面部皮炎类疾病皮肤屏障状况及CE、KLK5含量比较

目的 比较不同种类面部皮炎类疾病临床症状、皮肤屏障的变化特点。方法 实验分为激素依赖性皮炎 （hormone-dependent dermatitis，HDD）组、敏感性皮肤 （sensitive skin，SS）组、化妆品不耐受 （cosmetic intolerance，CI）组和对照组，以量表评估疾病组症状，仪器测量各组角质层含水量 （stratum corneum water content，SCWC）、皮脂、pH、经皮失水率 （trans-epidermal water loss，TEWL）和浅表微循环，免疫荧光评估鳞屑中不成熟角质套膜 （cornified envelope，CE）比例，酶联免疫分析法检测鳞屑中人组织激肽释放酶5 （kallikrein 5，KLK5）含量。结果 纳入136例 （HDD 38例，SS 53例，CI 15例，对照组30例），多数患者量表评分为中、重度；较之对照组，疾病组的SCWC、皮脂低 （P<0.05），pH、TEWL和浅表血流量高 （P<0.05），不成熟CE比例高 （P=0.011），KLK5含量低 （P=0.000）；上述指标各疾病组间差异均无统计学意义。结论 不同病因的面部皮炎的临床症状、皮肤屏障损伤无差异；面部皮炎中CE发育可能受到抑制，KLK5表达下调；CE荧光染色可用于评价面部皮炎皮肤屏障状况。

The Changes of Skin Barrier of Patients with Different Facial Dermatitis and the Comparison of CE and KLK5

Objective To study the clinical symptoms and the condition of skin barrier of different facial dermatitis. Methods The patients with facial dermatitis were divided into 4 groups based on their diagnosis: hormone-dependent dermatitis (HDD) group, sensitive skin (SS) group, cosmetic intolerance (CI) group and normal control group. All patients received the evaluation on clinical symptoms with measuring scale, measurements of stratum corneum water content (SCWC), sebum, pH, trans-epidermal water loss (TEWL) and blood flow. The skin scales were collected for the measurements of the ratio of immature cornified envelope (CE) via immunofluorescence and the concentration of kallikrein 5 (KLK5) via enzyme-linked immunosorbent assay. Results There were total 146 patients included (HDD 38, SS 53,CI 15, control group 30), most of them had their symptoms evaluated as moderate to severe. Compared with the control,the disease groups had lower SCWC and sebum (P<0.05), higher pH, TEWL and blood flow (P<0.05), higher ratio of immature CE (P=0.011) and lower concentration of KLK5 (P=0.000); while these parameters among the disease groups did not show statistical significant difference. Conclusion There is no difference in the clinical symptoms and the condition of skin barrier between facial dermatitis with different inducements. The growth of CE may be inhibited and the concentration of KLK5 decreases in facial dermatitis.