Atrophy is the most common adverse effect of topical corticosteroids. The objective of this study was to determine whether atrophogenicity of a potent steroid could be demonstrated in a 3-week period of open application using non-invasive bioengineering methods.Methods:
Volar forearms were treated twice daily for 3 weeks with clobetasol propionate cream. The following methods were used: 1) B-scan ultrasound; 2) Silflo-replicas for microtopography; 3) scanning electron microscopy; 4) Cutometer for biomechanical assessments; 5) colorimetry for measuring skin color; 6) evaporimetry for transepidermal water loss; 7) polarized light photos; 8) sticky slides for corneocyte sizing; 9) D'Squames for estimating scaling; and 10) biopsies for histologic evaluation of atrophy.Results:
After only 1 week, Silflo-replica showed that glyphic patterns had been partially obliterated. At the same time, ultrasound scans showed dermal thinning, which increased over the 3-week period. Extensibility by Cutometer decreased steadily during the treatment. Image analysis of D'Squames revealed an increase in scaliness. Evaporimetry showed an increase in transepidermal water loss. Atrophy was confirmed by histology.Conclusion:
The use of non-invasive bioengineering techniques provides a powerful tool to monitor atrophogenicity in a short period of open applications.