Ultrasound of Skin in Prednisolone-induced Short-terin Growth Suppression

OBJECTIVE: To assess the thickness of the cutis and subcutis in children with prednisolone-induced knemometric growth suppression. DESIGN: A double blind, placebo-controlled crossover trial with two 7-day treatment periods. PATIENTS: Twenty children with asthma aged 7.7 to 13.8 (mean 10.4) years. INTERVENTIONS: 5 mg prednisolone/day. OUTCOME MEASURES: Lower leg growth rate, thickness of cutis and subcutis and the fraction of low echogenic pixels determined by ultrasound. RESULTS: Mean lower leg growth rate was -0.23 during prednisolone, 0.58 mm/week during placebo treatment (p < 0.01). Mean total thickness of cutis and subcutis over the knee was reduced by 0.28 during prednisolone, increased by 0.07 mm/week during placebo treatment (p = 0.04). Lower leg growth rate was positively correlated to changes in thickness of cutis and subcutis (p = 0.04; r = 0.31). CONCLUSIONS: Reductions in thickness of cutis and subcutis may account for some of the lower leg growth suppression caused by systemic glucocorticoids.