title: Comparison of effects of tacrolimus ointment and mometasone furoate cream on the epidermal barrier of patients with atopic dermatitis.
abstract: BACKGROUND
  The skin barrier plays a crucial role in the pathophysiology of atopic dermatitis. The quality of the skin barrier can be assessed using a new semi-quantitative method to measure intercellular lipid lamellae. This procedure was used to evaluate the influence of the topical application of the calcineurin inhibitor tacrolimus 0.1% ointment (Protopic®) versus mometasone furoate cream (Ecural®) on the quality of the skin barrier.
  
  
  METHODS
  20 adult patients with active atopic dermatitis (SCORAD 10-63) were included in an open, non-interventional study. Lesions on their forearms were treated twice daily over 10 days with either tacrolimus 0.1% ointment or mometasone furoate cream. At the beginning and the end of the treatment period, SCORAD, TEWL and skin hydration were determined and the intercellular lipids were measured using transmission electron microscopy.
  
  
  RESULTS
  The SCORAD improved in both groups nearly to the same extent, whereas TEWL and skin hydration improved significantly only in the tacrolimus group. Using the semi-quantitative analysis of intercellular lipid length per 1,000 nm(2) intercellular space, a twofold increase for mometasone furoate cream and a fourfold increase for tacrolimus 0.1% ointment were determined.
  
  
  CONCLUSIONS
  In addition to its known antiinflammatory effect, tacrolimus 0.1% ointment leads also to a measurable increase of the lipids of the skin barrier in patients with atopic dermatitis, exceeding the effect of mometasone furoate cream.
authors.affiliation: Microscopy Services Dähnhardt GmbH, Flintbek, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Dähnhardt-Pfeiffer
authors.forename: Dorothee
authors.initials: D
authors.lastname: Dähnhardt
authors.forename: Matthias
authors.initials: M
authors.lastname: Buchner
authors.forename: Kersten
authors.initials: K
authors.lastname: Walter
authors.forename: Ehrhardt
authors.initials: E
authors.lastname: Proksch
authors.forename: Regina
authors.initials: R
authors.lastname: Fölster-Holst
mesh_terms: D000287:Administration, Topical; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000473:pathology*; D004817:Epidermis / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D009824:Ointments; D011244:Pregnadienediols / Q000008:administration & dosage*; D012869:Skin Absorption / Q000187:drug effects*; D063465:Skin Cream / Q000008:administration & dosage; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D009824:Ointments; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D016559:Tacrolimus