title: Combination therapy improves the recovery of the skin barrier function: an experimental model using a contact allergy patch test combined with TEWL measurements.
abstract: BACKGROUND
  Nickel (Ni) allergic contact dermatitis (ACD) alters the skin barrier.
  
  
  OBJECTIVE
  Our aim was to compare the efficacy of combination therapies on ACD, using a topical corticosteroid and a corneotherapy agent (barrier cream), with that of a single therapy with corticosteroids.
  
  
  METHODS
  On day 1, 3 Ni test patches were applied on each forearm of 14 Ni-patch-test-positive females. Four contained 5% Ni and 2 physiological saline. Either topical corticosteroid or barrier cream were matched with the combination of both products on 3 of the 4 Ni ACD. The fourth was not treated. Clinical scoring, transepidermal water loss (TEWL) and stratum corneum (SC) capacitance were measured before (day 1) and after (days 4-8) ACD.
  
  
  RESULTS
  The combination therapy showed a significant decrease in TEWL values and an increase in SC capacitance.
  
  
  CONCLUSIONS
  Combining a topical corticosteroid with corneotherapy agents prevents the delay in the healing process of skin barrier disruption due to ACD.
authors.affiliation: Department of Dermatology, Vrije Universiteit Brussel, Belgium. jphachem@belcast.be
authors.forename: J P
authors.initials: JP
authors.lastname: Hachem
authors.forename: K
authors.initials: K
authors.lastname: De Paepe
authors.forename: E
authors.initials: E
authors.lastname: Vanpée
authors.forename: L
authors.initials: L
authors.lastname: Kaufman
authors.forename: V
authors.initials: V
authors.lastname: Rogiers
authors.forename: D
authors.initials: D
authors.lastname: Roseeuw
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000481:Allantoin / Q000008:administration & dosage*; D000485:Allergens / Q000009:adverse effects*; D000730:Androstadienes / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D017449:Dermatitis, Allergic Contact / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D005542:Forearm; D005938:Glucocorticoids; D006582:Hexachlorophene / Q000008:administration & dosage*; D006801:Humans; D009532:Nickel / Q000009:adverse effects*; D010328:Patch Tests / Q000379:methods; D013185:Squalene / Q000008:administration & dosage*; D014870:Water Loss, Insensible
chemical_list: D000485:Allergens; D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D004338:Drug Combinations; D005938:Glucocorticoids; C058062:allantoin, hexachlorophene, squalene drug combination; D000481:Allantoin; D009532:Nickel; D013185:Squalene; D000068298:Fluticasone; D006582:Hexachlorophene