아토피피부염 환자에서 국소 스테로이드 사용에 따른 혈청 스테로이드 농도 측정 = The measurement of serum corticosteroid level in atopic dermatitis patients associated with application of topical corticosteroids

다국어 초록 (Multilingual 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. (Allergy Asthma Respir Dis 2017:5:79-82)

참고문헌 (Reference)

1 Pariser D, "Topical corticosteroids and topical calcineurin inhibitors in the treatment of atopic dermatitis: focus on percutaneous absorption" 16 : 264-273, 2009

2 이진용, "Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea" 대한피부과학회 27 (27): 499-506, 2015

3 Barbarot S, "Therapeutic patient education in children with atopic dermatitis: position paper on objectives and recommendations" 30 : 199-206, 2013

4 Rasmussen JE, "Percutaneous absorption of topically applied triamcinolone in children" 114 : 1165-1167, 1978

5 Turpeinen M, "Percutaneous absorption of hydrocortisone during exacerbation and remission of atopic dermatitis in adults" 68 : 331-335, 1988

6 Billich A, "Percutaneous absorption of drugs used in atopic eczema: pimecrolimus permeates less through skin than corticosteroids and tacrolimus" 269 : 29-35, 2004

7 Zuberbier T, "Patient perspectives on the management of atopic dermatitis" 118 : 226-232, 2006

8 Maibach HI, "Issues in measuring percutaneous absorption of topical corticosteroids" 31 (31): 21-25, 1992

9 Turpeinen M, "Influence of age and severity of dermatitis on the percutaneous absorption of hydrocortisone in children" 118 : 517-522, 1988

10 Kojima R, "Factors associated with steroid phobia in caregivers of children with atopic dermatitis" 30 : 29-35, 2013

11 Tempark T, "Exogenous Cushing's syndrome due to topical corticosteroid application: case report and review literature" 38 : 328-334, 2010

12 Turpeinen M, "Effect of percutaneous absorption of hydrocortisone on adrenocortical responsiveness in infants with severe skin disease" 115 : 475-484, 1986

13 팽기정, "Determination of Corticosteroids in Moisturizers by LC-MS/MS" 사단법인 한국질량분석학회 7 (7): 26-29, 2016

14 Nieman LK, "Consequences of systemic absorption of topical glucocorticoids" 65 : 250-252, 2011

15 Hengge UR, "Adverse effects of topical glucocorticosteroids" 54 : 1-15, 2006