Evaluation of the vasoconstrictive effects of topical steroids by laser-Doppler-perfusion-imaging.

Corticosteroids are one of the most frequently prescribed local therapeutic treatments. Their potency and bioavailability are tested with different methods. One of the most accepted methods is the skin-blanching test designed by McKenzie. In this study we investigated whether the skin-blanching test designed by McKenzie for screening topically active corticosteroids, producing vasoconstriction, is sufficiently detectable by a laser-Doppler-perfusion-imager (LDPI). Eight sites in two rows on the right forearm of 10 healthy volunteers were treated with a topical glucocorticosteroid (clobetasol-17-propionate 0.05% (Dermovate), and the bloodflow at each site was measured by the LDPI at different timesteps. Four sites per row were chosen to evaluate the dependency of bioavailability according to anatomical differences due to skin changes within the forearm. Furthermore, half of the sites were occluded to demonstrate the difference between occluded and non-occluded sites in bioavailability. The results show that the LDPI can easily detect changes in bloodflow due to the vasoconstriction caused by topical corticosteroid. The results showed significant changes during the different measurements, with a maximum reaction 30 h after the application of the corticosteroid. The sites under occlusion showed a slower decrease of laser values than those without occlusion, so that it can be pointed out that occlusion prolongs the bioavailability of corticosteroids but does not influence the speed of onset. So far we conclude that this technique is a simple and non-traumatic method for assessing steroid potency. Blanching, as a result of vasoconstriction, can be quantified by LDPI measurement. However, LDPI measurements have to be compared with other techniques, such as the non-traumatic 133Xe washout technique, to find out if the two technologies respond in a similar way.