Assessment of the atrophogenicity of corticosteroids to human skin using non-invasive methods

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.