Quantification of Corticosteroid-Induced Skin Vasoconstriction: Visual Ranking, Chromameter Measurement or Digital Imaging Analysis

Abstract

Topical corticosteroid formulations have been evaluated by visual grading protocols for many years. Toward a more objective methodology, several instrumental methods have been evaluated for applicability in quantifying the vasoconstriction side-effect that follows corticosteroid application to the skin. Although the chromameter has been adopted by regulatory bodies throughout the world as the current standard for topical bioequivalence determinations, there is considerable criticism of this instrument from several quarters. A preliminary comparison reported here indicates that digital image analysis provides statistically significant results that are similar to those obtained by visual assessment techniques, and shows considerably greater precision than that obtained by the chromameter. Continued evaluation of objective assessment techniques, such as digital imaging, and continued modernisation of regulatory bioequivalence requirements will assist in protecting patients and optimising clinical results.

Time of Erythema Onset after Application of Methyl Nicotinate Ointments as Response Parameter: Influence of Penetration Kinetics and Enhancing Agents

“…With fl ux measurements, an EF (equation 4) for LMO of 1.5 was found by Leopold and Lippold [25] . However, this factor is rather small and the enhancing effects observed with this vehicle could not be confi rmed in the present study because of the large standard deviations as a result of the interindividual differences in erythema response [26,27] . Compared to infi nite dose conditions, percutaneous drug penetration under fi nite dose conditions is characterized by an exponential curve profi le.…”

Evaluation of the atrophogenic potential of hydrocortisone 1% cream and pimecrolimus 1% cream in uninvolved forehead skin of patients with atopic dermatitis using optical coherence tomography

“…Meanwhile, as one of the target genes of b-catenin, Tbx3 is directly regulated by b-catenin (9) and it can prevent mouse embryonic fibroblasts from senescence (10). Moreover, previous studies showed that b-catenin directly repressed the expression of p16 INK4a (11), which is a biomarker and effector of mammalian aging (12), by binding to its promoter (11). More importantly, recent study showed that loss of b-catenin can reduce the activity of FoxO3a and the association of b-catenin and FoxO3a increased …”

“…Histopathologically, a reduced thickness of the epidermis with decreased size of keratinocytes (5,8), a reduced number of fibroblasts (9) and a diminution of stratum corneum intercellular lipid lamellae (10) can be seen. Factors that determine the atrophogenic potential of a given TCS are its potency, duration and frequency of application, chemical formulation and further unknown factors (11). The TCS-treated body site is also an important factor contributing to the development of skin atrophy.…”

Test systems for the determination of glucocorticoid receptor ligand induced skin atrophy

“…The vasoconstriction may be quantified by a dermoscop, 46 by a chromameter or by digital image analysis. 47 Whereas this method is appropriate for the characterization of classical GCs, it may not be appropriate for novel GR agonists with dissociation between effects and side effects, since the assay just measures the potency of GCs. However, several methods exist to measure the thinning of the skin directly, e.g., confocal laser microscopy, micrometer screw gauge and ultrasound.…”