Modulation of the atopy patch test reaction by topical corticosteroids andtar

Background: Pharmacologic studies in atopic eczema (AE) are difficult to st andardize. Patients with AE differ in the stage of their skin disease (acut e, subacute, chronic). Objective: This study was designed to assess macroscopic and microscopic ef fects of pretreatment with topical glucocorticosteroids (GCSs) and tar on t he atopy patch test (APT) reaction in patients with atopic eczema. Methods: Nonlesional skin of the back of patients with AE (n = 6) was treat ed for 3 weeks at 3 different sites with triamcin-olonacetonide 0.1% in cet amacrogol ointment (GCSs), pix liquida 10% in cetamacrogol ointment (tar), and cetamacrogol ointment (vehicle), respectively. APTs were performed, and biopsy specimens were taken from all these sites (time = 0 and 24 hours) f or immunohistochemical analysis. Results: Treatment with both GCSs and tar was able to reduce the macroscopi c outcome of the APT reaction. Furthermore, both treatment modalities had a n almost equally inhibiting effect on the influx of T cells, eosinophils, a nd CD1(+), RFD1(+), IFN-gamma (+), and IL-4(+) cells, as well as on the per centage of vessels expressing the adhesion molecules vascular cell adhesion molecule 1 and E-selectin in response to epicutaneous aeroallergen challen ge. Conclusion: Although both treatments significantly reduced the various cell ular constituents of allergic inflammation, all cell types remained present . In addition, this study shows that the APT fan be used to evaluate the ef fect of topical antiinflammatory treatments on allergic inflammation in pat ients with AE.