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Effects of a novel formulation of fluocinonide 0.1% cream on skin barrier function in atopic dermatitis.

ABSTRACT: To determine the effect a novel formulation of fluocinonide cream on skin barrier function in subjects with atopic dermatitis.The authors performed an open-label, investigator-blinded, side-by-side, controlled trial examining skin barrier function before and after a two-week course of a class I, super-potent topical steroid.Outpatient university-based dermatology clinic in Portland, OR.Twenty-five subjects aged 12 or older with a diagnosis of moderate, severe, or very severe AD were recruited for this study.Fluocinonide 0.1% cream, a novel formulation of a class I super-potent topical steroid was applied to all affected areas, except a control site, once daily for two weeks or until clear. The control target site was treated with the vehicle once daily.The study's primary outcome was change in skin barrier function as measured by basal transepidermal water loss (TEWL) in acute lesional skin from baseline as measured at two weeks.TEWL readings significantly decreased (reflecting improved barrier function) in both the active and control target sites. The active target site decreased 14.35+/-16 mg/cm2 per hour; 95 percent confidence interval, P<0.001. The control target site decreased 8.75+/-11.80 mg/cm2 per hour in 25 subjects; 95 percent confidence interval, P<0.001. Skin electrical capacitance also improved significantly, reflecting improved stratum corneum hydration with therapy. Pruritus, clinical severity, and quality of life scores all showed significant improvement by the end of the study.The authors have shown that short-term treatment with a novel formulation of 0.1% fluocinonide led to significantly improved barrier function as measured by basal TEWL in subjects with active moderate to severe AD. These data suggest short-term treatment with AD with a super-potent corticosteroid improves skin barrier function.

SUBMITTER: Woods MT

PROVIDER: S-EPMC3156681 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Effects of a novel formulation of fluocinonide 0.1% cream on skin barrier function in atopic dermatitis.

Woods Matthew T MT Brown Peter A PA Baig-Lewis Shahana F SF Simpson Eric L EL

Journal of drugs in dermatology : JDD 20110201 2

<h4>Objective</h4>To determine the effect a novel formulation of fluocinonide cream on skin barrier function in subjects with atopic dermatitis.<h4>Design</h4>The authors performed an open-label, investigator-blinded, side-by-side, controlled trial examining skin barrier function before and after a two-week course of a class I, super-potent topical steroid.<h4>Setting</h4>Outpatient university-based dermatology clinic in Portland, OR.<h4>Subjects</h4>Twenty-five subjects aged 12 or older with a ...[more]

PMID: 21283922

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Project description:Atopic dermatitis (AD) is a widely spread cutaneous chronic disease characterised by sensitive reactions (eg. eczema) to normally innocuous elements. Although relatively little is understood about its underlying mechanisms due to its complexity, skin barrier dysfunction has been recognised as a key factor in the development of AD. Skin barrier homeostasis requires tight control of the activity of proteases, called kallikreins (KLKs), whose activity is regulated by a complex network of protein interactions that remains poorly understood despite its pathological importance. Characteristic symptoms of AD include the outbreak of inflammation triggered by external (eg. mechanical and chemical) stimulus and the persistence and aggravation of inflammation even if the initial stimulus disappears. These characteristic symptoms, together with some experimental data, suggest the presence of positive feedback regulation for KLK activity by inflammatory signals. We developed simple mathematical models for the KLK activation system to study the effects of feedback loops and carried out bifurcation analysis to investigate the model behaviours corresponding to inflammation caused by external stimulus. The model analysis confirmed that the hypothesised core model mechanisms capture the essence of inflammation outbreak by a defective skin barrier. Our models predicted the outbreaks of inflammation at weaker stimulus and its longer persistence in AD patients compared to healthy control. We also proposed a novel quantitative indicator for inflammation level by applying principal component analysis to microarray data. The model analysis reproduced qualitative AD characteristics revealed by this indicator. Our results strongly implicate the presence and importance of feedback mechanisms in KLK activity regulation. We further proposed future experiments that may provide informative data to enhance the system-level understanding on the regulatory mechanisms of skin barrier in AD and healthy individuals.

Dataset Information

Effects of a novel formulation of fluocinonide 0.1% cream on skin barrier function in atopic dermatitis.

Publications

Effects of a novel formulation of fluocinonide 0.1% cream on skin barrier function in atopic dermatitis.

Similar Datasets

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