Effects Of Salicylic Acid On Skin Barrier And Its Clinical Response In Atopic Dermatitis

Objective: To investigate the effects of salicylic acid on skin barrier function andeffects of salicylic acid combined with Compound Flumetasone Ointment (0.02%Flumetasone and3%salicylic acid)on treating Atopic Dermatitis(AD).Methods: Sixty five AD patients (31males and33females) at the age of18to58years were involved in present study. Lesions of AD patients on bilateralis body withsimilar size and severity were topically treated with Compound Flumetasone Ointment,0.02%Flumetasone ointment,3%salicylic acid ointment or vehicle, respectively;apparently normal skin of AD patients on bilateralis body were topically treated with3%salicylic acid ointment or vehicle. All these ointments were treated2times everyday for3weeks. Transepidermal water loss (TEWL) was tested before treatment and atthe end of week1, week2and week3. The symptoms and sighs scores were valuedbefore and after treatment. Meanwhile, bilateralis volar forearms skin in30healthycontrols was treated with3%salicylic acid ointment or vehicle twice a day for3weeks.And TEWL was tested before treatment and at the end of week1and week3.Results: In healthy control, TEWL value showed no significant difference betweensalicylic acid group and vehicle group. In the lesions skin, TEWL values in CompoundFlumetasone group on0,1,2,3weeks were34.26±20.82，22.38±16.16，17.04±12.74，15.34±13.13, respectively. The decrease was more significant than that inFlumetasone group (33.02±16.71，24.63±17.08，20.37±9.53，19.06±9.17,respectively；two-way ANOVA, p<0.05); TEWL value in salicylic acid group on0,1,2,3weeks were34.16±18.03，26.49±8.59，21.91±8.46，21.20±9.38, respectively.The decrease was more significant than that in vehicle group (33.81±17.11，29.80±12.48，26.16±8.31，25.52±6.05, respectively；two-way ANOVA, p<0.01or p<0.05);in non-lesion skin, TEWL value in salicylic acid group on2,3weeks decreased from17.26±12.10to11.69±6.63and11.08±5.22. The decrease was more significant than that in vehicle group (from16.63±11.76to14.10±7.99and13.65±7.61；two-wayANOVA, p<0.05). The decrease of symptoms and sighs scores in CompoundFlumetasone group (9.27±4.05) were significantly larger than decrease in Flumetasonegroup (7.73±3.99)(p<0.05). And the cure rate (53.1%) and effective rate (83.1%) inCompound Flumetasone group were significantly higher than that in Flumetasone group(cure rate34.4%, Χ2=4.571, p<0.05; effective rate64.1%, Χ2=6.900, p<0.01).Conclusions: The response of AD patients treating with Compound FlumetasoneOintment was better than that of patients treating with Flumetasone Ointment, and3%salicylic acid improved the skin barrier in AD patients.