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.