Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia.
Skin Res Technol. 2014 May;20(2):136-40. doi: 10.1111/srt.12095. Epub 2013 Jul 1.
BACKGROUND/PURPOSE: The present study aimed to investigate the influence of topical corticosteroid therapy and tacrolimus on morphological indices of different skin phototypes and to optimize topical therapy using the OCT technique.
Twenty healthy volunteers aging from 20 to 30 (14 men and 6 women) took part in the study: 10 persons with skin phototype I, II and 10 persons with skin phototype V, VI. Morphological state of the skin was assessed before and during application of topical steroids of different strength and calciumneurin inhibitors for 49 days. Morphological state was studied in vivo using the optical coherence tomograph.
Morphological manifestations of skin atrophy with the use of clobetasol propionate appear earlier than with the use of hydrocortisone 17-butyrate; this process was faster in representatives of groups V, VI. Epidermal thinning in the zone of tacrolimus application was not recorded in any phototype.
Recording of early preclinical signs of epidermis thinning in the course of OCT follow-up may be an indication for changing the corticosteroid therapy by calciumneurin inhibitors, which will permit to individualize the therapy, to increase its efficacy, and to minimize the possibility of complications in each particular case.
背景/目的：本研究旨在探讨局部皮质类固醇治疗和他克莫司对不同皮肤光型的形态学指标的影响，并利用 OCT 技术优化局部治疗。
20 名年龄在 20 至 30 岁之间的健康志愿者（14 名男性和 6 名女性）参与了这项研究：10 名皮肤光型 I、II 型和 10 名皮肤光型 V、VI 型志愿者。在 49 天的时间里，我们评估了不同强度的局部皮质类固醇和钙调神经磷酸酶抑制剂应用前后的皮肤形态。使用光学相干断层扫描仪对皮肤的形态进行了活体研究。
与使用氢化可的松 17-丁酸酯相比，使用氯倍他索丙酸酯会更早出现皮肤萎缩的形态表现；在 V、VI 组的代表中，这一过程更快。在任何光型中，均未记录到他克莫司应用区域的表皮变薄。
在 OCT 随访过程中记录到表皮变薄的早期临床前迹象可能表明需要通过钙调神经磷酸酶抑制剂改变皮质类固醇治疗，这将允许个体化治疗，提高其疗效，并最大限度地减少每个特定病例发生并发症的可能性。
