Effect of gentian violet, corticosteroid and tar preparations in Staphylococcus-aureus-colonized atopic eczema.
BACKGROUND
In atopic eczema (AE), skin colonization with Staphylococcus aureus plays a possible role in the pathophysiology of the disease.


METHODS
Thirty-eight patients with AE were screened for their cutaneous colonization with S. aureus. The antibacterial and clinical efficacy of topical therapy with the antiseptic dye gentian violet, a potent glucocorticosteroid or a tar solution (liquor carbonis detergens) was evaluated in vivo in 21 patients with a density of >10(4) CFU/cm(2) and in vitro. Skin sites were treated twice daily for 4 days with the active drug or a corresponding control. Quantification of S. aureus was done daily during therapy as well as 3 days thereafter. The severity of the lesions was rated by a regional SCORAD.


RESULTS
In gentian-violet-treated skin, bacterial density decreased significantly in lesional (p < 0.001) and unaffected skin (p < 0. 001). Bacterial densities did not decrease during therapy with glucocorticosteroid or liquor carbonis detergens but dropped afterwards. All therapeutics reduced the severity score, reduction being greatest for the glucocorticosteroid and lowest for liquor carbonis detergens. In vitro, a high antibactericidal efficacy was demonstrated only for gentian violet.


CONCLUSIONS
Antibacterial therapy with gentian violet not only reduces S. aureus dramatically, but also reduces the severity of the eczema. Reduction of S. aureus after therapy with glucocorticosteroids and LCD seems to be secondary to improvement of the skin condition.
Brockow
K
K
Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Deutschland.
Grabenhorst
P
P
Abeck
D
D
Traupe
B
B
Ring
J
J
Hoppe
U
U
Wolf
F
F
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003033:Coal Tar / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D005260:Female; D005840:Gentian Violet / Q000627:therapeutic use; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012720:Severity of Illness Index; D012867:Skin / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003033:Coal Tar; D005840:Gentian Violet