Background: The ultraviolet (UV) erythema test is one of the most frequently used methods to investigate the anti-inflammatory potency of topical dermatological preparations in vivo. Methods: The following questions were addressed in four separate studies with healthy persons (skin types 2 and 3): (1) the optimal localization was determined by comparing light scales on the back, buttocks and volar forearms; (2) the optimal UV-B dose was determined by comparing the 1-fold, 1.5-fold and 2-fold minimal erythema doses (MEDs); (3) hydrocortisone and prednicarbate were evaluated as positive controls, and a sample size calculation was performed, and (4) betamethasone valerate and pimecrolimus were tested as further positive controls in the optimized study model. Results: The back proved to be the best localization for the UV erythema test. It showed a good correlation between the light scale and the test areas. The 1.5-fold MED was the best irradiation dose. In contrast to prednicarbate and betamethasone valerate, hydrocortisone was a rather weak positive control. However, when the sample size was ≧40 subjects, significant results were also obtained with hydrocortisone. Pimecrolimus was not effective in the UV erythema test. Conclusions: The UV erythema test should be performed on the back with at least 40 subjects using the 1.5-fold MED. It may be useful to include a potent corticosteroid, such as prednicarbate or betamethasone valerate, in addition to hydrocortisone. The UV erythema test seems to be suitable only for substances with corticosteroid-like effects, since in this test model the calcineurin inhibitor pimecrolimus was not effective.

Background:Aloe vera is a natural product that is frequently used in soothing skin care products such as aftersun lotions. In the present study we aimed to explore the anti-inflammatory potential of a highly concentrated A. vera gel in the UV erythema test in vivo. Methods: 40 volunteers with skin types II and III were included in the randomized, double-blind, placebo-controlled, phase III monocenter study. Test areas on the back were irradiated with the 1.5-fold minimal erythema dose of UVB. Subsequently, the test areas were treated occlusively on 2 subsequent days with A. vera gel (97.5%), the positive controls (0.25% prednicarbate, 1% hydrocortisone in placebo gel and 1% hydrocortisone cream) and a placebo gel. Erythema values were determined photometrically after 24 and 48 h. Results:A. vera gel (97.5%) significantly reduced UV-induced erythema after 48 h, being superior to 1% hydrocortisone in placebo gel. In contrast, 1% hydrocortisone in cream was more efficient than A. vera gel. Conclusions: In this study after 48 h the A. vera gel (97.5%) displayed some anti-inflammatory effects superior to those of 1% hydrocortisone in placebo gel. The A. vera gel tested here might be useful in the topical treatment of inflammatory skin conditions such as UV-induced erythema.

The leaves of sage (Salvia officinalis L., Lamiaceae) contain high amounts of phenolic diterpenes such as carnosol and carnosic acid. These compounds display antioxidant and anti-inflammatory effects in vitro. Here, we have investigated the anti-inflammatory potency of a sage extract (SE) rich in phenolic diterpenes in vivo using the ultraviolet (UV) erythema test. In a prospective randomised double-blind placebo-controlled study, test areas on the backs of 40 healthy volunteers were irradiated with the 1.5-fold minimal erythema dose. Subsequently, the test areas were treated occlusively with 2% SE in a hydrophilic ointment, compared to 1% hydrocortisone and 0.1% betamethasone as positive controls, and the vehicle alone as placebo. Erythema values were measured photometrically prior to irradiation and after 48 hours. Compared to placebo, SE significantly reduced the ultraviolet-induced erythema, to a similar extent as hydrocortisone. These data suggest that SE might be useful in the topical treatment of inflammatory skin diseases.

A 47-year-old Turkish woman developed an erythematous scaly plaque on her thigh over 20 years. Cutaneous sarcoidosis had been diagnosed eight years previously on a skin biopsy. We confirmed Mycobacterium tuberculosis infection by polymerase chain reaction and cultivation of the causative organism from lesional skin. After several months of antituberculous treatment with isoniazid, rifampicin, ethambutol and pyrazinamide, the lesion resolved.