Basal Serum Cortisol and Adrenocorticotropic Hormone Levels in Patients with Atopic Dermatitis

Background: Atopic dermatitis (AD) is an inflammatory skin disease with eczematous pruritic lesions.Topical corticosteroids are the most widely used and the mainstay of treatment for AD.There are some studies that percutaneous systemic absorption of topical steroids may occur and lead to suppression of hypothalamic-pituitaryadrenal axis (HPAA).However, almost in all of these studies, "basic" HPAA function (before application of topical steroids) was not evaluated.Aim: The aim of this study was to investigate basal serum cortisol, adrenocorticotropic hormone (ACTH), and IgE levels in patients with AD and their correlation with disease severity.Methods: Levels of basal serum cortisol, ACTH, and IgE were assessed by ELISA in 31 patients with AD and 31 control subjects.Clinical severity of AD was evaluated by the SCORAD (SCORing Atopic Dermatitis) index.Results: Data analysis showed no statistical difference for basal serum cortisol and ACTH levels between two groups.The serum IgE level was significantly higher in AD group (P=0.02).The SCORAD index was correlated with serum IgE level, but not with the basal serum cortisol level and ACTH level.Conclusions: Basal serum cortisol and ACTH levels are normal in AD patients.Serum IgE level is significantly higher in AD patients and correlated with disease severity.