Different effects of pimecrolimus and betamethasone on the skin barrier in patients with atopic dermatitis

Jensen, Jens‐Michael; Pfeiffer, Stephan; Witt, Magdalena; Bräutigam, Matthias; Neumann, Claudia; Weichenthal, Michael; Schwarz, Thomas; Fölster‐Holst, Regina; Proksch, Ehrhardt

doi:10.1016/j.jaci.2009.07.015

Cited by 107 publications

(87 citation statements)

References 53 publications

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“…The reduction of epidermal thickness was associated with clinical efficacy by using hydrocortisone, as we have shown previously [13]. An initial step of skin atrophy is the reduction in epidermal thickness followed by dermal atrophic changes.…”

Section: Discussionsupporting

confidence: 72%

Clinical Efficacy and Tolerability of a Novel Selective Corticosteroid in Atopic Dermatitis - Two Randomised Controlled Trials

Dölle

Hielscher

Bareille

et al. 2015

Skin Pharmacol Physiol

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Topical corticosteroids remain the first-line therapy for atopic dermatitis (AD). Hence, we investigated the efficacy and safety profile of a novel selective corticosteroid, GW870086. We performed 2 randomised, double-blind, controlled studies with 25 AD patients and 20 healthy subjects. The changes in the Three-Item Severity (TIS) score and the skin thickness were the primary end points, respectively. The adjusted TIS score (day 22) shows that the novel corticosteroid resulted in a non-significant, but dose-dependent reduction compared to placebo (GW870086 0.2% vs. placebo = -0.38, GW870086 2% vs. placebo = -0.89). Significant skin thinning was observed in the second study on days 14 and 21 when patients were treated with the comparator but not with the novel corticosteroid compared to placebo. The clinical efficacy of the new selective corticosteroid was not superior to placebo, although a dose-dependent improvement upon treatment was noticed without the onset of skin thinning.

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Section: Discussionsupporting

confidence: 72%

Clinical Efficacy and Tolerability of a Novel Selective Corticosteroid in Atopic Dermatitis - Two Randomised Controlled Trials

Dölle

Hielscher

Bareille

et al. 2015

Skin Pharmacol Physiol

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“…However, this effect was less pronounced than with betamethasone, which reduced the proliferation rate to below normal levels and led to epidermal thinning of 49%. In the pimecrolimus group, the reduction brought the value to within the normal range for healthy skin (33).…”

Section: Discussionmentioning

confidence: 89%

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

Aschoff

Schmitt

Knuschke

et al. 2011

Experimental Dermatology

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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 4 weeks 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 Ò ). Treatment with HCT leads to a significant decrease in epidermal thickness after only 2 weeks of treatment, while the decrease in PIM-treated sites was less pronounced and was not statistically significant. By 4 weeks 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 Ò , 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 PIMalthough 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.

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“…30,31 Certain groups have found significant differences in TEWL between patients with AD with and without FLG haploinsufficiency; 32,33 however, others could not confirm these results. 30,31 Certain groups have found significant differences in TEWL between patients with AD with and without FLG haploinsufficiency; 32,33 however, others could not confirm these results.…”

Section: Discussionmentioning

confidence: 97%

Severe skin inflammation and filaggrin mutation similarly alter the skin barrier in patients with atopic dermatitis

et al. 2014

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Different effects of pimecrolimus and betamethasone on the skin barrier in patients with atopic dermatitis

Cited by 107 publications

References 53 publications

Clinical Efficacy and Tolerability of a Novel Selective Corticosteroid in Atopic Dermatitis - Two Randomised Controlled Trials

Clinical Efficacy and Tolerability of a Novel Selective Corticosteroid in Atopic Dermatitis - Two Randomised Controlled Trials

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

Severe skin inflammation and filaggrin mutation similarly alter the skin barrier in patients with atopic dermatitis

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