Comparison of Skin Hydration Evaluation Sites and Correlations among Skin Hydration, Transepidermal Water Loss, SCORAD Index, Nottingham Eczema Severity Score, and Quality of Life in Patients with Atopic Dermatitis

Hon, Kam‐Lun Ellis; Wong, Kin Hong; Leung, Ting‐Fan; Chow, Chung-Mo; Ng, Pak‐Cheung

doi:10.2165/00128071-200809010-00005

Cited by 91 publications

(73 citation statements)

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“…In 2008, two groups of researchers, Hon et al 60 and Gupta et al, 61 showed a correlation between TEWL and SCORAD in children, proving that there is an association between injury to the skin barrier measured by TEWL and the clinical intensity of the disease.…”

Section: Authorsmentioning

confidence: 99%

Barreira cutânea na dermatite atópica

Addor

Aoki

2010

An. Bras. Dermatol.

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Research about the skin barrier and its properties has increased significantly since the 60s, with studies that indicated its resistance when isolated, as well as its particularities in relation to skin permeability. At the same time, description of Odland bodies helped to understand how stratum corneum stability is maintained. The "brick and mortar" model is the most accepted so far. In this analogy, the corneocytes are the bricks and the intercellular lipids are the mortar. Currently, there is concrete evidence that the stratum corneum is an active metabolic structure that holds adaptive functions, interacting dynamically with the underlying epidermal layers. The skin barrier also plays a role in the inflammatory response through melanocyte activation, angiogenesis, and fibroplasia. The intensity of this response will essentially depend on the severity of the injury. Skin barrier abnormalities in atopic dermatitis are clinically observed by the presence of dry skin, a common and significant symptom which constitutes a diagnostic and monitoring parameter. The stratum corneum hydration level and transepidermal water loss are associated with the level of damage to the barrier, representing biophysical parameters. These parameters help doctors monitor patients in a less invasive and more sensitive manner. Keywords: Dermatitis, atopic; Insensible; Keratinocytes; Water loss Resumo: O estudo da barreira cutânea e de suas propriedades ganhou impulso a partir da década de 60, com estudos que apontaram sua resistência de forma isolada e suas propriedades com relação à permeação cutânea. Paralelamente, a descrição dos corpos de Odland auxiliou a compreensão da manutenção da estabilidade da camada córnea. O modelo brick & mortar, em que os corneócitos são os tijolos e o cimento são os lipídeos intercelulares, é o mais aceito, até o momento. Atualmente, há evidências consistentes de que o estrato córneo é uma estrutura metabolicamente ativa e exerce funções adaptativas. A barreira cutâ-nea também tem um papel na resposta inflamatória, com ativação de melanócitos, angiogênese e fibroplasia, cuja intensidade depende, basicamente, da intensidade da agressão. As anormalidades da barreira cutâ-nea da dermatite atópica são clinicamente observáveis pela presença de pele seca, achado muito frequente e significativo, que constitui parâmetro diagnóstico e de acompanhamento. O grau de hidratação da camada córnea, assim como a perda de água transepidérmica (transepidermal water loss -TEWL), estão relacionados com o grau de dano à barreira, constituindo parâmetros biofísicos que permitem acompanhar os pacientes de maneira não invasiva e com maior grau de sensibilidade. Palavras-chave: Dermatite atópica; Queratinócitos; Perda insensível de água

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Section: Authorsmentioning

confidence: 99%

Barreira cutânea na dermatite atópica

Addor

Aoki

2010

An. Bras. Dermatol.

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“…A modified skin barrier with increased transepidermal water loss and reduced hydration of the skin is a characteristic feature of AD patients, whereupon the extent of barrier dysfunction correlates with AD severity [1] . The epidermis functions both as a physical barrier and as an active immunological organ.…”

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confidence: 99%

Modifications of the Innate Immune System in Atopic Dermatitis

Maintz

Novak²

2011

J Innate Immun

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Atopic dermatitis (AD) is a frequent chronic inflammatory skin disease which is often complicated by recurrent microbial superinfections. Genetically based modifications which might have an impact on the innate immune system, such as impairment of the skin barrier, modifications of pattern recognition receptors, deficiency of antimicrobial peptides, antiviral natural killer cells and plasmacytoid dendritic cells, facilitate the entry of allergens and infectious microbes into the skin, where they encounter immunocompetent cells. The micromilieu in the skin of AD patients further potentiates dysfunctions of the innate immune system, leading to a vicious circle promoting the disease. This article provides an overview of modifications of the innate immune system in AD.

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“…Environmental allergens' penetration through the skin is facilitated by the skin barrier impairment what causes xerosis and transepidermal water loss (TEWL) increase [2][3][4][5]. As AD is a chronic disease, there are many factors responsible for exacerbations during the course of the disease, including stress.…”

Section: Introductionmentioning

confidence: 99%

“…It can cause some psychological disturbances, such as stigmatization, discrimination and social isolation. Affected individuals have been reported to suffer from anxiety, emotional excitability and depression [4,[9][10][11][12]. Health-related quality of life (HRQoL) is correlated with the disease duration: the longer the disease duration, the lower HRQoL in allergo-dermatological patients is [13].…”

Section: Introductionmentioning

confidence: 99%

Psychological stress and transepidermal water loss in atopic dermatitis: preliminary results

Kępska¹,

Haftek²,

Nosbaum³

et al. 2012

pdia

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A Ad dd dr re es ss s f fo or r c co or rr re es sp po on nd de en nc ce e: : Prof. Anna Zalewska-Janowska MD, PhD, Department of Psychodermatology, Chair of Clinical Immunology and Microbiology, Medical University of Lodz, 251 Pomorska, Poland, phone: +48 42 Original paper A b s t r a c t I In nt tr ro od du uc ct ti io on n: : Atopic dermatitis (AD) is an inflammatory skin disease in which activation of specific T cells directed towards environmental allergens plays an important role. Environmental allergens' penetration through the skin is facilitated by the skin barrier impairment what causes xerosis and transepidermal water loss (TEWL) increase. As AD is a chronic disease, there are many factors responsible for exacerbations during the course of the disease, including environmental stress. A Ai im m: : Evaluation of the correlation between the level of psychological stress and epidermal barrier function in AD patients. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : Eight AD patients were included in the study during which two consultations were performed in one month's time. During each visit patients completed psychological questionnaires and had TEWL of uninvolved skin measured. The TEWL was also evaluated before and after the educational session which took place during the first visit. R Re es su ul lt ts s: : The study did not show any statistically significant correlation between the level of psychological stress, epidermal barrier function (measured by TEWL) and AD severity both at the beginning of the study (before and after the educational session) and a month later (all p > 0.05). C Co on nc cl lu us si io on ns s: : Negative observations could result from a small number of participants and a short follow-up period. However, consecutive studies excluding these limitations may play an important role in understanding the influence of stress on the skin barrier in atopic dermatitis and have reliable clinical implications. K Ke ey y w wo or rd ds s: : atopic dermatitis, transepidermal water loss, stress, education, psychodermatology.

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Comparison of Skin Hydration Evaluation Sites and Correlations among Skin Hydration, Transepidermal Water Loss, SCORAD Index, Nottingham Eczema Severity Score, and Quality of Life in Patients with Atopic Dermatitis

Abstract: In AD research, three sites on the forearm appear to be convenient for determination of SH and TEWL. This is the first report to demonstrate that significant correlations are obtained among acute and chronic scores of AD disease severity, quality of life, and the bioengineering parameters.

Cited by 91 publications

References 23 publications

Barreira cutânea na dermatite atópica

Barreira cutânea na dermatite atópica

Modifications of the Innate Immune System in Atopic Dermatitis

Psychological stress and transepidermal water loss in atopic dermatitis: preliminary results

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