect, tacrolimus 0.1% ointment leads also to a measurable increase of the lipids of the skin barrier in patients with atopic dermatitis, exceeding the effect of mometasone furoate cream.
皮肤屏障在特应性皮炎的病理生理学中起着至关重要的作用。可以使用一种新的半定量方法来测量细胞间脂质层来评估皮肤屏障的质量。该程序用于评估局部应用钙调神经磷酸酶抑制剂他克莫司 0.1%软膏（普特彼®）与莫米松糠酸酯乳膏（艾洛松®）对皮肤屏障质量的影响。
20 例患有活动性特应性皮炎（SCORAD 10-63）的成年患者参与了一项开放、非干预性研究。在前臂的病变部位，每天两次用他克莫司 0.1%软膏或莫米松糠酸酯乳膏治疗 10 天。在治疗开始和结束时，测定 SCORAD、TEWL 和皮肤水合作用，并使用透射电子显微镜测量细胞间脂质。
两组的 SCORAD 均得到了几乎相同程度的改善，而 TEWL 和皮肤水合作用仅在他克莫司组中显著改善。使用每 1000nm² 细胞间空间的细胞间脂质长度的半定量分析，莫米松糠酸酯乳膏增加了两倍，他克莫司 0.1%软膏增加了四倍。
除了已知的抗炎作用外，他克莫司 0.1%软膏还可导致特应性皮炎患者的皮肤屏障脂质明显增加，超过莫米松糠酸酯乳膏的作用。
