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Background/aims: Atrophy is a distressing side effect of potent corticosteroids. After open application of a high potency steroid, we monitored atrophogenicity by a variety of non-invasive methods. Methods: Volar forearms were treated twice daily for 3 or 4 weeks, with clobetasol propionate cream (Temovate®). The following methods were used: 1) confocal microscopy, 2) transepidermal water loss (TEWL), 3) dimethyl sulfoxide whealing, 4) sodium hydroxide erosions, 5) analysis of stratum corneum lipids, and 6) B-scan ultrasound. Results: Confocal microscopy revealed thinning of the epidermis, decreased microvasculature and decreased size of keratinocytes. Evaporimetry demonstrated transepidermal water loss. Whealing to dimethyl sulfoxide was enhanced. Sodium hydroxide erosions formed more quickly. The amount of ceramides, cholesterol, and free fatty acids was reduced. Ultrasound showed thinning of the dermis. Conclusion: Non-invasive methods are very useful for quantifying the atrophogenicity of topical corticosteroids.

Background/alms: Optical coherence tomography is a new in vivo imaging tool originally developed to investigate the eye. We undertook a preliminary investigation of experimental and clinical dermatological applications. Methods: We obtained optical coherence tomography images of ethnic groups, of cutaneous changes induced by exposure to water and dimethyl sulfoxide, of corticosteroid atrophy and of acne vulgaris. Results: Optical coherence tomography was able to visualize specific structural changes in stratum corneum and viable epidermis in these diverse conditions. Conclusions: The high lateral and axial resolution of 4 urn and 7 μm, respectively, and the image quality of this prototype make optical coherence tomography a promising instrument for clinical and investigative dermatology.

Background/aims: Atrophy is the most common adverse effect of topical corticosteroids. The objective of this study was to determine whether atrophogenicity of a potent steroid could be demonstrated in a 3-week period of open application using non-invasive bioengineering methods. Methods: Volar forearms were treated twice daily for 3 weeks with clobetasol propionate cream. The following methods were used: 1) B-scan ultrasound; 2) Silflo-replicas for microtopogra-phy; 3) scanning electron microscopy; 4) Cutometer for bio-mechanical assessments; 5) colorimetry for measuring skin color; 6) evaporimetry for transepidermal water loss; 7) polarized light photos; 8) sticky slides for corneocyte sizing; 9) D'Squames for estimating scaling; and 10) biopsies for histologic evaluation of atrophy Results: After only 1 week, Silflo-replica showed that glyphic patterns had been partially obliterated. At the same time, ultrasound scans showed dermal thinning, which increased over the 3-week period. Extensibility by Cutometer decreased steadily during the treatment. Image analysis of ?Squames revealed an increase in scaliness. Evaporimetry showed an increase in trans-epidermal water loss. Atrophy was confirmed by histology. Conclusion: The use of non-invasive bioengineering techniques provides a powerful tool to monitor atrophogenicity in a short period of open applications.