scholarly journals Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity

2021 ◽  
Vol 10 (2) ◽  
pp. 359 ◽  
Author(s):  
Trinidad Montero-Vilchez ◽  
María-Victoria Segura-Fernández-Nogueras ◽  
Isabel Pérez-Rodríguez ◽  
Miguel Soler-Gongora ◽  
Antonio Martinez-Lopez ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Water Loss ◽  
Barrier Function ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Diagnostic Tools ◽  
Psoriatic Skin ◽  
Skin Barrier Function ◽  
Healthy Controls

Multiple diagnostic tools are used to evaluate psoriasis and atopic dermatitis (AD) severity, but most of them are based on subjective components. Transepidermal water loss (TEWL) and temperature are skin barrier function parameters that can be objectively measured and could help clinicians to evaluate disease severity accurately. Thus, the aims of this study are: (1) to compare skin barrier function between healthy skin, psoriatic skin and AD skin; and (2) to assess if skin barrier function parameters could predict disease severity. A cross-sectional study was designed, and epidermal barrier function parameters were measured. The study included 314 participants: 157 healthy individuals, 92 psoriatic patients, and 65 atopic dermatitis patients. TEWL was significantly higher, while stratum corneum hydration (SCH) (8.71 vs. 38.43 vs. 44.39 Arbitrary Units (AU)) was lower at psoriatic plaques than at uninvolved psoriatic skin and healthy controls. Patients with both TEWL > 13.85 g·m−2h−1 and temperature > 30.85 °C presented a moderate/severe psoriasis (psoriasis area severity index (PASI) ≥ 7), with a specificity of 76.3%. TEWL (28.68 vs. 13.15 vs. 11.60 g·m−2 h−1) and temperature were significantly higher, while SCH (25.20 vs. 40.95 vs. 50.73 AU) was lower at AD eczematous lesions than uninvolved AD skin and healthy controls. Patients with a temperature > 31.75 °C presented a moderate/severe AD (SCORing Atopic Dermatitis (SCORAD) ≥ 37) with a sensitivity of 81.8%. In conclusion, temperature and TEWL values may help clinicians to determine disease severity and select patients who need intensive treatment.

scholarly journals Changes in nano-mechanical properties of human epidermal cornified cells in children with atopic dermatitis

2020 ◽  
Vol 5 ◽  
pp. 97
Author(s):  
Marek Haftek ◽  
Maeve A McAleer ◽  
Ivone Jakasa ◽  
WH Irwin McLean ◽  
Sanja Kezic ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Atopic Dermatitis ◽  
Elastic Modulus ◽  
Barrier Function ◽  
Degradation Products ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
Healthy Children ◽  
Healthy Controls ◽  
Strongly Correlated

Background: Impaired skin barrier is an important etiological factor in atopic dermatitis (AD). The structural protein filaggrin (FLG) plays a major role in maintenance of the competent skin barrier and its deficiency is associated with enhanced susceptibility to mechanical injury. Here we examined biomechanical characteristics of the corneocytes in children with AD and healthy controls. Methods: We recruited 20 children with AD and 7 healthy children. They were genotyped for filaggrin gene (FLG) loss-of-function mutations. Stratum corneum was collected from clinically unaffected skin by adhesive tapes. Cell stiffness (apparent elastic modulus, Ea) was determined by atomic force microscopy and filaggrin degradation products (NMF) by liquid chromatography. Skin barrier function was assessed through trans-epidermal water loss (TEWL) and disease severity by the SCORing Atopic Dermatitis (SCORAD) tool. Results:  Corneocytes collected from AD patients showed a decreased elastic modulus which was strongly correlated with NMF and TEWL, but not with SCORAD. As compared with healthy controls, AD patients had reduced TEWL and NMF levels regardless of FLG mutations. NMF was strongly correlated with TEWL. Conclusion: Our findings demonstrate that AD patients have decreased corneocyte stiffness which correlates with reduced levels of filaggrin degradation products, NMF and skin barrier function. Altered mechanical properties of the corneocytes likely contribute to the loss of mechanical integrity of the SC and to reduced skin barrier function in AD.

scholarly journals Effects of Cast Immobilisation on Skin Barrier Function

2020 ◽  
Vol 49 (6) ◽  
pp. 354-359
Author(s):  
Chin Yee Woo ◽  
Mark JA Koh ◽  
Winnie KY Fung ◽  
Cheri SH Chan ◽  
Chong Bing Chua ◽  
...  
Keyword(s):  
Stratum Corneum ◽  
Water Loss ◽  
Barrier Function ◽  
Skin Irritation ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Skin Barrier Function ◽  
Hair Density ◽  
Cast Immobilisation ◽  
Volar Surface

Introduction: Cast immobilisation remains the mainstay of treatment for various fractures in paediatric patients, yet patients commonly complain of skin irritation and discomfort. This study aimed to perform a qualitative and quantitative evaluation of the effects of cast immobilisation on the skin of children and adolescents. Materials and Methods: Patients aged 6–17 years of age with a fracture treated in a fiberglass short-arm or short-leg cast were recruited. Transepidermal water loss (TEWL), stratum corneum (SC) hydration, hair density and presence of any skin signs were assessed before and after cast. Patients were required to complete a weekly questionnaire to rate itch, malodour, warmth, and dampness of the skin under the cast. Results: A total of 60 subjects completed the study. Thirty-six patients received a short-arm cast; 24 received a short-leg cast. Upon cast removal, TEWL was significantly increased on the volar surface of the arms and legs (P <0.05), and the dorsal surface of the arm (P <0.05). Likewise, SC hydration was significantly increased at most sites (P <0.05), except the volar surface of the leg (P = 0.513). There was no change in hair density. Throughout the duration of casting, there was an increase in itch and malodour scores. Conclusions: Moderate but significant changes in TEWL, SC hydration and subjective symptoms were observed during the duration of cast immobilisation, demonstrating that cast immobilisation for up to 4 weeks exerts moderate adverse impact on patients’ skin. Further studies to explore the use of better materials for cast immobilisation to improve skin barrier function and overall patient satisfaction are warranted. Ann Acad Med Singapore 2020;49:285–93 Ann Acad Med Singapore 2020;49:354–59 Key words: Cast immobilisation, Transepidermal water loss, Stratum corneum hydration

scholarly journals Transepidermal Water Loss (TEWL) Reflects Skin Barrier Function of Dog

2008 ◽  
Vol 70 (8) ◽  
pp. 841-843 ◽  
Author(s):  
Kenichiro SHIMADA ◽  
Toru YOSHIHARA ◽  
Masahiko YAMAMOTO ◽  
Katsuhiko KONNO ◽  
Yasuyuki MOMOI ◽  
...  
Keyword(s):  
Water Loss ◽  
Barrier Function ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Skin Barrier Function

scholarly journals Transepidermal Water Loss Does Not Correlate with Skin Barrier Function In Vitro

2002 ◽  
Vol 118 (5) ◽  
pp. 871-875 ◽  
Author(s):  
Robert P. Chilcott ◽  
Christopher H. Dalton ◽  
Andrew J. Emmanuel ◽  
Ceri E. Allen ◽  
Simon T. Bradley
Keyword(s):  
Water Loss ◽  
Barrier Function ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Skin Barrier Function

scholarly journals Altered Levels of Sphingosine, Sphinganine and Their Ceramides in Atopic Dermatitis Are Related to Skin Barrier Function, Disease Severity and Local Cytokine Milieu

2020 ◽  
Vol 21 (6) ◽  
pp. 1958 ◽  
Author(s):  
Ruzica Jurakic Toncic ◽  
Ivone Jakasa ◽  
Suzana Ljubojevic Hadzavdic ◽  
Susan MI Goorden ◽  
Karen JM Ghauharali-van der Vlugt ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Barrier Function ◽  
Skin Barrier ◽  
Skin Barrier Function ◽  
Sphingoid Bases ◽  
Lesional Skin ◽  
Cytokine Levels ◽  
Cytokine Milieu ◽  
Local Cytokine

Dysfunctional skin barrier plays a key role in the pathophysiology of atopic dermatitis (AD), a common inflammatory skin disease. Altered composition of ceramides is regarded as a major cause of skin barrier dysfunction, however it is not clear whether these changes are intrinsic or initiated by inflammation and aberrant immune response in AD. This study investigated the levels of free sphingoid bases (SBs) sphingosine and sphinganine and their ceramides and glucosylceramide in the stratum corneum (SC) and related them to skin barrier function, disease severity and local cytokine milieu. Ceramides were measured in healthy skin, and lesional and non-lesional skin of AD patients by a novel method based on deacylation of ceramides which were subsequently determined as corresponding sphingoid bases by using liquid chromatography–tandem mass spectrometry (LC–MS/MS). The cytokine levels were determined by multiplex immunoassay. Atopic skin showed increased levels of most investigated markers, predominantly in lesional skin. The largest difference in respect to healthy skin was found for glucosylceramide with respective median values of 0.23 (IQR 0.18–0.61), 0.56 (IQR 0.32–0.76) and 19.32 (IQR 7.86–27.62) pmol/g protein for healthy, non-lesional and lesional skin. The levels of investigated ceramide markers were correlated with disease severity (scoring atopic dermatitis, SCORAD) and skin barrier function (trans-epidermal water loss, TEWL) and furthermore with cytokines involved in innate, Th-1, and Th-2 immune response. Interestingly, the strongest association with SCORAD was found for sphinganine/sphingosine ratio (r = −0.69, p < 0.001; non-lesional skin), emphasizing the importance of SBs in AD. The highest correlation with TEWL was found for glucosylceramide (r2 = 0.60, p < 0.001), which was investigated for the first time in AD. Findings that the changes in SBs and ceramide levels were predominant in lesional skin and their association with disease severity and cytokine levels suggest an immune-system driven effect. a novel analysis method demonstrates a robust and simple approach that might facilitate wider use of lipid biomarkers in the clinics e.g., to monitor (immune) therapy or dissect disease endotypes.

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