title: Modulation of epidermal terminal differentiation in patients after long-term topical corticosteroids.
abstract: The expression of the various markers for terminal epidermal differentiation in atrophic skin of patients after long-term topical corticosteroids (TCS) was studied by electron microscopy, immunofluorescence using antibody to profilaggrin/filaggrin (PF/FG), immunoperoxidase staining using antibody to involucrin, and oil red O stain for neural lipids of the stratum corneum. Thirty-nine patients were subdivided into two groups: (A) 19 patients suffering from rebound phenomenon after stopping TCS and (B) 20 patients without rebound phenomenon. Biopsy specimens were taken before ending the use of TCS in both groups. In group A, both the morphological markers (including the different epidermal strata, keratohyalin granules, lamellar granules, and cornified cell envelopes) and the molecular markers (including involucrin, PF/FG, and neutral lipids) of terminal epidermal differentiation were significantly suppressed. On the other hand, the differentiational markers in the atrophic skin of patients without rebound phenomena were only slightly altered. These results suggest that potent TCS not only has antiproliferative actions but also inhibits the differentiation of epidermis, resulting in structural defects in the epidermis, especially the stratum corneum.
authors.affiliation: Department of Dermatology, Kaohsiung Medical College, Taiwan, R.O.C.
authors.forename: H M
authors.initials: HM
authors.lastname: Sheu
authors.forename: C L
authors.initials: CL
authors.lastname: Tai
authors.forename: K W
authors.initials: KW
authors.lastname: Kuo
authors.forename: H S
authors.initials: HS
authors.lastname: Yu
authors.forename: C Y
authors.initials: CY
authors.lastname: Chai
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001284:Atrophy; D002454:Cell Differentiation / Q000187:drug effects; D004817:Epidermis / Q000378:metabolism / Q000648:ultrastructure*; D005260:Female; D000091344:Filaggrin Proteins; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000378:metabolism
chemical_list: D000893:Anti-Inflammatory Agents; C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D005938:Glucocorticoids; D011498:Protein Precursors