Effects of calcipotriol on stratum corneum barrier function, hydration and cell renewal in humans

Summary Calcipotriol. a vitamin D analogue utilized for psoriasis, has irritation as its most frequent reported adverse event. However, studies on its irritant properties in humans have produced conflicting data. This study evaluates the effect of calcipotriol on stratum corneum barrier function, hydration and cell turnover in healthy volunteers, compared with sodium lauryl sulphate (SLS) as a model irritant. Calcipotriol 0·005% ointment and 1% aqueous SLS solution were applied for 2 weeks (5 consecutive days weekly) on untreated and on dansyl-chloride-labelled skin. Irritant responses were documented by visual scoring and by measurement of the transepidermal water loss (TEWL) and stratum corneum hydration (electrical capacitance), until day 18 Stratum corneum turnover time (SCTT) was the time in days between staining (day 0) and the disappearance of dansyl fluorescence. SLS caused more erythema, scaling, and a significant TEWL increase for 18 days. In contrast, calcipotriol induced erythema, and slightly but significantly increased TEWL on day 11 only, as compared with the vehicle control (P<0·05) SLS, but not calcipotriol, caused skin dryness from day 4 to day 18. The shortest SCTT was obtained at SLS-exposed sites (11·2 ± 0·7 days: mean± SD). Calcipotriol significantly shortened SCTT (16.3 ± 1.1 days) when compared with its vehicle. Compared with the skin irritation induced by SLS, under these test conditions, calcipotriol is a far weaker irritant on normal human skin. In addition, calcipotriol accelerates stratum corneum turnover to a significantly greater extent than its vehicle.     

Racial differences in sodium lauryl sulphate induced cutaneous irritation: black and white

The different reactivity of black and white skin after exposure to sodium lauryl sulphate (SLS) has been investigated. 9 white and 10 black male volunteers entered the study. The tests were performed on the back at 3 sites: untreated skin, skin pre-treated with occlusion and skin pre-delipidized. Irritant reactions were elicited applying 0.5% and 2.0% SLS via Finn chamber patch tests and monitored by means of laser Doppler velocimetry (LDV), transepidermal water loss (TEWL) and stratum corneum water content (WC). Higher TEWL, LDV, and WC values were recorded for 2.0% SLS when compared to 0.5% SLS and baselines. Pre-treatment with short-term occlusion generally increased values, while delipidization produced flattening of the data more detectable in whites than in blacks. Significant TEWL differences for the two concentrations were recorded in whites for the occluded site (P less than 0.02) while in blacks in the untreated (P less than 0.04) and delipidized (P less than 0.03) sites. LDV revealed significant changes in the untreated and pre-occluded white skin (P less than 0.05 and 0.01, respectively). In blacks, the values were significantly different only in the pre-occluded skin (P less than 0.01). Water content correlated with the visual score and was greatly increased in sites with strongly positive reactions (P less than 0.01). It appears that there are significant differences in the modulation of irritation, in the behavior of water barrier function and of the erythematous response between blacks and whites. Clinical correlations are discussed.     

On the course of the irritant reaction after irritation with sodium lauryl sulphate

Background: The sodium lauryl sulphate (SLS) irritation test is a well-established model for irritant contact dermatitis after the effects of surfactants.
Aim of the study: The course of changes in corneometric measurements (stratum corneum hydration), in transepidermal water loss (TEWL), in laser Doppler measurements (epidermal perfusion) and in colorimetric measurements (skin redness), after a single SLS irritation, should be studied over time.
Methods: Twenty healthy volunteers were studied. Irritation with 1% SLS solution was applied to the side of one forearm for 24 h under occlusive conditions, while the symmetrical experimental site remained untreated. Measurements were made for 9 days after completion of SLS irritation.
Results: Stratum corneum hydration was reduced immediately after irritation, and subsequently a hyper-hydration was observed. The increase in TEWL, laser Doppler measurements and skin redness persisted for 7–9 days. With regard to skin redness, a mild blanching effect was noticeable after 9 days.
Discussion: The evidence of very short-term exsiccation of the stratum corneum with persistent barrier damage, as well as reactive hyper-hydration and blanching of the skin, is remarkable. These first findings suggest that exsiccation of the stratum corneum is not caused by a damage to barrier lipids.     

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.     

Monitoring the water-holding capacity in visually non-irritated skin by plastic occlusion stress test (POST)

Skin-surface water loss (SSWL) and transepidermal water loss (TEWL) were studied after a plastic occlusion stress test (POST) in visually non-damaged skin treated with 7% sodium lauryl sulphate for 3 days (open application). After removal of the 24-h plastic occlusion, SSWL and TEWL were recorded continuously for 25 min. SSWL decay curves show significant differences between control and treated areas. The total amount of water trapped within the stratum corneum and released after 1 min is significantly reduced (P less than 0.01) in the treated site. Higher TEWL (P less than 0.02) in visually non-irritated skin is noticeable in the terminal part of the curve reflecting the damage of the water barrier in irritated skin. The data suggest that clinically normal skin exposed to subliminal irritant stimuli is less capable of storing water within the stratum corneum resulting in decreased hydration. The POST appears to be a simple and reliable tool to investigate non-visible but biologically relevant changes in stratum corneum function.     

Sodium lauryl sulfate (SLS) induced irritant contact dermatitis: a correlation study between ceramides and in vivo parameters of irritation

Sodium lauryl sulfate (SLS), a surfactant frequently used in the induction of experimental irritant contact dermatitis in animals and in humans, characterstically induces a dose-related increase in TEWL (transepidermal water loss). Ceramides are considered to be important in the regulation of the skin barrier. We therefore examined the relationship between initial ceramide content of stratum corneum and induced changes in skin color (erythema) and barrier function, after SLS application under occlusion (1% and 3% in water) to the forearm of 14 volunteers. Stratum corneum sheets were removed, stratum corneum lipids extracted, and ceramide composition determined from chromatograms (TLC) using densitometry. After determining baseline skin color and TEWL at each area. 2 samples of stratum corneum were obtained from each volunteer. Clinical and instrumental controls of the SLS-induced irritation were performed at 24, 48, 72 and 96 h. Erythema was evaluated by colorimetry; barrier impairment by changes in TEWL. We found inverse correlations between baseline ceramide 61 (weight) and the 24 h erythema score for SLS: between ceramide I and 24 h TEWL, and between ceramide 611 and 72 h TEWL for SLS 3%. Our findings suggest that low levels of these ceramides may determine a proclivity to SLS-induced irritant contact dermatitis.     

Differential irritant skin responses to topical retinoic acid and sodium lauryl sulphate: alone and in crossover design

Topically applied all-trans retinoic acid (RA) is often associated with skin irritation. A detailed quantification of RA-induced functional changes in stratum corneum is. however, still limited. U sing noti-invasive bioengineering techniques of measurements of transepidermal water loss (TEWL), stratum corneum hydration and cutaneous blood flow (CBF). we quantified the irritant effects of 0·05% and 0·1% RA in ethanol on normal skin compared with 1% sodium lauryl sulphate (SLS) in water as a model irritant in a 24-h occlusive patch-test assay. Additionally, in order to document data possibly related to the mechanism of action, skin responses to both compounds applied in tandem was also investigated over 18 days The extent of the irritant response to 0·05 and 0·1% RA, respectively, were similar, implying analogous irritation potency. While RA caused more intense scaling than SLS. other skin responses to RA were significantly weaker than those due to SLS. An increase in TEWL. on day 7. in RA-exposed sites indicates a secondary delayed impairment of the stratum corneum (SC) barrier. In a tandem-design assay, pretreatment with RA appeared to reduce the irritant effects of SLS on SC hydration and CBF. In contrast, pre-exposure to SLS showed a synergestic response in erythema, scaling and TEWL Our results demonstrate that RA, like SLS. is capable of impairing SC water barrier function, which may be responsible, in part, for the irritation associated with its topical use. However, the distinctive biological responses to these compounds suggest a different mode of action of RA and SLS. In addition, the precise reason for the unique results observed in the tandem-design assays is not clear.     

Sodium – lauryl – sulphate – induced cutaneous irritation

Reactivity of white and hispanic skin after exposure to sodium lauryl sulphate (SLS) has been investigated. The tests were performed on the back as follows: untreated skin, skin pre-treated with short-term occlusion and delipidized skin. Irritant reactions were induced by applying 0.5% and 2.0% SLS via Finn chamber patch tests and monitored by means of laser Doppler velocimetry (LDV), transepidermal water loss (TEWL) and stratum corneum water content (WC). Higher TEWL, LDV and WC were recorded for 2.0% SLS when compared to 0.5% SLS and baselines. Differences between white and hispanic skin reactivity were recorded. TEWL and WC responses showed a greater sensitivity in hispanics possibly reflecting a different modulation of the water barrier function after chemical exposure. On the other hand, the microcirculatory response, as long as detected with LDV, was similar in the 2 groups. Correlations between these data and findings observed in other races are discussed.     

Percutaneous penetration of sodium lauryl sulphate is increased in uninvolved skin of patients with atopic dermatitis compared with control subjects

BACKGROUND: Involved regions of the skin in patients with atopic dermatitis (AD) have been shown to have higher transepidermal water loss (TEWL), indicating a compromised skin barrier. Whether uninvolved skin also has diminished barrier characteristics is controversial. OBJECTIVES: To study the penetration of sodium lauryl sulphate (SLS) into uninvolved skin of patients with AD compared with the skin of control subjects. METHODS: Percutaneous penetration was assessed using the tape stripping technique on the stratum corneum (SC). Twenty patients with AD and 20 healthy subjects were exposed to 1% SLS for 4 h on the mid-volar forearm. After the end of exposure the SC was removed by adhesive tape. The amount of SLS was determined in each consecutive strip. Fick's second law of diffusion was used to deduce the diffusivity and the partition coefficient of SLS between water and the SC. RESULTS: The SC thickness was similar in both groups; however, the TEWL was higher in patients with AD compared with that of the control group (mean+/-SD 8.4+/-4.3 and 6.3+/-2.0 g m-2 h-1, respectively). There was a correlation between SC thickness and TEWL in control subjects but no correlation was found in patients with AD. The diffusivity of SLS through uninvolved AD skin was higher compared with normal skin (mean+/-SD 12.7+/-5.8x10(-9) and 6.2+/-3.0x10(-9) cm-2 h-1, respectively), while the partition coefficient between SC and water was lower (mean+/-SD 137+/-64 and 196+/-107, respectively). CONCLUSIONS: The results show a different penetration profile of SLS into the SC of patients with AD compared with control subjects. This indicates that even noninvolved skin in patients with AD has altered barrier characteristics, emphasizing the importance of skin protection and prevention of skin contact with chemicals.     

Functions of the stratum corneum in systemic sclerosis as distinct from hypertrophic scar and keloid functions

Both transepidermal water loss (TEWL) and skin surface high-frequency conductance are functions of the skin barrier. Systemic sclerosis (SSc) and hypertrophic scar (HS)/keloid are characterized by abnormal fibrotic changes in the dermis. Since the close interrelationship between the epidermis and the dermis has been well established, we analyzed the stratum corneum functions of forearm skin in 39 SSc patients after assessing the degree of the skin thickening and compared those functions with 10 age-matched normal controls. We also analyzed the stratum corneum functions of HS or keloid lesions in seven patients using the same methods, and compared those functions to adjacent or contralateral normal skin in identical patients. Neither the TEWL, nor high-frequency conductance of forearm skin in SSc patients were significantly different from those in normal controls. There was no correlation between the levels of TEWL or high-frequency conductance and the degree of skin thickening in SSc. In HS or keloid conditions, high-frequency conductance was significantly elevated (42.5+/-8.9 vs. 26.4+/-5.7, P<0.001). Although TEWL was elevated, there was no statistical significance (48.6+/-39.7 vs. 25.1+/-10.1). Our results revealed that stratum corneum functions are distinct between SSc and HS or keloid. This may reflect the various natures of dermal changes, which in turn differentiate the functions of the stratum corneum in the diseases.     

Effects of prolonged occlusion on stratum corneum barrier function and water holding capacity.

PURPOSE OF THE STUDY: We aimed to evaluate whether prolonged occlusion can induce stratum corneum barrier damage, alterations in stratum corneum hydration or water-holding capacity (WHC) lasting longer than the occlusion time. MATERIALS AND METHODS: 12 subjects were occluded on the forearm for 24, 48, 72 and 96 h. Two hours after occlusion removal, transepidermal water loss (TEWL) and skin hydration were measured and a sorption-desorption test performed. RESULTS: TEWL showed an increase reaching a plateau on day 2. Hydration and WHC did not show significant changes. Hygroscopicity showed the highest level on day 1, decreasing during the following days. A highly significant correlation between capacitance values and the WHC could be detected (p < 0.0001, r = 0.8206). No correlation could be detected between hygroscopicity and TEWL. CONCLUSIONS: Prolonged occlusion induces barrier damage without skin dryness. Occlusion also induces an increased hygroscopicity. A correlation between these two findings could not be proven.     

Alpha hydroxyacids modulate stratum corneum barrier function

Alpha hydroxyacids (AHAs) are used to enhance stratum corneum desquamation and improve skin appearance. The purpose of this study was to evaluate whether some AHAs improve skin barrier function and prevent skin irritation. Eleven healthy subjects (aged 28 ± 6 years. mean ± SD) entered the study. Six test sites of 8×5 cm (four different AHAs, vehicle only (VE) and untreated control (UNT)) were selected and randomly rotated on the volar arm and forearm. The four different AHAs at 8% concentration in base cream were glycolic acid (GA), lactic acid, tartaric acid (TA) and gluconolactone (GLU). The products were applied twice a day for 4 weeks (2 mg/cm²). At week 4, a 5% sodium lauryl sulphate (SLS) challenge patch test was performed under occlusion for 6 h (HillTop chamber. 18 mm wide) on each site. Barrier function and skin irritation were evaluated by means of evaporimetry (Servomed EP-1) and chromametry (a* value, Minolta CR200) weekly, and at 0.24 and 48 h after SLS patch removal. No significant differences in transepidermal water loss (TEWL) and erythema were observed between the four AHAs at week 4. After SLS challenge. GLU and TA-treated sites resulted in significantly lower TEWL compared with VE, UNT (P<0.01) and GA (P<0.05) both at 24 and 48 h. Similarly, a* values were significantly reduced after irritation in GLU-and TA-treated sites. This study shows that AHAs can modulate stratum corneum barrier function and prevent skin irritation: the effect is not equal for all AHAs. being more marked for the molecules characterized by antioxidant properties.     

Influence of surfactant mixtures on intercellular lipid fluidity and skin barrier function

Background/aims: Surfactant mixtures are used in cosmetic and pharmaceutical formulas in order to establish product efficacy while maintaining mildness and skin lipids. The electron paramagnetic resonance (EPR) technique of the spin labeling method with a nitroxide spin probe is a valuable method in the study of biological membranes. The objective of this study was to define the influence of surfactant mixtures on intercellular lipid fluidity and correlate EPR spectral data with in vivo safety data. Methods: EPR experiment: EPR spectra of 5-doxyl stearic acid (5-DSA) labeled stratum corneum treated with sodium lauryl sulfate (SLS), sodium lauroyl glutamate (SLG) and their mixtures were measured and order parameters were calculated. Clinical testing: Fifteen healthy volunteers free of skin disease and with no history of atopic dermatitis were treated with SLS solutions (0.25%, 0.50%, 0.75%, 1.00%), 1.00% SLG solution and 1.00% surfactant mixture solutions: 0.75% SLS+0.25% SLG, 0.50% SLS+0.50% SLG, 0.25% SLS+0.75% SLG. One hundred μl of solution was applied using a polypropylene chamber for 24 h. Transepidermal water loss (TEWL) was measured with an evaporimeter before and after the application of surfactant solutions and each site was also visually graded according to Lee (1). Results: The order parameter (S) calculated from 1.00 %wt SLS treated stratum corneum was 0.56 ± 0.03, indicating disordering of lipid structure. On the contrary, the high S value (0.82 ± 0.02) for 1.00 %wt SLG suggests a reduced effect on the structured lipid, almost equaling the value of water. Treatment with 0.25 %wt, 0.50 %wt and 0.75 %wt SLS solutions revealed intermediate levels between 1.00 %wt SLG and SLS. The order parameters at each SLS concentration (0.25, 0.50, 0.75 and 1.00 %wt SLS) with 1.00 %wt SLG showed higher values than those of SLS only solutions. There were statistically significant differences between with and without 1.00 %wt SLG (P < 0.05). These results suggest that the addition of 1.00 %wt SLG inhibits the fluidization of intercellular lipid induced by SLS. The visual scores and TEWL values of 1.00% SLG solution were lower than those of the other test solutions (except for the vehicle control: deionized water). The 1.00% surfactant mixture solutions showed lower visual scores and TEWL values of the 1.00% SLS solution. An increase of SLG concentration decreased the visual scores and TEWL values. Order parameter S obtained from EPR spectra correlated with the clinical study. The correlation coefficient (r²) of visual score and TEWL values was 0.73 and 0.83, respectively. Conclusion: SLS disorder (fluidity) intercellular lipids at low concentrations, such as 0.25 %wt, presumably due to the SLS molecules being intercalated into the intercellular lipids. However, EPR spectral data suggest that the addition of 1.00 %wt SLG to an SLS solution (<1.00 %wt) inhibits the fluidization of intercellular lipid induced by SLS. A reasonable correlation between order parameters and human clinical data (visual scores and TEWL values) was observed (r²=0.73 and 0.83, respectively). The use of the EPR spin labeling method for predicting the fluidity of stratum corneum should give further insight into the mechanism of epidermal barrier disruption by surfactants and possibly other chemicals.     

ATR-FTIR技术在面部敏感性皮肤角质层成分分析中的应用研究

【摘要】 目的 利用衰减全反射傅里叶变化红外光谱仪（ATR-FTIR）分析敏感性皮肤与正常皮肤角质层成分的差异,探讨该技术在敏感性皮肤发生机制研究中的应用价值。方法 自2018年12月至2019年2月,招募在上海市居住 ≥ 6年的148例志愿者,通过问卷调查、乳酸刺痛试验和辣椒素试验,将受试者分为正常皮肤组和敏感性皮肤组;同时,记录乳酸刺痛试验和辣椒素试验中受试者的总刺痛评分和总灼痛评分。应用ATR-FTIR检测角质层成分,包括天然保湿因子（NMF）、角质层脂质、游离脂肪酸（FFA）和β/α比值;同时应用其他无创技术测量经表皮失水率（TEWL）、角质层含水量、角质层脂质、皮肤pH值和3种周围感觉神经纤维的电流感觉阈值和浅表皮肤血流灌注量等皮肤生理参数。分析角质层成分与总刺痛评分和总灼痛评分的Spearman相关系数,以及与皮肤生理参数的Pearson相关系数。结果 73例志愿者完成全部试验,其中敏感性皮肤组34例,男15例,女19例,年龄（41.8 ± 8.9）岁;正常皮肤组39例,男19例,女20例,年龄（42.8 ± 9.4）岁。敏感性皮肤组和正常皮肤组角质层NMF分别为30.90 ± 7.38、37.01 ± 8.77（t = 3.193,P < 0.01）,FFA分别为14.90 ± 6.75和20.45 ± 11.76（t = 2.422,P < 0.05）,β/α值分别为3.17 ± 1.03和2.67 ± 0.56（t = -2.595,P < 0.05）,角质层脂质两组差异无统计学意义（t = 1.458,P > 0.05）。皮肤生理参数中,敏感性皮肤组TEWL显著高于正常皮肤组（t = -3.496,P < 0.001）,而5 Hz电流感觉阈值和表皮致密度显著低于正常皮肤组（P < 0.05）,角质层脂质差异无统计学意义（P > 0.05）。相关分析显示,NMF、FFA和β/α与TEWL（r值分别为-0.405、-0.562、0.503,均P < 0.01）和总刺痛评分（rs值分别为-0.401、-0.285、0.316,P < 0.01或0.05）均呈良好的相关性,同时,表皮致密度与NMF（r = 0.402,P < 0.01）和β/α比值（r = -0.369,P < 0.05）也呈良好的相关性。但NMF、FFA和β/α与角质层脂质、3种感觉神经纤维的电流感觉阈值、浅表皮肤血流灌注量及表皮厚度之间均无相关性（均P > 0.05）。结论 敏感性皮肤与正常皮肤角质层NMF、FFA和β/α存在显著差异,且NMF、FFA和β/α与部分角质层屏障功能生理参数之间具有良好的相关性。因此,ATR-FTIR是一种有效评价敏感性皮肤屏障功能的手段。     

Human cutaneous irritation: induced hyporeactivity

The variation in human skin response to sodium lauryl sulfate (SLS) was determined with patch and open applications. Reactions in different subjects and in multiple simultaneous patch tests were compared. Skin responses were assessed with visual scoring (VS), laser Doppler velocimetry (LDV) and transepidermal water loss (TEWL). Previous open, unpatched SLS exposure decreased patch test reactivity to 1% SLS assessed with VS (p less than 0.05) or LDV (p less than 0.05). Corresponding TEWL alteration was inconstant. Variation in reactivity at different test sites in multiple simultaneous tests was considerable, though less than the variation at different test times (p less than 0.05). Inter-subject variation in test reactivity was greater than the variation between different test times or adjacent test sites. Repeated open applications and the subclinical dermatitis appear to have produced a hyporeactive state. The results suggest that non-specific skin inflammation is elicited by multiple factors, e.g., stratum corneum integrity and vascular reactivity. Their balance determines the ensuing reactions. The induced hyporeactivity may be one of many causes of false negative diagnostic patch tests.     

Claim substantiation and efficiency of hydrating body lotions and protective creams

In the present work a practical claim substantiation study is shown by the example of 5 commercially available body lotions. Their efficacy with respect to effects on transepidermal water loss (TEWL) and stratum corneum (SC) hydration of ageing skin has been examined. Results were obtained after single and repeated application (14 days, 2 x a day). The best performing product was then selected and further tested for its potential effects on sodium lauryl sulfate (SLS)-damaged skin. This was done in a younger population and the recovery of the impaired barrier function was followed by TEWL measurements. The selected body lotion had a high efficacy, improving both the TEWL and SC hydration of ageing skin by more than 30%. When applied to SLS-damaged skin, the product was able to improve skin barrier repair in comparison with physiological barrier repair. The results of this study show that a combination of non-invasive objective measurements can be used to substantiate product claims. Claims can be made with respect to protective and preventive properties of products, but also as to effectiveness of topical skin treatment in the case of abnormal barrier function or barrier restoration.     

Changes in skin barrier during treatment with systemic alitretinoin: focus on skin susceptibility and stratum corneum ceramides

Alitretinoin is a new drug for systemic treatment of chronic hand eczema. Previous functional tests of skin topically treated with retinoids have indicated impaired skin barrier function, but no data are available on barrier parameters after systemic alitretinoin treatment. To investigate the effect of systemic alitretinoin on skin barrier function and response to irritants, a secondary objective was to determine if changes occur in the lipid profile of stratum corneum after treatment with systemic alitretinoin. We conducted an open clinical intervention study on eight people ascribed to systemic alitretinoin treatment. The criteria for being ascribed to alitretinoin were chronic hand eczema and insufficient therapeutic response to potent topical corticosteroids. Before initiation and after 2 months of systemic treatment with 30 mg alitretinoin, a challenge with sodium lauryl sulphate (SLS) was performed on the volar forearm and evaluated by trans-epidermal water loss (TEWL), erythema, and a cyanoacrylate skin sample was obtained for lipid analysis. We found no significant changes in response to SLS irritation as evaluated by TEWL and erythema, after treatment with alitretinoin for 2 months. No significant changes in stratum corneum lipids were found after 2 months of treatment. In conclusion, systemic alitretinoin does not influence skin susceptibility to irritants or the ceramide profile of stratum corneum.     

Cutaneous sodium lauryl sulphate irritation potential: age and regional variability

To investigate differences in response to irritation according to age and site seven young-adult and eight elderly females were exposed to 0.25% sodium lauryl sulphate (SLS) under patch-test occlusion for 24 h. Ten anatomical regions were tested: forehead, upper arm, volar and dorsal forearm, postauricular, palm, abdomen, upper back, thigh, and ankle. The skin responses were evaluated 24 h post-patch removal by visual scoring and by transepidermal water loss measurements (TEWL). Non-treated symmetrical anatomical regions served as controls. SLS induced a mild erythematous reaction on most anatomical regions except the palm and TEWL was significantly increased as compared with controls. The elderly group demonstrated significantly less susceptibility to SLS-induced irritation for most regions of the body as indicated by visual scores and TEWL measurements. In addition, evaluation of the stratum corneum water content following SLS irritation demonstrated lower responses in the old age group for most regions. The thigh had the highest reactivity and the palm the lowest, in both age groups. These data suggest that young adult skin is more sensitive to SLS than old skin and that SLS irritation varies considerably with respect to region. Moreover, objective TEWL measurements seem to be a better indicator of irritant susceptibility, especially in the elderly, than clinical evaluation by visual scoring.     

Induction of a Hardening Phenomenon and Quantitative Changes of Ceramides in Stratum Corneum

Background

Hardening phenomenon of human skin after repeated exposure to the irritants is well-known, but the precise mechanism remains elusive.

Objective

To modify the previous experimental model of hardening phenomenon by repeated applications of two different concentrations of sodium lauryl sulfate (SLS) solutions to Korean healthy volunteers and to investigate the quantitative changes of ceramides in stratum corneum before and after chronic repeated irritation.

Methods

Eight hundred microliters of distilled water containing 0.1% and 2% SLS was applied for 10 minutes on the forearm of 41 healthy volunteers for 3 weeks. After an intervening 3-week rest, 24-hour patch tests with 1% SLS were conducted on previously irritated sites. Transepidermal water loss (TEWL), erythema index and quantity of ceramide were measured in the stratum corneum before and after irritation.

Results

TEWL values on the sites preirritated with 2% SLS were lower than those with 0.1% SLS. Hardening phenomenon occurred in 24 volunteers at day 44. The changes in ceramide levels were not significantly higher in the hardened skin than in the non-hardened skin.

Conclusion

Repetitive stimulation with a higher concentration of SLS can more easily trigger skin hardening.     

Skin barrier response to occlusion of healthy and irritated skin: Differences in trans‐epidermal water loss,erythema and stratum corneum lipids

Background. Occlusion of the skin is a risk factor for development of irritant contact dermatitis. Occlusion may, however, have a positive effect on skin healing. No consensus on the effect of occlusion has been reached. Objectives. To investigate skin barrier response to occlusion on intact and damaged skin. Methods. In study A, the response to occlusion (nitrile glove material) for either 8 hr daily for 7 days or for 72 consecutive hours, respectively, was determined and compared with that of non‐occluded skin. In study B, the response to occlusion of for 72 consecutive hours of skin that had been damaged by either sodium lauryl sulfate (SLS) or tape stripping, respectively, was determined and compared with that of to non‐occluded pre‐damaged skin. Skin barrier function was assessed by measurements of trans‐epidermal water loss (TEWL) and erythema. In study A, stratum corneum lipids were analysed. Results. Occlusion of healthy skin did not significantly influence skin barrier function, ceramide profile or the ceramide/cholesterol ratio. Occlusion of the skin after SLS irritation resulted in higher TEWL than in the control (P = 0.049). Occlusion of the skin after tape stripping resulted in lower TEWL than in control skin (P = 0.007). Conclusions. A week of occlusion did not significantly affect healthy skin, but was found to decrease healing of SLS‐damaged skin, and to improve healing of tape‐stripped skin.