The early use of local cortisone preparations in dermatologic therapy proved quite disappointing (1, 2). Topical hydrocortisone preparations, however, have been fairly effective in the treatment of certain acute inflammatory dermatoses, particularly those in the eczema group (3-6). The striking therapeutic disparity between these two hormones has suggested one of two explanations: that either there are marked differences in percutaneous absorption of these compounds, or that anti-inflammatory

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... fects depend on hydrocortisone or its metabolites, substances which the skin cannot produce from cortisone. Since the penetration of hydrocortisone-4-C'4 throngh normal human skin had been established by a previous study (7) identical with that now being reported for cortisone-4-C'4, it appeared that an investigation of the percutaneous absorption of cortisone might add further to our knowledge of the physiology and metabolism of these adrenal steroids in the skin. METHOI) The studies were performed on three hospitalized patients at bed rest. Subect * 1, a fifteen-year old girl with idiopathic thoracolnmbar scoliosis and spondylolisthesis, had undergone surgery for spinal fusion. Subject *' 2 was a sixty-six-year old woman with degenerative arthritis of the right hip recently operated on for hip fusion. Subject 3 was a sixteen-year old girl who, like the first patient, had undergone a spinal fusion procedure for progressive idiopathic thoracolumbar scoliosis. All three individuals were otherwise in good health except for subject *' 1 who vas recovering from homologous serum jaundice. This complication had developed one month following blood tranfusion received at the time of surgery, and the study with cortisone -4-C'4 ointment was begun 13 days later when her liver functiou tests were as follows: serum bilirnbin direct 0.79 mgm. %; serum bilirnbin indirect 0.99 mgm. %; alkaline phosphatase 7.6 units %; thymol flocculation 1+; cephalin flocculation negative. The results of liver function studies for subjects 2 and 3 were normal. 7.5 microcuries of cortisone -4-C'4 acetatet weighing 6.30 mgm. and having a specific activity of 0.49pc/m mole were incorporated with 6.27 mgm. of nonradioactive "carrier" cortisone acetate into 0.5 Gm. of a cholesterolized petro-