Different effects of pimecrolimus and betamethasone on the skin barrier in patients with atopic dermatitis. 2009

Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
Department of Dermatology, University of Kiel, Kiel, Germany.

BACKGROUND Genetic defects leading to skin barrier dysfunction were recognized as risk factors for atopic dermatitis (AD). It is essential that drugs applied to patients with AD restore the impaired epidermal barrier to prevent sensitization by environmental allergens. OBJECTIVE We investigated the effect of 2 common treatments, a calcineurin inhibitor and a corticosteroid, on the skin barrier. METHODS In a randomized study 15 patients with AD were treated on one upper limb with pimecrolimus and on the other with betamethasone twice daily for 3 weeks. RESULTS Stratum corneum hydration and transepidermal water loss, a marker of the inside-outside barrier, improved in both groups. Dye penetration, a marker of the outside-inside barrier, was also reduced in both drugs. Electron microscopic evaluation of barrier structure displayed prevalently ordered stratum corneum lipid layers and regular lamellar body extrusion in pimecrolimus-treated skin but inconsistent extracellular lipid bilayers and only partially filled lamellar bodies after betamethasone treatment. Both drugs normalized epidermal differentiation and reduced epidermal hyperproliferation. Betamethasone was superior in reducing clinical symptoms and epidermal proliferation; however, it led to epidermal thinning. CONCLUSIONS The present study demonstrates that both betamethasone and pimecrolimus improve clinical and biophysical parameters and epidermal differentiation. Because pimecrolimus improved the epidermal barrier and did not cause atrophy, it might be more suitable for long-term treatment of AD.

UI MeSH Term Description Entries
D003876 Dermatitis, Atopic A chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. It is manifested by lichenification, excoriation, and crusting, mainly on the flexural surfaces of the elbow and knee. In infants it is known as infantile eczema. Eczema, Atopic,Eczema, Infantile,Neurodermatitis, Atopic,Neurodermatitis, Disseminated,Atopic Dermatitis,Atopic Eczema,Atopic Neurodermatitis,Disseminated Neurodermatitis,Infantile Eczema
D003879 Dermatologic Agents Drugs used to treat or prevent skin disorders or for the routine care of skin. Agent, Dermatologic,Agent, Dermatological,Agents, Dermatologic,Dermatologic Agent,Dermatological Agents,Agents, Dermatological,Dermatological Agent
D004817 Epidermis The external, nonvascular layer of the skin. It is made up, from within outward, of five layers of EPITHELIUM: (1) basal layer (stratum basale epidermidis); (2) spinous layer (stratum spinosum epidermidis); (3) granular layer (stratum granulosum epidermidis); (4) clear layer (stratum lucidum epidermidis); and (5) horny layer (stratum corneum epidermidis).
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000279 Administration, Cutaneous The application of suitable drug dosage forms to the skin for either local or systemic effects. Cutaneous Drug Administration,Dermal Drug Administration,Drug Administration, Dermal,Percutaneous Administration,Skin Drug Administration,Transcutaneous Administration,Transdermal Administration,Administration, Dermal,Administration, Transcutaneous,Administration, Transdermal,Cutaneous Administration,Cutaneous Administration, Drug,Dermal Administration,Drug Administration, Cutaneous,Skin Administration, Drug,Administration, Cutaneous Drug,Administration, Dermal Drug,Administration, Percutaneous,Administrations, Cutaneous,Administrations, Cutaneous Drug,Administrations, Dermal,Administrations, Dermal Drug,Administrations, Percutaneous,Administrations, Transcutaneous,Administrations, Transdermal,Cutaneous Administrations,Cutaneous Administrations, Drug,Cutaneous Drug Administrations,Dermal Administrations,Dermal Drug Administrations,Drug Administrations, Cutaneous,Drug Administrations, Dermal,Drug Skin Administrations,Percutaneous Administrations,Skin Administrations, Drug,Skin Drug Administrations,Transcutaneous Administrations,Transdermal Administrations
D000893 Anti-Inflammatory Agents Substances that reduce or suppress INFLAMMATION. Anti-Inflammatory Agent,Antiinflammatory Agent,Agents, Anti-Inflammatory,Agents, Antiinflammatory,Anti-Inflammatories,Antiinflammatories,Antiinflammatory Agents,Agent, Anti-Inflammatory,Agent, Antiinflammatory,Agents, Anti Inflammatory,Anti Inflammatories,Anti Inflammatory Agent,Anti Inflammatory Agents
D001623 Betamethasone A glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. Its lack of mineralocorticoid properties makes betamethasone particularly suitable for treating cerebral edema and congenital adrenal hyperplasia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p724) Betadexamethasone,Flubenisolone,Celeston,Celestona,Celestone,Cellestoderm
D012869 Skin Absorption Uptake of substances through the SKIN. Absorption, Skin,Intracutaneous Absorption,Intradermal Absorption,Percutaneous Absorption,Transcutaneous Absorption,Transdermal Absorption,Absorption, Intracutaneous,Absorption, Intradermal,Absorption, Percutaneous,Absorption, Transcutaneous,Absorption, Transdermal,Absorptions, Intracutaneous,Absorptions, Intradermal,Absorptions, Percutaneous,Absorptions, Skin,Absorptions, Transcutaneous,Absorptions, Transdermal,Intracutaneous Absorptions,Intradermal Absorptions,Percutaneous Absorptions,Skin Absorptions,Transcutaneous Absorptions,Transdermal Absorptions
D014870 Water Loss, Insensible Loss of water by diffusion through the skin and by evaporation from the respiratory tract. Insensible Water Loss,Insensible Water Losses
D016559 Tacrolimus A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Anhydrous Tacrolimus,FK-506,FK506,FR-900506,Prograf,Prograft,Tacrolimus Anhydrous,Anhydrous, Tacrolimus,FK 506,FR 900506,FR900506,Tacrolimus, Anhydrous

Related Publications

Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
March 2012, Experimental dermatology,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
March 2012, Allergy,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
January 2011, Current problems in dermatology,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
April 2014, The British journal of dermatology,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
January 2014, Frontiers in bioscience (Landmark edition),
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
January 2010, Anais brasileiros de dermatologia,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
May 2024, The Journal of investigative dermatology,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
May 2024, Dermatitis : contact, atopic, occupational, drug,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
June 2022, Clinical and experimental dermatology,
Jens-Michael Jensen, and Stephan Pfeiffer, and Magdalena Witt, and Matthias Bräutigam, and Claudia Neumann, and Michael Weichenthal, and Thomas Schwarz, and Regina Fölster-Holst, and Ehrhardt Proksch
August 2000, Journal of dermatological science,
Copied contents to your clipboard!