Short-term glucocorticoid treatment compromises both permeability barrier homeostasis and stratum corneum integrity: inhibition of epidermal lipid synthesis accounts for functional abnormalities.

Prolonged exposure of human epidermis to excess endogenous or exogenous glucocorticoids can result in well-recognized cutaneous abnormalities. Here, we determined whether short-term glucocorticoid treatment would also display adverse effects, specifically on two key epidermal functions, permeability barrier homeostasis and stratum corneum integrity and cohesion, and the basis for such changes. In humans 3 d of treatment with a potent, commonly employed topical glucocorticoid (clobetasol), applied topically, produced a deterioration in barrier homeostasis, characterized by delayed barrier recovery and abnormal stratum corneum integrity (rate of barrier disruption with tape strippings) and stratum corneum cohesion (microg protein removed per stripping).

Do the benefits of varicella vaccination outweigh the long-term risks? A decision-analytic model for policymakers and pediatricians.

Although varicella vaccine is recommended for infants, many physicians and parents have withheld vaccination from infants because of concerns about the vaccine's long-term efficacy. We used a decision-analytic Markov model to examine the effects of decreasing vaccine efficacy on individuals and society. The model incorporated published data on age-specific incidence, morbidity, and mortality rates, as well as data on shifting disease burden from childhood to adulthood as vaccine compliance increases.