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Improvement of skin barrier function during treatment of atopic dermatitis
1Department of Dermatology, University Central Hospital, Helsinki, Finland.
Background:
Active dermatitis causes a disturbance in skin barrier function. This can be evaluated by the measurement of transepidermal water loss (TEWL) and percutaneous absorption of hydrocortisone.
Objective:
The study objective was to evaluate changes in skin barrier function during treatment of atopic dermatitis.
Methods:
Nine patients with widespread atopic dermatitis were studied longitudinally by measuring the severity of the dermatitis and TEWL at intervals of 1 to 3 days. Percutaneous absorption of hydrocortisone was measured at entry and during treatment.
Results:
At entry, both TEWL and percutaneous absorption of hydrocortisone were elevated. Four to six days later, a significant decline was observed in both variables, indicating rapid improvement in skin barrier function. Individual changes in TEWL correlated with the changes in the systemic absorption of hydrocortisone.
Conclusion:
TEWL reflects changes in the systemic absorption of topical hydrocortisone during treatment of atopic dermatitis.