Topical sodium cromoglycate in the management of atopic eczema—a controlled trial

Abstract

A double-blind, group comparison trial of a topical cream containing 4% sodium cromoglycate (SCG) was undertaken in forty-six patients with chronic atopic eczema. A statistically significant improvement was seen after 9 weeks in the actively treated patients compared with the placebo group. However, in general, no benefit was observed in severe eczema, perhaps due in some part to the seemingly late onset of action of SCG. Measurement of total serum IgE before and after the trial showed an increase in levels which was apparently unrelated to treatment with SCG or placebo or to a change in severity of the eczema. The amount of SCG in the urine was small and very variable, indicating low percutaneous absorption. The calculated bioavailability ranged from 0.01% to 2.75% of the applied dose. These results together with follow-up studies suggest that topical SCG as a long-term measure may be useful in the management of mild or moderately severe eczema, reducing the frequency of acute exacerbations.

Nedocromil sodium inhibits histamine‐induced itch and flare in human skin

“…One possible explanation is the poor and inconsistent penetration of cromones into the skin. Given their polar nature (p K a ∼2), penetration of these drugs through the epidermis with conventional vehicles is very poor, one study reporting a mean efficiency of absorption of 0.44% (range 0.01 – 2.75%) from an oil in water formulation containing 4% sodium cromoglycate ( Ariyanayagam et al ., 1985 ).…”

Mast cell mediators other than histamine induce pruritus in atopic dermatitis patients: a dermal microdialysis study

“…3,4 Clinical studies of mast cell degranulation inhibition in AD patients have produced divergent results with both improvement of the eczema seen in some, 5,6 but not all studies. 7,8 However, mast cell density has not been shown to correlate with severity of AD, 9 and plasma levels of mast cell mediators in AD have been found to be normal. 10 There is also some controversy about the role of histamine in AD patients.…”

“…Several authors describe an increased density of mast cells in AD 1,2 and speculate on the pathophysiological relevance of mast cells in AD 3,4 . Clinical studies of mast cell degranulation inhibition in AD patients have produced divergent results with both improvement of the eczema seen in some, 5,6 but not all studies 7,8 . However, mast cell density has not been shown to correlate with severity of AD, 9 and plasma levels of mast cell mediators in AD have been found to be normal.…”

Efficacy and acceptability of a new topical skin lotion of sodium cromoglicate (Altoderm) in atopic dermatitis in children aged 2-12 years: a double-blind, randomized, placebo-controlled trial

“…Two further trials used this formulation, 17,18 but neither showed any clear benefits. Three trials used a 4% oil‐in‐water cream formulation 19–21 and only one of these 21 showed positive effects. In three trials carried out in Japan the drug was applied to the skin as a 1% aqueous solution 5–7 .…”