Ultrasound of skin in prednisolone-induced short-term growth suppression

Area of Science:

• Pediatric endocrinology
• Dermatology
• Pharmacology

Background:

• Systemic glucocorticoids, like prednisolone, are widely used for pediatric asthma.
• Knemometric growth suppression is a known side effect of long-term corticosteroid use in children.
• The precise mechanisms underlying glucocorticoid-induced growth suppression require further elucidation.

Purpose of the Study:

• To investigate the effect of short-term prednisolone administration on the thickness of the cutis and subcutis in children.
• To determine if changes in skin thickness correlate with reduced lower leg growth rate.

Main Methods:

• A double-blind, placebo-controlled crossover trial involving 20 children with asthma (aged 7.7-13.8 years).
• Participants received 5 mg of prednisolone daily for 7 days, followed by a placebo period, or vice versa.
• Ultrasound was used to measure lower leg growth rate and the thickness of the cutis and subcutis.

Main Results:

• Prednisolone treatment significantly reduced the mean lower leg growth rate compared to placebo (-0.23 vs. 0.58 mm/week, p < 0.01).
• The total thickness of the cutis and subcutis over the knee was reduced during prednisolone treatment (-0.28 mm/week) compared to an increase during placebo (0.07 mm/week, p = 0.04).
• A positive correlation was observed between lower leg growth rate and changes in cutis and subcutis thickness (p = 0.04; r = 0.31).

Conclusions:

• Short-term systemic glucocorticoid use, specifically prednisolone, leads to a reduction in skin thickness (cutis and subcutis).
• This decrease in skin thickness may be a contributing factor to the observed knemometric growth suppression in children treated with systemic glucocorticoids.