Allergy Asthma Respir Dis.  2017 Mar;5(2):79-82. 10.4168/aard.2017.5.2.79.

The measurement of serum corticosteroid level in atopic dermatitis patients associated with application of topical corticosteroids

• Kang HG
• Lee SA
• Kim HJ
• Yum HY

• KMID: 2392378
• DOI: http://doi.org/10.4168/aard.2017.5.2.79

Abstract

PURPOSE
Most of the atopic dermatitis (AD) patients and their parents refuse topical treatment because of concern about generalized side effect due to systemic absorption of topical corticosteroids. Therefore, a large number of studies reported difficulty in properly controlling in AD. However, investigations of the percutaneous absorption of topical corticosteroids are still insufficient.
METHODS
One hundred nine patients who visited our atopy clinic and diagnosed as AD by a physician from January 2005 to January 2012 were enrolled. We examined serum corticosteroid (clobetasol propionate, hydrocortisone) level by liquid chromatography (LC) coupled with a tandem mass spectrometric (MS/MS) method.
RESULTS
We developed the LC-MS/MS method to determine corticosteroids (clobetasol propionate, hydrocortisone) in sera of AD patients. Also, we confirmed precision, accuracy, limit of detection, limit of quantification, absolute recovery, and relative recovery of the experimental methods. We could not detect clobetasol propionate or hydrocortisone in sera of 109 AD patients using the newly developed LC-MS/MS method.
CONCLUSION
Regardless of age, the severity and illness duration of AD, clobetasol and hydrocortisone were not detected in sera. Although there are many other factors of determining systemic absorption of topical medications, our results showed that topical corticosteroids applied for several years in AD patients may be under the limit of detection in their sera by the LC-MS/MS method.

Keyword

Atopic dermatitis, Steroids; Skin absorption

MeSH Terms

Absorption, Physiological
Adrenal Cortex Hormones*
Chromatography, Liquid
Clobetasol
Dermatitis, Atopic*
Diethylpropion
Humans
Hydrocortisone
Limit of Detection
Methods
Parents
Skin Absorption
Adrenal Cortex Hormones
Clobetasol
Diethylpropion
Hydrocortisone

Figure

• 

  Fig. 1. Calibration of analytical clobetasol propionate (A), hydrocortisone (B).

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