Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Department of Clinical Sensoring and Monitoring, Technische Universität Dresden, Dresden, Germany.
Skin Pharmacol Physiol. 2022;35(1):41-50. doi: 10.1159/000518214. Epub 2021 Jul 8.
Proactive therapy with topical corticosteroids (TCSs) is the standard treatment for chronic inflammatory diseases such as atopic dermatitis; however, skin atrophy as TCS side effect remains a concern.
This 16-week, evaluator-blinded, within-patient placebo-controlled, randomized study enrolled volunteers with healthy skin conditions. For 12 weeks, their volar forearm and the back of their hand were applied with hydrocortisone acetate 1% cream (HC), methylprednisolone aceponate 0.1% cream (MPA), betamethasone valerate 0.1% cream (BMV), or an active agent-free base cream (Dermatop® Basiscreme) once daily twice weekly, and pimecrolimus 1% cream (PIM) twice daily twice weekly. Epidermal and dermal thickness was measured by optical coherence tomography and high-frequency ultrasound, respectively. Furthermore, skin atrophy and telangiectasia were determined by contact dermatoscopic photography (Dermaphot®).
After 8 and 12 weeks, only BMV led to significant epidermal thinning on both sites. Four weeks after the end of treatment, epidermal thickness returned to baseline. No dermal thinning, atrophy, or telangiectasia was observed.
MPA, HC, and PIM may be more suitable for repeated and prolonged treatment, especially in chronic diseases.
对于特应性皮炎等慢性炎症性疾病，采用局部皮质类固醇（TCS）进行主动治疗是标准疗法；然而，TCS 的副作用——皮肤萎缩仍然令人担忧。
这是一项为期 16 周、评估者设盲、同一患者内安慰剂对照、随机研究，纳入了健康皮肤状况的志愿者。在前臂掌侧和手背，志愿者接受醋酸氢化可的松 1%乳膏（HC）、醋酸甲泼尼龙龙 0.1%乳膏（MPA）、戊酸倍他米松 0.1%乳膏（BMV）或无活性物质赋形剂乳膏（Dermatop® Basiscreme）每日一次、每周两次，吡美莫司 1%乳膏（PIM）每日两次、每周两次治疗，共 12 周。使用光学相干断层扫描和高频超声分别测量表皮和真皮厚度。此外，通过接触式共聚焦皮肤显微镜摄影（Dermaphot®）评估皮肤萎缩和毛细血管扩张。
治疗 8 周和 12 周后，仅 BMV 导致两个部位的表皮显著变薄。治疗结束后 4 周，表皮厚度恢复至基线。未观察到真皮变薄、萎缩或毛细血管扩张。
MPA、HC 和 PIM 可能更适合重复和长期治疗，特别是治疗慢性疾病。
