不同肤色人种皮肤对硫酸月桂酯钠引发刺激性接触性皮炎反应差异 …

目的 评估不同肤色人种皮肤对化学刺激物的敏感性。方法 用多个浓度的硫酸月桂酯钠对３２例健康志愿者的背部皮肤进行斑贴试验,结果 显示黑种人组最小红斑刺激量高于白种人组和黄种人组。然而在相同浓度的硫酸月柱酯钠刺激部位,黑种人、白种人和黄种人３组经表皮水分散失和真皮浅层微血管血流量值无显著性差异。黑种人、白种人和黄种人３组经表皮水分散失和真皮浅层微血管充量值分别与硫酸月桂酯钠刺激浓度有明显的剂量应答关系     

量化硫酸月桂酯钠引发的刺激性接触性皮炎红斑反应——经表皮水份散失的测量

用０．２５％、０．５％、０．７５％、１％和２％５个浓度的硫酸月桂酯钠（ＳＬＳ）对１６例健康志愿者进行斑贴试验。在去斑贴后３０分钟记录临床观察指标（ＶＳ），并测其经表皮水份散失（ＴＥＷＬ）。结果显示ＴＥＷＬ值与ＶＳ高度线性相关（ｒ＝０．９４，Ｐ＜０．０１），随着ＳＬＳ刺激浓度增加，ＴＥＷＬ值增高。在去斑贴后２４小时，４８小时，７２小时，进一步测试０．５％、１％和２％部位ＴＥＷＬ，观察到ＴＥＷＬ值在２４～４８小时达到高峰，７２小时下降。这些改变与临床红斑反应的转归一致     

量化硫酸月桂酸钠引发的刺激性接触性皮炎红斑反应—经表皮…

用０．２５％，０．５％，０．７５％，１％和２％５个浓度的硫酸月桂酯钠对１６例健康志愿者进行斑贴试验。在去斑贴后３０分钟记录临床观察指标，并测春缚皮水份散失。结果显示ＴＥＷＬ值与ＶＸ高度线性相关，随着ＳＬＳ刺激浓度增加，ＴＥＷＬ值半高。     

辣椒和乙醇对肉桂醛引起的兔耳刺激性接触性皮炎的影响

目的 探讨辣椒和乙醇对肉桂醛引起的皮肤刺激性接触性皮炎的影响.方法 日本大耳白兔32只,随机分成对照组、乙醇组、辣椒组、混合组,每组8只.对照组:生理氯化钠溶液日2次灌胃;乙醇组:50％乙醇、生理氯化钠溶液分别灌胃;辣椒组:10％辣椒液、生理氯化钠溶液分别灌胃;混合组:50％乙醇、10％辣椒液分别灌胃.剂量均为每次8 ml/kg,各组连续灌注7d.出现饮水量增加、大便干结、耳廓血管充血等辛辣刺激体征后,再将各组实验动物分成完整皮肤组和破损皮肤组,每组4只,按化妆品卫生规范进行皮肤刺激性实验,分别记录1、24、48和72 h刺激部位的情况,对皮肤刺激反应进行评分,组间差异比较采用方差分析.结果 辣椒与乙醇连续7d灌胃后,对照组症状体征评分为0.25±0.46,辣椒组为5.38±0.74,乙醇组为7.25±0.71,混合组为12.75±0.70,辣椒组、乙醇组及混合组的症状体征评分明显高于对照组,差异有统计学意义(P＜0.01).在家兔完整皮肤刺激状态评分中,混合组皮肤刺激反应强度在24、48 h显著高于灌注辣椒组(F=28.44、30.33,P＜0.05);在家兔破损皮肤刺激状态评分中,乙醇组、混合组皮肤刺激反应强度在24、48、72 h评分显著高于辣椒组(F=197.12、94.54、87.63,P＜ 0.01).结论 按照实验所用的剂量,辣椒、乙醇和混合物都能够在家兔诱导出辛辣刺激体征,辣椒和乙醇能明显增加皮肤对肉桂醛刺激的敏感性.     

青蒿琥酯对小鼠变应性接触性皮炎及白细胞介素1的影响

用青蒿琥酯对实验性变应性接触性皮炎的致敏前,激发时,激发后12小时三个不同阶段进行研究,结果表明:青蒿琥酯用于致敏前,激发后12小时对皮炎的抑制作用最为明显.此外用青蒿琥酯对小鼠体内、外巨噬细胞分泌白细胞介素I(IL1)活性进行测定,结果显示:青蒿琥酯对体内外IL1活性均有抑制,提示青蒿琥酯是一种很有前途的免疫调节剂,临床可推广用于治疗湿疹皮炎.     

胶布撕脱皮肤角质层对皮肤刺激性斑贴试验结果的影响

目的:比较直接进行斑贴试验(patch test,PT)与先反复多次进行胶带粘贴(tapestripping,TAP)再进行斑贴试验(tapestripping+pacth test,TAPPT)后皮肤反应的异同,探讨已受到亚临床刺激的皮肤对再次发生的刺激性皮炎严重程度的影响.方法:30名健康女性双前臂屈侧按随机原则分别进行TAP、PT、TAPPT及空白对照4种处理.TAP共5 d,PT于第6天进行.试验期间每天进行临床评估,第0、第6天PT前及第7、第8天进行经表皮水分丢失率、表皮含水量、Chromameter a*值及皮肤表面pH值的检测.结果:①PT、TAPPT刺激率分别为60%、100%,TAPPT刺激率高于PT(P＜0.05).②TAPPT评分高于PT(P＜0.05).③与基础值相比,第8天,PT与TAPPT的经表皮水分丢失率值均升高,TAPPT部位△B-8经表皮水分丢失率值大于PT部位△8-8经表皮水分丢失率值(P＜0.05).与第7天相比,第8天PT、TAPPT的经表皮水分丢失率值均下降,TAPPT△7-8经表皮水分丢失率值小于PT△7-8经表皮水分丢失率值(P＜0.05).④与基础值相比,第8天PT的表皮含水量下降,TAPPT的表皮含水量上升,PT部位△B-8表皮含水量与TAPPT部位△B-8表皮含水量差异有显著性(P＜0.05).⑤与基础值相比,PT、TAPPT部位的a*值均升高,TAPPT△B-8a*值高于PT△B-8a*值(P＜0.05).⑥PT部位临床评分与经表皮水分丢失率、a*值正相关,TAPPT部位临床评分与经表皮水分丢失率、表皮含水量、a*值、pH值之间正相关.结论:①当皮肤屏障经胶带粘贴后产生亚临床刺激的破坏,如再次发生刺激性皮炎,会增加其发生率,增强其严重程度.②经表皮水分丢失率、表皮含水量、Chromameter a*值能反映皮肤受到TAP及PT刺激后的变化,可作为评判刺激性接触性皮炎的客观参数.     

苦豆子总碱对刺激性接触性皮炎肥大细胞数量及TNF-α表达的影响

探讨苦豆子总碱(total alkaloids from Sophora alopecuroides,TASA)对小鼠变应性接触性皮炎模型肥大细胞及TNF-α表达的影响.用1%浓度的2,4-二硝基氟苯(2, 4-DNFB)对BALB/c小鼠进行皮肤刺激制成小鼠刺激性接触性皮炎模型,将小鼠分为四组,G1组未作任何处理,G2组单纯外用0.9%生理盐水,G3组外用0.1%哈西奈德溶液,G4组外用0.1%的TASA治疗,均在刺激后30 min搽药.5 h后进行肥大细胞染色及对皮肤组织采用ELISA检测前炎症因子肿瘤坏死因子(TNF-α)表达水平.G4组与G1组及G2组小鼠比较,皮肤组织的肥大细胞数量明显减少,皮损ELISA检测示TNF-α明显降低.外用0.1%的TASA对DNFB所致的小鼠刺激性接触性皮炎具有抑制作用.     

特应性皮炎相关细胞因子对皮肤屏障的影响

【摘要】 皮肤是人体最大的器官,是一个重要的屏障。特应性皮炎患者存在皮肤屏障功能异常,同时其细胞因子的组成与健康人不同。在特应性皮炎患者皮肤中发现的许多细胞因子能够影响角质形成细胞的分化和角化过程。本文综述了特应性皮炎相关细胞因子的最新进展及其对皮肤屏障功能的影响,这些结果有利于了解特应性皮炎的发病机制,并可能为特应性皮炎的治疗提供新的方向。     

苦豆子总碱对刺激性接触性皮炎肥大细胞数量及TNF—α表达的影响

探讨苦豆子总碱（totalalkaloids from Sophora alopecuroides,TASA）对小鼠变应性接触性皮炎模型肥大细胞及TNF—α表达的影响。用1％浓度的2,4-二硝基氟苯（2,4-DNFB）对BALB／c小鼠进行皮肤刺激制成小鼠刺激性接触性皮炎模型,将小鼠分为四组,G1组未作任何处理,G2组单纯外用0．9％生理盐水,G3组外用0．1％哈西奈德溶液,G4组外用0．1％的TASA治疗,均在刺激后30min搽药。5h后进行肥大细胞染色及对皮肤组织采用ELISA检测前炎症因子肿瘤坏死因子（TNF—α）表达水平。G4组与G1组及G2组小鼠比较,皮肤组织的肥大细胞数量明显减少,皮损ELISA检测示TNF—α明显降低。外用0．1％的TASA对DNFB所致的小鼠刺激性接触性皮炎具有抑制作用。     

类人胶原蛋白敷料治疗面部脂溢性皮炎疗效观察及对皮肤屏障功能的影响

目的探讨类人胶原蛋白敷料治疗面部脂溢性皮炎的疗效、安全性及其对皮肤屏障功能的影响。方法将20~50岁女性面部脂溢性皮炎患者67例随机入组,试验组患者外用酮康唑乳膏加类人胶原蛋白敷料,对照组患者单独外用酮康唑乳膏,两组患者均用药10 d,观察皮损变化并测定皮肤屏障功能相关指标。结果第2次随访时,试验组症状积分[(1.06±1.06)分]、经皮水分丢失量(transepidermal water loss,TEWL)[(11.99±5.84)g/(m2?h)]均低于对照组[(1.94±1.17)分、(16.17±8.47)g/(m2?h)],角质层含水量(40.20±11.69)高于对照组(34.13±10.86),差异均有统计学意义(P=0.002,0.024,0.033)。两组患者均未出现明显不良反应。结论类人胶原蛋白敷料治疗成年女性面部脂溢性皮炎,能改善皮肤屏障功能,减轻皮损,可以作为面部脂溢性皮炎的一个安全有效的辅助治疗手段。     

Barrier function of the skin in a repetitive irritation model and influence of 2 different treatments*

Background/aims: The aim of this study was to develop and characterize an experimental model of cumulative irritant contact dermatitis using the repetitive application over 2 weeks of 2 different irritative stimuli, sodium lauryl sulphate (SLS) in low concentration and toluene. Further, it was intended to look at the effect of 2 different treatments which could influence the regeneration of the skin barrier, as already investigated in preliminary short-term experiments. Methods: Occlusive short-time daily application of the irritants (SLS 30 min; toluene 10 min) was performed. After removal of the occlusive patch, the irritated areas were treated with 2 different preparations, Lotio Alba Aquosa and vaseline (white petroleum jelly). Bioengineering techniques were used to precisely measure the skin condition. Results: A mild irritation was obtained under these experimental conditions. The bioengineering measurements allowed us to differentiate both irritants through their different influences on trans-epidermal water loss and skin hydration. Treatment with vaseline did not significantly influence the course of the irritation, but Lotio Alba Aquosa clearly potentiated it, whereby different effects were noticed for both irritative stimuli. Conclusions: The use of bioengineering techniques in this model of mild cumulative irritation allowed us to differentiate the action of both irritants, showing that they act through different mechanisms. The results of the treatments pointed out the need to treat an irritation with the right product for the right time period.     

SLS-irritated human skin shows no correlation between degree of proliferation and TEWL increase

Abstract It is well known that cutaneous irritants influence epidermal proliferation but the pathogenesis is poorly understood. Recent investigations have shown that the skin barrier integrity influences the proliferation of the basal keratinocytes. Our question was whether the proliferating activity of keratinocytes is indeed regulated by the degree of skin barrier damage or by a direct toxic action of the irritant on the keratinocytes. Therefore various degrees of skin irritation were induced by the application of 0.1%, 0.5% and 2% sodium lauryl sulphate (SLS) solution to the forearm skin of six healthy volunteers. This experiment was performed to evaluate the relationship between SLS concentration and epidermal proliferation. In a second experiment another 14 volunteers were treated with a single SLS concentration (0.5%) to look for interindividual differences in the patterns of skin reaction and susceptibility to the irritant. Skin barrier function was evaluated by measurements of transepidermal water loss (TEWL) before and after irritation. Punch biopsies were taken after 96 h from exposed areas and from unexposed normal skin. Dividing keratinocytes were identified immunocytochemically using three different monoclonal antibodies: PCNA, MIB 1 and KiS1. Exposure to SLS resulted in concentration-dependent increases in both TEWL and epidermal proliferation. However, no significant correlation could be found between the degree of hyperproliferation and the TEWL changes. The results suggest that epidermal proliferation is modulated by a direct interaction of the surfactant with the keratinocytes and/or by release of mediators rather than the consequence of a barrier disturbance. Received: 5 February 1997 / Received after revision: 12 August 1998 / Accepted: 24 August 1998     

Skin areas,clinical severity,duration and risk factors of intertrigo: A secondary data analysis

AimTo describe the skin areas most often affected by intertrigo, the clinical severity and duration of intertrigo and possible risk factors.Materials and methodsSecondary analysis of data from 2013 to 2016 collected by the International Prevalence Measurement of Care Quality in Dutch hospitals, care homes and community care.ResultsIn total, n = 7865 (mean age 80.1 years) subjects were included in this analysis. The inguinal, breast and gluteal cleft skin areas were most often affected by intertrigo. The skin was often inflamed but not eroded. Strongest associations between intertrigo at inguinal skin and diabetes mellitus (OR 1.8; 95% CI 1.1–3.1), intertrigo at sub mammary folds and urinary incontinence (OR 1.6; 95% CI 0.9–2.9) and between intertrigo at gluteal cleft and urinary incontinence (OR 2.9; 95% CI 1.4–5.2) were observed.ConclusionThe inguinal region, sub mammary folds and gluteal clefts are most often affected by intertrigo. Female sex, urinary incontinence and high BMI seem to enhance intertrigo risk at all of these skin areas.     

Complement profiles in human skin lymph during the course of irritant contact dermatitis

Using microsurgery a superficial peripheral lymph vessel draining the skin of the upper and medial part of the foot was cannulated on the lower leg of two healthy human volunteers. An irritant contact dermatitis was induced 2 days later by the application of 10% sodium lauryl sulphate to the drained skin area. After a further 3 days the spontaneously regressing skin reaction was treated with clobetasol propionate. Lymph was continuously collected in two aliquots per day for 7 days. The levels of total protein, of albumin and globulins, and of complement components of the classical, the alternative and the lytic pathway as well as the C4A and C4B gene products and the regulatory proteins FB, C1INH, C4BP, FH and FI were determined by ELISA and radial immunodiffusion techniques. Postoperatively, the levels of complement proteins and globulins in the lymph were 5–10 times lower than those in normal human serum, but increased during the course of the skin reaction, while the irritant contact dermatitis did not induce a change in their plasma concentration. In comparison to the baseline, the mean values for C1q, C1r, C2, C5, C6, C7, C8, C9, FB, C1INH, C4BP, FH and FI exhibited a 3–5-fold increase, C3, total C4, albumin and the alphal-globulin fraction a 6–9-fold increase, and C1s, C4A, C4B, FB and alpha2-, beta- and gamma-globulins a 10–20-fold increase. The increase in the levels of complement proteins, in contrast to IL-6 and TNF, did not occur in the early phase of the skin reaction, but correlated with the lymph flow, the output of cells and the levels of several other cytokines. These results suggest that complement proteins do not play a role in the initial pathomechanism of irritant contact dermatitis, but are locally involved in the inflammatory process and interact with inflammatory cells, cytokines and further soluble mediators transported to the regional lymph nodes.In this report, the nomenclature for complement follows Bull World Health Organ (1968) 39: 935–938, and that of the alternative pathway of complement follows Bull World Health Organ (1981) 59: 489–491. This work was supported by a grant from the Swiss National Fund (23-7774.89).     

青鹏软膏对小鼠实验性刺激性接触性皮炎的抑制作用及可能机制研究

目的 探讨外用青鹏软膏对实验性刺激性接触性皮炎（ICD）的抑制作用及可能机制。方法 用十二烷基硫酸钠在BALB/c小鼠背部皮肤建立实验性持续刺激性接触性皮炎模型。将小鼠分为6组：模型组（不治疗）,治疗组（分别外用100%浓度青鹏软膏、75%及50%浓度青鹏软膏）,基质对照组（外用青鹏软膏基质）和空白对照组。连续用药11 d。分别在用药第8天及第12天测量小鼠背部皮损厚度及质量,并对皮损取材进行HE染色,计数炎症细胞,用ELISA方法测定血清及局部皮损组织匀浆中IL-2、TNF-α,IFN-γ的表达水平。结果 用药后100%青鹏软膏能明显减轻皮肤炎症和水肿,减少中性粒细胞浸润,第12天血清IL-2、TNF-α,IFN-γ的表达水平分别为（5.55 ± 0.33）、（70.88 ± 1.55）、（76.99 ± 1.85） pg/ml,与模型组（6.41 ± 0.96）、（76.67 ± 1.14）、（82.20 ± 2.36） pg/ml和基质对照组（6.25 ± 0.92）、（76.95 ± 1.08）、（81.76 ± 3.19） pg/ml相应的细胞因子水平比较,显著降低（P < 0.05）,100%青鹏软膏组皮损匀浆中IL-2、TNF-α,IFN-γ的表达水平分别为（17.75 ± 0.97）、（66.95 ± 3.58）、（46.85 ± 2.43） pg/ml,与模型组（23.92 ± 0.82）、（70.66 ± 2.68）、（55.14 ± 2.68） pg/ml和基质对照组（23.11 ± 0.82）、（71.17 ± 3.30）、（53.55 ± 3.24） pg/ml相应的细胞因子水平比较,水平显著降低（P < 0.05）。结论 100%青鹏软膏能降低小鼠ICD模型的炎症反应,并能降低皮损和血清中TNF-α、IL-2及INF-γ的表达水平。     

Variation in barrier impairment and inflammation of human skin as determined by sodium lauryl sulphate penetration rate

BACKGROUND: Skin irritability after a brief exposure to the model skin irritant, sodium lauryl sulphate (SLS), is known to vary considerably between individuals. A difference in the skin barrier to SLS may contribute to this variation. To date, no human in vivo data have been available on SLS penetration into the skin. OBJECTIVES: We studied whether the SLS penetration rate into the stratum corneum (SC) is related to impairment of the water barrier function and inflammation of the skin. METHODS: The penetration of SLS into the SC was assessed using a noninvasive tape-stripping procedure in 20 volunteers after a 4-h exposure to 1% SLS. Additionally, the effect of a 24-h exposure to 1% SLS on the skin water barrier function was assessed by measuring the transepidermal water loss (TEWL). The accompanying inflammation was quantified by measuring erythema. RESULTS: The mean +/- SD diffusivity of SLS (D) and the SLS permeability coefficient (Kp) were 1.4 +/- 0.6 x 10(-8) cm2 h(-1) and 1.5 +/- 0.7 x 10(-3) cm h(-1), respectively. A multiple regression analysis showed that the baseline TEWL, SC thickness and SLS penetration parameters K (SC/water partition coefficient) and D clearly influenced the increase in TEWL after the 24-h irritation test (explained variance: r2 = 0.80). Change in erythema was mainly influenced by SC thickness. CONCLUSIONS: We found that variation in the barrier impairment and inflammation of human skin depends on the SLS penetration rate, which was mainly determined by SC thickness.     

低氧诱导因子-1与皮肤的相关研究

低氧诱导因子-1是低氧时表达的一种蛋白,由低氧诱导因子-1α和低氧诱导因子-1β组成的异源二聚体。其中低氧诱导因子-1α决定着低氧诱导因子-1的活性,对伤口的愈合、新血管再生和肿瘤形成起着一定的作用,可能与皮肤疾病有一定关系。调控低氧诱导因子-1的水平可能为某些皮肤病的治疗开辟新的途径。     

基质金属蛋白酶表达在皮肤光老化皱纹形成中的作用

目的 探讨皮肤光老化皱纹形成与真皮成纤维细胞基质金属蛋白酶(MMP)-1,MMP-3mRNA及其组织抑制剂(TIMP)-1表达的关系。方法 采用原位杂交和免疫组化的方法检测紫外线光化学疗法(PUVA)治疗期间及治疗后不同时间银屑病患者背部非皮损区真皮成纤维细胞MMP-1,MMP-3mRNA及TIMP-1蛋白的表达并定量分析。结果 在PUVA治疗期间、治疗后1~6个月及治疗后6个月以上的银屑病患者背部非皮损区真皮成纤维细胞均持续表达MMP-1、MMP-3mRNA,而TIMP-1蛋白仅在治疗期间一过性轻度表达。结论 PUVA治疗引起的皮肤光老化皱纹形成可能与真皮成纤维细胞基质金属蛋白酶及其组织抑制剂表达失衡密切相关。     

Skin permeability barrier and occlusion: no delay of repair in irritated human skin *

It has been reported that occlusive treatment of irritated skin results in a reduction of barrier repair activities in hairless mice. In contrast, the clinically observed benefit of occlusion in the treatment of hand eczema and other chronic skin diseases with a perturbed barrier function is well–known. While the beneficial effect of occlusion has been proven for the treatment on psoriasis there are no controlled clinical studies of the effect of occlusion on irritated human skin. We have therefore evaluated the effect of various occlusive treatments on repair of the human skin permeability barrier under controlled experimental conditions. Barrier perturbation was induced either by application of sodium lauryl sulfate (SLS) or by repeated tape stripping. This was followed by treatment with different occlusive and semipermeable dressings, partly alter pre-treatment with petrolatum. Repair of water barrier function was evaluated by daily measurements of transepidermal water loss (TEWL) for 1 week. SLS irritation and tape stripping led to a 6-fold increase in TEWL as a sign of severe water barrier perturbation, followed by a stepwise decrease over the following days. Occlusion did not significantly delay barrier repair as measured by TEWL. Only in tape-stripped skin did TEWL stay at high levels during treatment with self-adhesive dressings. This may be explained by damage of newly formed stratum corneum caused by changing of these membranes. Our results indicate that, in contrast to earlier observations in hairless mouse skin, permeability barrier repair activities are not significantly delayed by occlusive treatment in human skin.