Comparison of Xeroradiographic and Ultrasound Detection of Corticosteroid Induced Dermal Thinning

Abstract

A pulsed ultrasound technique was shown to have a high degree of correlation with the established xeroradiographic method for the determination of dermal thickness both in normal skin and corticosteroid treated skin, although xeroradiography consistently gave a higher value than ultrasound. Using the pulsed ultrasound technique, an early onset of dermal thinning could be detected 2 days following treatment with creams containing 0.05% clobetasol propionate and 0.1% beta-methasone 17-valerate. The amount of dermal thinning produced by the clobetasol propionate preparation was significantly greater than that produced by cream base, clobetasone butyrate 0.05% cream and hydrocortisone 1% cream as determined by both techniques. The pulsed ultrasound technique is an accurate, noninvasive and safe method for determining dermal thickness.

Test systems for the determination of glucocorticoid receptor ligand induced skin atrophy

“…The methodology has originally been developed by Marks. 49 These two methods delineate one thickness of skin as well as they allow the selective measuring of epidermal or dermal thickness without any other tissues. All of these methods are capable of detecting skin atrophy induced by a potent topical GC.…”

High-Frequency Ultrasound in the Evaluation of Pharmacological Effects on the Skin

“…Skin Pharmacol Appl Skin Physiol 2002; 15:71-84 Unholzer /Korting Tan et al [3,4] confirmed the good correlation between both methods and demonstrated the high reproducibility of sonographic measurement. In their hands, ultrasound consistently gave a smaller value of skin thickness than xeroradiography did [3,4].…”

“…Tan et al [3], using a 15-MHz A-scan device, were the first to prove that application of betamethasone 17-valerate 0.1% cream and clobetasol 17-propionate 0.05% cream for 6 weeks reduces the total thickness of normal skin by 16 and 22%, respectively. Even dermal thinning of 5 and 4%, respectively, after 2 days of treatment could be detected by means of ultrasound [3].…”

“…In their hands, ultrasound consistently gave a smaller value of skin thickness than xeroradiography did [3,4]. The total thickness of epidermis plus dermis had been underestimated, probably because echo-poor hair follicles and islands of fatty tissue within the echo-rich dermis falsely had been attributed to the echo-poor subcutaneous fat [5].…”

“…Amode devices handle the amplitudes of the echoes received in a one-dimensional way, thus allowing only punctual assessment of the depth of structures, and not imaging of topography or morphology as a histological section does [5]. The scanners used by Tan et al [3,4] do not allow distinction between dermis and epidermis either, which is due to the comparatively low resolution of 15-MHz ultrasound. Nevertheless, 15-MHz A-scan sonography is appropriate for the evaluation of certain pharmacological effects on the skin, as has been shown for pre-treatment/post-treatment studies on corticosteroid-induced dermal thinning [3].…”