Evaluation of the atrophogenic potential of hydrocortisone 1% cream and pimecrolimus 1% cream in uninvolved forehead skin of patients with atopic dermatitis using optical coherence tomography

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Contributors

Abstract

Topical corticosteroids are widely used to treat atopic dermatitis (AD), but their anti-inflammatory mode of action can be accompanied by several unwanted side effects including skin atrophy and telangiectasia. In this 8-week, investigator-blinded, intraindividual right-left comparison study with patients with mild-to-moderate AD, hydrocortisone 1% cream (HCT) was applied twice daily for 4weeks on one side of forehead skin without clinical signs of AD and pimecrolimus 1% cream (PIM) on the other. Epidermal and dermal thickness were assessed by optical coherence tomography (OCT) and high-frequency ultrasound, respectively. Skin atrophy and telangiectasia were assessed by contact dermatoscopic photography (Dermaphot ®). Treatment with HCT leads to a significant decrease in epidermal thickness after only 2weeks of treatment, while the decrease in PIM-treated sites was less pronounced and was not statistically significant. By 4weeks after the end of treatment, epidermal thickness returned to baseline values. No dermal thinning or development of telangiectasia could be observed by means of ultrasound or Dermaphot ®, respectively. In summary, this study indicates that a 2-week single course of topical treatment with a mildly potent steroid can cause transient epidermal thinning, an effect not seen in the PIM group. The slight decrease with PIM - although not significant - could be due to normalization of the increased skin thickness caused by a subclinical inflammation in AD. This study suggests that PIM may be safer for treatment of AD in sensitive skin areas like the face, especially when repeated application is required.

Details

Original languageEnglish
Pages (from-to)832-836
Number of pages5
JournalExperimental dermatology
Volume20
Issue number10
Publication statusPublished - Oct 2011
Peer-reviewedYes

External IDs

PubMed 21771098
ORCID /0000-0003-0554-2178/work/163294997

Keywords

Keywords

  • Atopic dermatitis, Corticosteroid, Optical coherence tomography, Pimecrolimus, Skin atrophy