TABLE 2.

Effects of topical corticosteroids on epidermal barrier structure and function

APPLICATION	POSITIVE BARRIER EFFECTS	ADVERSE BARRIER EFFECTS
BETAMETHASONE VALERATE41 LESIONAL SKIN (ATOPIC DERMATITIS)	Normalized expression of filaggrin (producer of natural moisturizing factor, involved in normal epidermal differentiation) Normalized expression of loricin (a protein of cornified envelope, contributes to stratum corneum structural support)	Decreased expression of rate-limited enzymes involved in stratum corneum lipid synthesis Reduced expression of involucrin and proline-rich peptides (involved in binding of ceramides in the stratum corneum)
BETAMETHASONE VALERATE43 LESIONAL SKIN (ATOPIC DERMATITIS)	Decreased transepidermal water loss Increased epidermal hydration Normalized epidermal differentiation	Partially filled lamellar bodies Inconsistent intercellular lipid bilayers