Statin Therapy Has No Significant Effect on Skin Tissue Cholesterol: Results from a Prospective Randomized Trial

Large-scale clinical trials have conclusively demonstrated that lowering serum cholesterol concentrations with statins slows the progression of atherosclerosis and promotes the regression and stabilization of atherosclerotic plaques, thus substantially reducing the rates of major vascular events among a wide range of patients (1)(2)(3).Skin cholesterol (SkC) has previously been reported to be an additional independent marker of cardiovascular risk (4)(5)(6)(7)(8). The skin test is a quantitative interpretation of extracellular epidermal lipids, which are supplied from the circulation by a complex transport mechanism through dermal blood microcapillaries, the endothelial wall, the uppermost layers of the dermis, and the basement membrane, finally reaching the cells of the basal stratum (9). Thus, lipid-lowering therapy might also have an effect on epidermal lipid content.Despite the growing interest in this potential new marker of cardiovascular risk, no study has investigated the effects of statins on SkC concentrations. One aim of the present study was to assess the natural midterm course of SkC concentrations prospectively. In addition, we evaluated the potential influence of statin therapy on SkC concentrations as well as potential differences between atorvastatin and simvastatin in a prospective randomized controlled trial.Consecutive outpatients referred to the department of angiology of a tertiary care university hospital because of suspected vascular disease were eligible for the present prospective trial. Exclusion criteria included ( a ) current lipid-lowering therapy or lipid-lowering therapy within the last year; ( b ) age <18 years; ( c ) pregnancy; ( d ) psoriasis or eczema on either hand; ( e ) recent use (within 24 h before testing) of topical medication, as a cream or lotion, on either hand; ( f ) chronic liver disease or evidence of abnormal liver function (defined as an increase of transaminase activity two times above the upper reference …