Echographic assessment of corticosteroid-induced skin-thinning, including echogenicity measurement.
OBJECTIVE
Skin atrophy is one of the main side effects of long-term topical corticosteroid therapy. It has already been studied through ultrasound skin-thickness measurement. In this study, the quantification of dermal echogenicity was introduced to provide new information on this phenomenon.


METHODS
Skin thinning induced by topical application (without occlusion) of the superpotent corticosteroid clobetasol propionate (0.05% lotion), was assessed by means of ultrasonography in terms of thickness and echogenicity. 15 healthy volunteers were treated for 6 weeks, 1 daily, 5 days a week on the forearms.


RESULTS
The thinning showed a biphasic pattern, with a 1st period of rapid change (about 15% of thinning in a week) followed by a period of slower but significant change. Skin thickness returned to baseline values 3 weeks after the end of treatment. Dermal echogenicity, which represents the mean intensity of the ultrasound signals reflected by the dermis, was found to follow the same variations, increasing strongly during the 1st week, then more slowly. The 2 parameters are correlated and probably reflect the same physiological modifications responsible for skin thinning, i.e., a reduction in glycosaminoglycan synthesis (leading to a drastic fall in dermal water content) and vasoconstriction.


CONCLUSIONS
This sensitive and non invasive method enables us to identify the effects of clobetasol propionate on the healthy dermis in the absence of any clinical signs of thinning.
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Richard
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Duteil
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Poli
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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de Rigal
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Querleux
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Queille-Roussel
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Lévêque
ĽOréal, Advanced Research Laboratories, Aulnay-sous-bois, FranceInternational Center of Dermatological Research, Galderma, Valbonne, FranceDepartment of Dermatology, Hôpital Henri Mondor, Créteil, France.
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Revuz
dermal echogenicity; skin thinning; topical corticosteroid; ultrasound assessment