Influence of a Diester Glucocorticoid Spray on the Cortisol Level and the CCR4+ CD4+ Lymphocytes in Dogs with Atopic Dermatitis: Open Study

This study investigated the influence of 0.00584% hydrocortisone aceponate spray (HCA; Cortavance Virbac SA, Carros, France) on blood serum cortisol levels and peripheral blood CCR4+ CD4+ T-lymphocyte levels in dogs with atopic dermatitis. Patients were randomly divided into group I ( ) and group II ( ). The dogs in group I were sprayed with HCA on the affected skin once a day for three weeks. The dogs in group II were treated once a day for 3 days followed by no treatment for 4 days for a total of three weeks. For the dogs in group I and group II the CADESI-03 scores before and after use of HCA showed significant reduction ( ). The postcortisol level after the use of HCA in group I showed 36.0% decrease and showed significant suppression ( ). By comparison, the use of HCA on group II did not show decrease in postcortisol levels. There was a tendency of suppression for hypothalamus—pituitary gland—adrenal gland system, but it was not serious influence. In addition, there was no influence on peripheral blood CCR4+ CD4+ lymphocytes percentage in dogs in group I after treatment with HCA. 1. Introduction Canine atopic dermatitis is an intractable chronic skin disease, and management requires a combination of many treatments [1]. Treatment generally involves the use of an antifungal drug, an antibiotic, a shampoo therapy, a humidity retention treatment, an anti-inflammatory drug, and/or hyposensitization. The most frequently used therapy is a corticosteroid. Unfortunately there are not many practical guidelines for use of steroid therapy [2] in veterinary medicine, and there are only a few reports about the side effects. The prolongation of steroid treatment can cause atrophy of the skin, ulceration, hair loss, and skin calcification [3], but the adverse reaction we are concerned about most is the influence on hypothalamus—pituitary gland—adrenal gland system [4, 5]. 0.00584% hydrocortisone aceponate spray (HCA; Cortavance Virbac　SA, Carros, France) is different from a conventional steroid, due to the fact that the absence of a halogen at C6, C9, and C21 is associated with better local and systemic tolerance [6, 7]. Double esterification of C21 and C17 enhances penetration of the stratum corneum and ensures specific metabolism in the lower dermis. These actions minimize the effects on hair follicles, dermal fibroblasts, and blood vessels, decreasing the likelihood of local cutaneous and systemic adverse effects [6, 7]. The effectiveness of HCA for treatment of inflammation is proved in former studies [8–10]. The purpose of this study is to confirm the