Assessment of Topical Corticosteroid Activity on Experimentally Induced Contact Dermatitis: Echographic Evaluation with Binary Transformation and Image Analysis

Seidenari, Stefania; Nardo, Anna Di; Giannetti, Alberto

doi:10.1159/000211092

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…Contrasting to studies on corticosteroid pretreatment prior to patch testing, there are several studies of repetitive topical application of corticosteroids on already‐formed nickel patch test reactions. These studies show that at least potent corticosteroids suppress the reactions when used repeatedly (10–12). The reason why we saw no effect in this study may be that we used single doses of corticosteroids.…”

Section: Discussionmentioning

confidence: 85%

Single doses of local betamethasone do not suppress allergic patch test reactions to nickel sulfate

et al. 2004

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Topical corticosteroids are usually banned on test areas prior to patch testing. The previous literature on the effect of topical corticosteroids is conflicting. Patients allergic to nickel sulfate were patch tested on 4 sites with nickel on day (D) 0. Intracutaneous betamethasone was injected to test sites on D-1, D0 and D1. NaCl injection on D-1 was control. The patch test reactions were evaluated clinically and with laser Doppler. There were no differences in patch test reaction intensities on sites treated with intracutaneous betamethasone as compared to control. A single local dose of potent corticosteroid does not suppress allergic patch reactions to nickel. The current practice of avoiding topical corticosteroid use prior to patch testing should be re-evaluated.

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Section: Discussionmentioning

confidence: 85%

Single doses of local betamethasone do not suppress allergic patch test reactions to nickel sulfate

et al. 2004

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“…De Lacharriere et al (6), Seidenari et al (8,10) and Di Nardo et al (9) compared the effect of corticosteroid to sensitized, untreated skin. They did not include a vehicle control.…”

Section: Discussionmentioning

confidence: 99%

“…Echographic evaluation assumes that increased inflammation and edema will result in increased skin thickness and hypoechogenic area (8,10). Accordingly, the decrease should be positively correlated with the potency of corticosteroid tested.…”

Section: Discussionmentioning

confidence: 99%

An overview of the efficacy of topical corticosteroids in experimental human nickel contact dermatitis

Levin

Maibach

2000

Contact Dermatitis

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We review controlled trials of corticosteroid effect in experimentally elicited acute nickel contact dermatitis in man, in the hope of clarifying optimal efficacy for clinical use. To maximize discrimination and objectivity, we focus on data with 1 well-characterized allergen, nickel, in studies utilizing bioengineering documentation. Higher potency corticosteroids are effective (unlike in experimental irritant contact dermatitis), but optimum schedules still require definition.Key words: allergic contact dermatitis; corticosteroids; man; colorimetry; echography; laser Doppler flowmetry; transepidermal water loss; bioengineering methods; nickel. C Munksgaard, 2000. Accepted for publication 24 May 2000Allergic contact dermatitis (ACD) is an inflammatory disease for which topical corticosteroid therapy is widely utilized. Corticosteroids inhibit antigen-specific activation and proliferation of lymphocytes although their exact mechanism of action remains unclear (1, 2). We review studies that utilized bioengineering techniques to evaluate the efficacy of topical corticosteroid in human experimental nickel contact dermatitis, in the hope that these highly controlled experiments might provide insight into optimum therapy.Application of allergen in sensitized patients elicits a standardized allergic contact dermatitis. Bioengineering instrumentation, such as laser Doppler flowmetry (LDF), colorimetry and echography, is useful in quantifying the skin's allergic response. LDF evaluates the intensity of the inflammatory reaction (3). Colorimetry assesses the blanching effect of corticosteroids (4). Echography evaluates edema and inflammation (5). OverviewDe Lacharriere et al. studied the effects of clobetasol propionate 0.05%, hydrocortisone 1% and an emulsion control on experimentally elicited nickel ACD in 10 nickel-allergic patients (6). ACD was elicited by 2-day (D) patch test application of 5% NiSO 4 to the upper back. 1D following removal of nickel patches, the corticosteroids were occlusively applied for 6 h, evaluation of their efficacy occurring upon corticosteroid patch removal and again 18 h later. The corticosteroids produced a significant decrease in LDF (as well as an increase in transcutaneous pressure of oxygen) when compared to involved skin. As this was an abstract only, we do not know if they could distinguish between the compounds; this abstract also did not include the mass per unit area of corticosteroid applied.Queille-Roussel et al. (7) investigated the efficacy of clobetasol propionate 0.05% cream, hydrocortisone 1% cream and a cream vehicle on ACD,elicited by a 2-D patch application of 5% NiSO 4 on the lower back of 12 nickel-sensitive volunteers. Open application of 26 mg/cm 2 of corticosteroids 2¿ daily for 4D (D 3-6) and 1¿ on the morning of D7 followed nickel patch removal. The effect of corticosteroids was evaluated on the evening of D7. Clobetasol propionate 0.05% cream significantly decreased LDF, colorimetry and visual score values, when compared with untreated skin

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“…These problems have been partially solved by carrying out both clinical evaluation and instrumental assessment [10,15].…”

Section: Discussionmentioning

confidence: 99%

“…In general, the rank order, as evaluated by this method, corresponded to the internationally used classification of clinical potency of eorticosteroids [12,13], Recently, we described an echographic method for evaluating the intensity of patch test responses based on image processing of 20 MHz B scan recordings, enabling the determination of the amount of low reflecting amplitude echoes at positive patch test sites [14]. This method has been employed for objective assessment of the inhibition of patch test reactions after pharmacological treatment [15]. Our study aimed at determining the anti-inflammatory activity of methylprednisolone aceponate {MPA), a non-halogenated esterified molecule, using the echographic evaluation of the inhibition of experimentally induced allergic reactions in nickel sensitized subjects, and comparing its efficacy to that of other topical corticosteroids of known potency.…”

Section: Introductionmentioning

confidence: 99%

B‐Scanning assessment of the anti‐inflammatory activity of methylprednisolone aceponate on experimentally induced allergic reactions

Seidenari¹,

Nardo²,

Giannetti³

1994

Acad Dermatol Venereol

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BackgroundThe inhibitory activity of methylprednisolone aceponate (MPA) on experimentally induced allergic reactions was assessed by an cchographic method employing a B-scanner and a dedicated software, and compared to the effects of corticosteroids of known potency.Material and methods Experimental lesions, which were induced by patch testing 12 sensitized subjects with 5% nickel sulfate (pet.), were treated with two medications of different steroids (clobetasol propionate, fluocinolone acetonide, clobetasone butyrate., and methylprednisolone aceponate), performed 16 and 40 h after the application of the nickel patch tests. Clinical and echographic evaluations were carried out at the beginning of the experiment, and 64 hours after the induction of the reactions. Values of skin thickness and of extension of hypo-reflecting dermal areas were determined by image processing on echographic recordings.Results Rank order of the potency of the tested cortieosteroids, as evaluated by echography, was the same as the one obtained by visual scoring. MPA proved to be less effective than clobetasol propionate, more effective than clobetasone butyrate, and equally as effective as fluocinolone acetonide.Conclusion This experiment indieated MPA can be considered a potent steroid.

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Assessment of Topical Corticosteroid Activity on Experimentally Induced Contact Dermatitis: Echographic Evaluation with Binary Transformation and Image Analysis

Cited by 17 publications

References 14 publications

Single doses of local betamethasone do not suppress allergic patch test reactions to nickel sulfate

Single doses of local betamethasone do not suppress allergic patch test reactions to nickel sulfate

An overview of the efficacy of topical corticosteroids in experimental human nickel contact dermatitis

B‐Scanning assessment of the anti‐inflammatory activity of methylprednisolone aceponate on experimentally induced allergic reactions

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