特应性皮炎患儿与健康儿童皮肤屏障功能的对比

目的探讨特应性皮炎(AD)患儿与健康儿童皮肤屏障功能的差异。方法 0～7岁的AD患儿和健康儿童各60名,根据不同年龄段分成2组,0～2岁组和2～7岁组各30例。依次进行角质层含水量、pH值、经表皮水分丢失量(TEWL)的测量,使用SPSS13.0统计软件分析。结果 0～2岁、2～7岁AD患儿与健康儿童比较,角质层含水量除前臂无差异外,前额和颊前均明显低于健康对照组;皮肤表面pH值均明显高于健康对照组;0～2岁的AD患儿TEWL值除前臂无差异外,前额和颊前均明显高于健康对照组,而2～7岁AD患儿TEWL值均明显高于健康对照组。结论 AD患儿与健康儿童比较,皮肤屏障功能存在障碍。表现为角质层含水量、皮肤表面pH值、TEWL值有不同程度的差异。     

健康儿童皮肤透皮失水率与角质层含水量的相关性研究

目的探讨角质层含水量与透皮失水率的相关性。方法 2021年10月至2022年6月在普宁市公共健康医疗中心、2所幼儿园及2所小学招募≤ 17岁健康儿童。用皮肤生理功能测量仪测量健康儿童左前臂屈侧和右胫前部位的透皮失水率和角质层含水量, 采用Pearson相关分析法分析不同年龄、性别儿童的透皮失水率与角质层含水量的相关性。结果共招募1 396例健康儿童, 年龄1个月至17岁, 男783例、女613例。在1 ～ < 12个月组, 除男童前臂部位的皮肤透皮失水率与角质层含水量无显著相关性外, 男童胫前和女童前臂及胫前部位的透皮失水率与角质层含水量均呈正相关(r值为0.283、0.404、0.420, 均P < 0.05);在1 ～ 2岁组, 男童前臂和女童胫前部位的皮肤透皮失水率与角质层含水量无显著相关性, 而男童胫前和女童前臂部位的透皮失水率与角质层含水量均呈正相关(r值为0.370、0.419, 均P < 0.01);在3 ～ 5岁组和6 ～ 11岁组, 除6 ～ 11岁组男童胫前的透皮失水率与角质层含水量无显著相关性外, 两组男女性其他部位的透皮失水率与角质层含水量均呈...     

银屑病患者皮肤屏障功能受损的研究

目的 探讨银屑病患者皮肤屏障功能受损的实验依据,以指导临床辅助治疗银屑病。方法 60例银屑病患者运用无创性皮肤生理功能测试仪检测皮损角质层含水量、皮脂含量及经表皮水分流失（TEWL）。电镜观察皮损处细胞超微结构,同时运用免疫组化方法检测皮损处酸性神经酰胺酶的表达。结果 与正常皮肤比较,银屑病皮损角质层含水量降低（P < 0.01）,TEWL值增加（P < 0.01）,皮脂含量差异无统计学意义。电镜下,皮损颗粒层角质形成细胞中板层小体数量较正常对照组减少,分布紊乱,体积大小不等;免疫组化染色显示酸性神经酰胺酶表达明显减少。结论 银屑病皮肤屏障功能明显受损,因此,恢复皮肤屏障功能,加强保湿是银屑病重要的辅助治疗手段之一。     

含青刺果及马齿苋的医学护肤品对湿疹屏障修复作用的观察

目的 观察含马齿苋及青刺果提取物的医学护肤品恢复慢性湿疹患者皮肤屏障功能.方法 选取慢性湿疹患者80例,其中男46例,女34例.用自身对照试验,治疗侧使用含青刺果及马齿苋的医学护肤品及糠酸莫米松乳膏,对照侧单独使用糠酸莫米松乳膏,1周后双侧停用糠酸莫米松乳膏,但治疗侧继续使用使用含青刺果及马齿苋的医学护肤品,于第0天、7天、30天、60天进行随访,通过皮肤油脂含量、角质层含水量及经表皮水分流失量(TEWL)来评估皮肤屏障功能,于第60天观察患者症状和皮损改善情况评估疗效及复发率.结果 第60天,80例患者治疗侧使用医学护肤品后症状和体征改善的有效率较对照侧显著升高(P＜0.01);复发率较对照侧显著降低(P＜ 0.01).第0天、7天、30天、60天治疗侧皮脂含量、角质层含水量较治疗前及对照侧升高,TEWL值较治疗前及对照侧降低,差异有统计学意义(P＜0.01),随着治疗时间延长,皮肤油脂含量、角质层含水量及TEWL值逐渐恢复正常.结论 用含青刺果及马齿苋的医学护肤品可恢复慢性湿疹皮肤屏障功能,降低复发率.     

寻常型银屑病患者皮肤屏障功能相关指标检测分析

目的:探讨寻常型银屑病患者皮损区与非皮损区、患者与正常人皮肤屏障功能相关指标之间的差异。方法:1.收集寻常型银屑病患者35例,健康志愿者36例,使用皮肤屏障功能测试仪测定患者皮损区、非皮损区、健康志愿者的皮肤角质层含水量、PH值及经皮水分流失(TEWL)。2.收集30例寻常型银屑病患者与34例健康志愿者的血清,分别采用压板法、分光光度法测定NO、VitE水平。结果:寻常型银屑病患者皮损区PH值为(5.69±0.61)高于非皮损区PH值和健康对照组PH值;皮损区含水量为(17.90±6.75),低于非皮损区及健康对照组;皮损区TEWL为(18.58±11.55)g/m²h,高于非皮损区和健康对照组;然而非皮损区与健康对照组的PH值、角质层含水量及TEWL无统计学差异;寻常型银屑病患者血清维生素E含量(7.27±0.96)μg/mL低于健康对照组,银屑病组血清NO含量(5.29±1.91)μg/mL高于健康对照组。结论:寻常型银屑病患者皮损区,皮肤屏障功能指标异常,表现在皮肤表面PH值升高、角质层含水量下降、TEWL值升高、血清VitE下降、血清NO升高。     

青鹏软膏治疗双下肢慢性对称性湿疹疗效及其对皮肤屏障功能的影响

目的评价青鹏软膏治疗慢性对称性湿疹的临床疗效和安全性,并观察患者皮肤屏障功能的改变情况。方法采用自身对照研究,对86例双下肢慢性对称性湿疹患者左下肢皮损外用青鹏软膏(治疗组),右下肢皮损外用糠酸莫米松乳膏(对照组),比较两组皮损治疗前和治疗4周时瘙痒、皮损严重程度和面积、湿疹病情指数(EASI)、皮肤生理功能,包括经表皮水分流失(TEWL)、角质层含水量(WCSC)和皮肤油脂(SC)及有效率。结果治疗4周后,两组皮损的瘙痒评分、皮损严重程度评分、皮损面积及EASI评分和TEWL均显著低于其治疗前,而WCSC和SC显著高于其治疗前,且治疗组靶皮损面积、皮损面积评分、皮损瘙痒评分、EASI评分和TEWL均显著低于对照组,但是治疗组靶皮损WCSC,SC和有效率均显著高于对照组,以上差异均有统计学意义(P均0.01)。结论青鹏软膏治疗慢性对称性湿疹安全有效,有利于皮肤屏障功能修复。     

尿毒症患者皮肤屏障功能改变及含青刺果油保湿霜治疗尿毒症瘙痒疗效观察

目的:探讨尿毒症瘙痒患者皮肤屏障功能改变及研究含青刺果油保湿霜对治疗尿毒症瘙痒的有效性及安全性。方法:分别测量60例尿毒症瘙痒患者(UP+组)、60例尿毒症无瘙痒的患者(UP-组)及30名健康人(HV组)胸前V形区、季肋区、前臂屈侧及小腿伸侧皮肤角质层含水量(SCH)、经皮失水率(TEWL)及酸碱度(p H)并分别进行问卷调查、干燥评分(XS)及尿毒症瘙痒评分(UIS)。随机将UP+组分为试验组及对照组,试验组予含青刺果油保湿霜治疗28d,对照组不给予干预。于D0、D28进行皮肤病生活质量评分(DLQI)。于D0、D7、D14及D28对受试者进行XS、UIS及SCH、TEWL及皮肤p H值测量。结果:UP+组及UP-组测SCH均显著低于健康人群(P<0.01)。UP+组胸前V形区、季肋区、小腿伸侧TEWL较健康人群显著升高(P<0.05)。UP+组胸前V形区及小腿伸侧皮肤p H值高于HV组(P<0.05)。尿毒症患者发生UP与TEWL呈正相关(P<0.001)。皮肤瘙痒程度与干燥程度呈正相关(P<0.001),糖尿病加重瘙痒程度(P=0.011)。试验组受...     

含马齿苋及牛油果树提取物护肤品对乏脂性湿疹临床效果观察

目的:评价含马齿苋及牛油果树提取物的护肤品(商品名:薇诺娜舒缓柔润保湿霜)辅助治疗乏脂性湿疹的疗效和安全性.方法:乏脂性湿疹患者躯体一侧外用薇诺娜舒缓柔润保湿霜2周,于第0、3、7、14天进行随访,并以使用前后及身体的另一侧作为对照.采用研究者总体评估(IGA)及患者自身评价观察皮损改善情况;评价内容包括皮肤干燥程度、角质层含水量及经皮水分丢失(TEWL)值来反映皮肤的干燥程度和屏障功能.结果:8个中心共入选200例患者,使用保湿霜后IGA评分、患者自评及皮肤干燥程度评分均较使用前和对照侧显著改善(P<0.01),且随着使用时间的延长效果更好.角质层含水量试验侧明显高于对照侧(P<0.05);靶皮损治疗后高于治疗前(P<0.01).治疗后靶皮损TEWL值明显降低(P<0.05).试验过程中不良反应发生率<10%.结论:含马齿苋及牛油果树提取物护肤品可辅助治疗乏脂性湿疹,其疗效、安全性均较高.     

胶原贴敷料对面部轻度痤疮的屏障功能作用观察

目的评价胶原贴敷料对面部轻度痤疮患者面部屏障功能的作用,同时观察痤疮皮损、炎症后色素沉着的变化。方法对36例患有面部轻度痤疮的受试者,采用自身左右面部对比的方法,采用胶原贴敷料治疗。在治疗前、治疗1周和治疗4周对面部皮肤角质层含水量、经皮水分丢失、皮脂量、皮肤颜色进行测试;采用炎症性皮损和粉刺计数判定痤疮皮损改善情况。结果患者治疗侧面部皮肤角质层含水量显著升高（P〈0．05）;经皮水分丢失明显下降（P〈0．01）,治疗侧发生皮肤红斑,粗糙和脱屑低于对照侧面部皮肤。治疗侧炎性丘疹数目减少,红斑指数下降,但与对照侧相比无统计学差异。所有受试者均未出现不良反应。结论胶原贴敷料单独使用可促进轻度痤疮患者的面部屏障功能的修复,同时对于炎症性皮损、皮肤红斑反应有一定的抑制作用。     

多形性日光疹皮损中板层小体分布、神经酰胺酶表达与皮肤屏障功能

目的 探讨多形性日光疹（PLE）表皮中板层小体的分布、神经酰胺酶的表达与皮肤屏障受损的相关性。方法 选取PLE患者47例及正常人对照40例,通过电镜观察两组皮损处颗粒层、棘层板层小体的数量及分布情况,运用免疫组化测定皮损处神经酰胺酶的表达,采用无创性皮肤测试仪测量皮损处经皮水分丢失（TEWL）、角质层含水量及皮脂含量。结果 透射电镜结果显示：与对照组相比,PLE患者颗粒层、棘层板层小体数量明显少于正常人对照组,分布较正常人对照组紊乱。免疫组化结果显示：PLE患者皮损处神经酰胺酶表达20例阳性、21例弱阳性、6例阴性;正常人对照组中36例阳性、4例弱阳性,差异有统计学意义（P < 0.01）;皮损处TEWL（34.2191 ± 12.70）较正常人对照组（16.8350 ± 6.50）高,角质层含水量（22.7319 ± 8.71）较正常人对照组（29.4250 ± 5.08）低,差异有统计学意义（P < 0.01）;皮脂含量两者之间差异无统计学意义。结论 PLE患者存在神经酰胺合成障碍,可能是皮肤屏障受损的原因之一。     

Acute irritant threshold correlates with barrier function,skin hydration and contact hypersensitivity in atopic dermatitis and rosacea

The aim of the study was to disclose interactions between epidermal barrier, skin irritation and sensitization in healthy and diseased skin. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were assessed in adult patients with atopic dermatitis (AD), rosacea and healthy controls. A 4‐h patch test with seven concentrations of sodium lauryl sulphate was performed to determine the irritant threshold (IT). Contact sensitization pattern was revealed by patch testing with European baseline series. Subjects with a lower IT had higher TEWL values and lower SCH. Subjects with positive allergic reactions had significantly lower IT. In AD, epidermal barrier deterioration was detected on both volar forearm and nasolabial fold, while in rosacea, impeded skin physiology parameters were observed on the facial skin only, suggesting that barrier impediment is restricted to the face in rosacea, in contrast with AD where the abnormal skin physiology is generalized.     

Normal recovery of the stratum corneum barrier function following damage induced by tape stripping in patients with atopic dermatitis

Patients with atopic dermatitis (AD) constantly inflict mechanical damage to their skin by scratching induced by pruritus. On excoriated lesions of the cheek we found exceedingly high levels of transepidermal water loss (TEWL) as compared to those in the normal skin of healthy subjects. However, it is not clear whether the skin of patients with AD also shows an abnormally slow recovery after mechanical damage. We compared the recovery of the barrier function of the stratum corneum (SC). after its complete removal by tape stripping, in patients with AD and age-matched healthy control subjects. On the normal-looking skin of the flexor forearm, we found no difference in the recovery process of the water barrier function of the SC between the two groups. This suggests that ability to reconstruct SC barrier function after mechanical damage is not impaired in AD patients.     

Transepidermal water loss in dry and clinically normal skin in patients with atopic dermatitis

To obtain data on the function of the epidermal barrier in patients with atopic dermatitis (AD) the transepidermal water loss (TEWL) was studied. Measurements were made on three body locations in two clinically well defined groups of patients with AD and in a control group. The TEWL was found to be increased both in dry non-eczematous skin and in clinically normal skin in patients with AD. The TEWL was highest in patients with dry skin. The result of the study may indicate a primary defect in the epidermal barrier: the stratum corneum.     

Clinical severity correlates with impaired barrier in filaggrin-related eczema

Mutations in the gene-encoding filaggrin (FLG), a key molecule involved in skin barrier function, have been shown to be a major predisposing factor for atopic dermatitis (AD; eczema). To elucidate the pathomechanisms underlying filaggrin-related AD, we investigated stratum corneum (SC) hydration and transepidermal water loss (TEWL) as parameters of barrier function in AD patients harboring FLG mutations compared to AD patients without any FLG mutation. In filaggrin-related AD, SC hydration was both significantly reduced (P<0.01-0.05) and thicker (P<0.01-0.05) than that in healthy controls. TEWL was demonstrably increased in non-filaggrin AD compared to healthy controls (P<0.01-0.05). The objective score of atopic dermatitis (OSCORAD), a disease clinical severity index, significantly correlated with TEWL (r=0.81, P<0.005), SC hydration (r=-0.65, P<0.05), and SC thickness (r=0.59, P<0.05) in filaggrin-related AD. On the contrary, there was no correlation between these parameters and the OSCORAD in non-filaggrin AD. Furthermore, a significant correlation was obtained between the OSCORAD and specific IgE for house dust (r=0.66, P<0.05), mite allergen (r=0.53, P<0.05), and cat dander (r=0.64, P<0.05) in filaggrin-related AD, but not in non-filaggrin AD. All these data suggest that experimentally demonstrable skin barrier defects due to FLG mutations may play a crucial role in the pathogenesis of AD.     

Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity

BACKGROUND: It is currently fashionable to consider atopic dermatitis (AD), like other inflammatory dermatoses, as immunologic in pathogenesis ("inside-outside" hypothesis). Accordingly, topical glucocorticoids and other immunosuppressive agents are mainstays of therapy, but the risk of toxicity from these agents is not insignificant, particularly in children. Alternatively, because stratum corneum (SC) permeability barrier function is also abnormal in AD, it has been hypothesized that the barrier abnormality could drive disease activity. Yet commonly used emollients and moisturizers do not correct the SC ceramide deficiency, the putative cause of the barrier abnormality. OBJECTIVES: We assessed the efficacy of a newly developed, ceramide-dominant, physiologic lipid-based emollient, when substituted for currently used moisturizers, in 24 children who were also receiving standard therapy for stubborn-to-recalcitrant AD. METHODS: All subjects continued prior therapy (eg, topical tacrolimus or corticosteroids), only substituting the barrier repair emollient for their prior moisturizer. Follow-up evaluations, which included severity scoring of atopic dermatitis (SCORAD) values and several biophysical measures of SC function, were performed every 3 weeks for 20 to 21 weeks. RESULTS: SCORAD values improved significantly in 22 of 24 patients by 3 weeks, with further progressive improvement in all patients between 6 and 20 or 21 weeks. Transepidermal water loss levels (TEWL), which were elevated over involved and uninvolved areas at entry, decreased in parallel with SCORAD scores and continued to decline even after SCORAD scores plateaued. Both SC integrity (cohesion) and hydration also improved slowly but significantly during therapy. Finally, the ultrastructure of the SC, treated with ceramide-dominant emollient, revealed extracellular lamellar membranes, which were largely absent in baseline SC samples. CONCLUSION: These studies suggest that (1) a ceramide-dominant, barrier repair emollient represents a safe, useful adjunct to the treatment of childhood AD and (2) TEWL is at least as sensitive an indicator of fluctuations in AD disease activity as are SCORAD values. These studies support the outside-inside hypothesis as a component of pathogenesis in AD and other inflammatory dermatoses that are accompanied by a barrier abnormality.     

The effect of aqueous cream BP on the skin barrier in volunteers with a previous history of atopic dermatitis

Background The emollient aqueous cream BP is frequently used for the treatment of atopic dermatitis (AD), yet it is associated with a high rate of adverse cutaneous reactions. It contains the harsh anionic surfactant sodium lauryl sulphate, a known negative environmental factor associated with the exacerbation of AD. Objectives To investigate the effect of aqueous cream BP on stratum corneum (SC) integrity and skin barrier function in volunteers with a predisposition to a defective skin barrier. Methods Thirteen volunteers with a previous history of AD (no symptoms for 6 months) applied aqueous cream BP twice daily to the volar side of one forearm for 4 weeks. The other forearm was left untreated as a control. Permeability barrier function and SC integrity were determined before and after treatment by measuring transepidermal water loss (TEWL) in conjunction with tape‐stripping. For comparison, 13 volunteers with current AD were recruited for assessment, without treatment, of SC integrity and skin barrier function at unaffected sites. Results Topical application of aqueous cream BP resulted in significant elevation of baseline TEWL and a concomitant decrease in SC integrity. Measurements made after no treatment in volunteers with current AD, at unaffected sites, suggest that application of aqueous cream BP negatively affects the skin barrier towards the damaged state associated with onset of flares of the disease. Conclusions Aqueous cream BP used as a leave‐on emollient caused severe damage to the skin barrier in volunteers with a previous history of AD. Aqueous cream BP should not be used as a leave‐on emollient in patients with AD.     

中间丝聚合蛋白在特应性皮炎患者皮损中的表达

目的：探讨中间丝聚合蛋白（Filaggrin,FLG）在特应性皮炎（Atopic dermatitis,AD）患者皮损的表达及其临床意义。方法：采用sP免疫组化方法检测16例AD患者皮损及14例对照组皮肤组织内FLG的表达,用图像分析软件Image-ProPlus（IPP）判定FLG在AD患者皮损及健康者皮肤组织中阳性染色面积百分比。结果：FLG在AD患者皮损及健康者皮肤角质层及颗粒层均有表达,胞质染色多见;阳性染色面积百分比分别为（18．92±4．40）％及（23．00±2．28）％;FLG在AD患者皮损阳性染色面积明显低于健康人皮肤（t=－3．11,P=0．004）。结论：FLG在AD患者皮损中表达降低,可能是导致AD患者皮肤屏障功能障碍的原因。     

Correlation of clinical features and skin barrier function in adolescent and adult patients with atopic dermatitis

BACKGROUND: Xerotic changes in atopic skin are considered to be related to a decrease in the water permeability barrier. Whether abnormal skin barrier function is the main cause of atopic dermatitis (AD) or a secondary change of the disease is still controversial. Noninvasive bioengineering methods, including the measurement of the transepidermal water loss (TEWL) and water capacitance, have been commonly used to evaluate skin barrier function. AIM: To evaluate the correlation between the clinical features of each evaluation site (severity of AD) and skin barrier function. METHODS: TEWL, capacitance, and pH were checked on five evaluation sites: postauricle, forearm, abdomen, thigh, and popliteal fossa. The subjects included 25 patients, both adolescents and adults, with AD and 25 age-matched normal controls. The clinical severity, from 0 (no clinical manifestation) to 3 (severe), was also scored for erythema, induration/papulation, lichenification, and xerosis on each evaluation site of the AD patients. RESULTS: Based on the data, we found that the clinical severity score was correlated with TEWL and capacitance in more than one-half of the evaluation sites. Erythema and induration/papulation showed a statistically significant correlation with TEWL in most cases (P < 0.05, four sites). Lichenification and xerosis showed a significant correlation with capacitance in most cases (P < 0.05, four sites). In most cases, severity scoring of the clinical features did not show a significant correlation with skin pH. The patients showed higher TEWL and lower capacitance than normal controls (P < 0.05, all five sites). CONCLUSIONS: The results of our study suggest that skin barrier function, measured by TEWL and capacitance, and clinical severity show a statistically significant correlation in patients with AD.     

特应性皮炎患者皮肤屏障与水闸蛋白1表达的相关性研究

目的 研究特应性皮炎（AD）患者皮肤屏障功能情况,并分析其与水闸蛋白1（claudin-1）表达的相关性。 方法 纳入AD患者和健康人各11例。应用皮肤经表皮失水率测定仪和皮肤高频超声检测仪测定受试者经表皮失水率、表皮厚度与表皮致密度,并用双抗体夹心ELISA法定量检测血清中脱落claudin-1表达量。应用单因素方差分析和t检验比较不同组别之间相关参数的差异;应用Pearson相关系数分析不同参数之间的相关性。 结果 AD患者皮疹部位经表皮失水率为（36.9 ± 34.2） g·m-2·h-1,非皮疹部位为（9.1 ± 6.0） g·m-2·h-1,均高于健康对照［（4.4 ± 3.1） g·m-2·h-1］;AD患者皮疹部位表皮厚度（0.23 ± 0.04） mm,显著高于非皮疹部位［（0.18 ± 0.03） mm］和健康对照［（0.18 ± 0.02） mm］。AD患者皮疹部位有其特征性表皮下低回声带。AD患者claudin-1表达量为（0.80 ± 0.88） ng/ml,显著低于健康人［（1.73 ± 1.85） ng/ml］;claudin-1与表皮厚度显著负相关（r = -0.61）,与经表皮失水率的倒数显著正相关（r = 0.44）。 结论 AD患者损伤的皮肤屏障功能与claudin-1表达相关,屏障功能状态可用经表皮失水率、经表皮失水率倒数和表皮厚度进行定量表述。