Reliability of the skin blotting method when used on the elderly

Abstract

The aim of this study was to compare protein secretion on intact skin of extremities and verify the relationship between the marker proteins on abdominal skin and systemic factors using skin blotting. A cross-sectional study was conducted among elderly patients aged 65 years and older (N = 73) at a long-term medical facility in Japan. Skin blotting was performed on the right and left forearms, right and left lower legs, and abdomen. Pearson's correlations and Bland-Altman plots were utilised for comparing the protein secretion from the skin between the right or left forearms or lower legs. Multiple regression analysis was applied to determine the relationship between intensity levels of 3 proteins on the abdominal skin and the systemic factors. Bland-Altman plots demonstrated that there was no significant difference between right and left secretion levels on the forearms and lower legs among 3 proteins. Multiple regression analysis showed that age and antiplatelet use was positively associated with decreased collagen type IV and increased matrix metalloproteinase 2 levels, respectively. Our findings suggested that collecting samples from either the right or the left skin would be sufficient if skin properties between arms and legs are evaluated using skin blotting.

Sampling the skin surface chemistry for diagnosis and prognosis

“…Koyano et al verified no difference in the bilateral protein secretion on the intact skin of extremities for type IV collagen (COL-4), matrix metalloproteinase-2 (MMP-2), and tumour necrosis factor-alpha (TNF-α). 28 The paper demonstrated that systemic (e.g., age) and local factors (e.g. environmental exposures) influenced the intensity levels of COL4 and MMP-2 on the extremities while systemic factors influenced abdominal COL4 and MMP-2 (but not TNFα).…”

“…Koyano et al disallowed ointments or bathing the day before sampling to avoid disturbing protein balance. 28 Higuchi et al allowed daily bathing but did not permit moisturisers. 29 Sari et al reported blotting at least 30 min after ablutions or 1 h after bathing, and participants were asked to avoid skincare product applications.…”

“…The use of adhesive backing 'tape' was most commonly used. 9,21,22,28,33,41 Adhesion was not reported by wound blotting studies. Hence, the surface influences the use of an adhesive agent.…”

“…17,22,26,29,41 Six studies used histological samples to improve criterion- and TNF-α proteins, suggesting these are reliable sites for skin blotting. 28 The individual skin variations seen with sex, age, race and body regions were accounted for by Ogai et al, who used total protein count curves to normalise the level of TNF-α, allowing comparison between populations. 21,42 3.3 | Skin blotting (intact skin)…”

“…Additionally, the repeated detachment of adhesive tapes creates a possible risk of tearing in elderly skin. 28 Our review highlights that more than one standardised protocol will exist to account for different clinical pictures and better clarify how the technique can affect results.…”