title: Synergistic effects of oral nonsteroidal drugs and topical corticosteroids in the therapy of sunburn in humans.
abstract: The ability to modify skin injury due to ultraviolet light (UVB) by the nonsteroidal anti-inflammatory drugs (NSAIDs) oral ibuprofen (IB) or indomethacin (IN) plus topical betamethasone dipropionate (BD) was studied in 24 subjects in this open-label, four-way, cross-over trial. All subjects received UVB at weekly intervals: group 1 was randomized to IB, BD, IB + BD or control, and group 2 to IN, BD, IN + BD or control. Oral medications were given prior to and after exposure to UVB, but BD was applied only afterwards. The skin response to UVB [erythema and increased skin blood flow (SBF)] was measured serially for 96 h. A skin biopsy was taken at 24 h after each dosing with UVB. At maximum erythema (8-12 h after UVB), the following approximate reductions in SBF (compared to control responses) were noted: 42-58% for combination therapies, 33-40% for IB or IN alone, and 17% for BD alone. SBF tended to equalize across all treatments by 24 h and remained until 96 h. Skin biopsy results were consistent with the noninvasive findings. Thus, we observed a synergistic effect of reduction of UVB-induced erythema and SBF with combinations of oral NSAIDs and topical corticosteroids. This study could have implications for the therapy of sunburn in humans.
authors.affiliation: Upjohn Research Clinics, Kalamazoo, MI 49007.
authors.forename: G S
authors.initials: GS
authors.lastname: Hughes
authors.forename: S F
authors.initials: SF
authors.lastname: Francom
authors.forename: L K
authors.initials: LK
authors.lastname: Means
authors.forename: D F
authors.initials: DF
authors.lastname: Bohan
authors.forename: C
authors.initials: C
authors.lastname: Caruana
authors.forename: M
authors.initials: M
authors.lastname: Holland
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001623:Betamethasone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001706:Biopsy; D001783:Blood Flow Velocity / Q000187:drug effects; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012867:Skin / Q000098:blood supply / Q000473:pathology; D013471:Sunburn / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D007052:Ibuprofen; D007213:Indomethacin