KNEMOMETRY IN CHILDREN WITH ATOPIC-DERMATITIS TREATED WITH TOPICAL GLUCOCORTICOIDS

Recently the knemometer, a lower leg length measuring device, has been introduced for sensitive assessment of systemic activity of exogeneou s glucocorticoids in children. The aim of this study was to assess by means of knemometry whether the topical glucocorticoid budesonide affe cts short-term growth in children with atopic dermatitis. Fourteen chi ldren 5 to 12 years old were studied in an open longitudinal trial wit h three periods of 2 weeks duration. In periods 1 (run-in) and 3 (run- out), the children were treated with emollient. In period 2, budesonid e cream 0.025% was followed by emollient twice daily to all of the bod y except the face. Eczema was evaluated according to a score based on extent and activity, Knemometry was performed twice weekly. Compared t o the run-in and run-out periods the mean growth rate during budesonid e treatment was reduced by 0.11 mm/wk (p > .05) and 0.40 mm/wk (p < .0 5), respectively. The mean growth rate during run-out was increased by 0.29 mm/wk as compared to run-in (p < .05). Compared to run-in the me an severity indices during budesonide treatment and run-out were reduc ed by 1.55 (p < .05) and 1.55 points (p < .05), respectively. The conc omittant variations in lower leg growth rate and disease activity sugg est that short-term treatment with topical glucocorticoids may provide a better growth potential during the weeks after withdrawal of the tr eatment. Whether this is due to improved disease control needs further study. Being a noninvasive method, knemometry may be useful for compa ring different topical glucocorticoids and administration regimens in children in whom vasoconstrictor assays are difficult.