METHODS: Fifty patients with stasis eczema were randomized to receive either a topical emollient or placebo for 6 weeks. Skin parameters, including melanin content, hydration, and transepidermal water loss, were assessed using Tewameter. Plasma levels of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), anti-inflammatory cytokine IL-10, and matrix metalloproteinases (MMPs: MMP-1, MMP-2, MMP-3, and MMP-9) were measured using enzyme-linked immunosorbent assay at baseline and after treatment.
RESULTS: Baseline clinical assessment demonstrated a high prevalence of comorbidities, particularly hypertension, chronic venous insufficiency, diabetes mellitus, and dyslipidemia. No statistically significant changes were observed in skin barrier parameters or circulating cytokine levels following 6 weeks of treatment. MMP-1 and MMP-2 concentrations remained stable in both groups. However, posttreatment MMP-3 levels were significantly higher in the emollient group than in the placebo group, while MMP-9 demonstrated a significant within-group change in the placebo group only.
CONCLUSION: Short-term use of a topical emollient may help maintain skin barrier function and systemic inflammatory status but does not appear to produce clinically meaningful improvements in most skin barriers or inflammatory parameters, despite isolated significant changes observed in specific MMP biomarkers in patients with chronic stasis eczema. These findings highlight the complexity of disease management in this population and suggest that longer treatment durations, larger sample sizes, consideration and statistical adjustment for baseline comorbidities are warranted in future studies.