The early phase of epidermal barrier regeneration is faster in patients with atopic eczema.
BACKGROUND
Altered epidermal barrier function as determined by transepidermal water loss (TEWL) is a typical feature in patients with atopic eczema (AE).


OBJECTIVE
The purpose of this study was to assess the kinetics of epidermal regeneration after barrier perturbation induced by two different stimuli, namely acetone treatment (removal of stratum corneum lipids) and tape stripping (removal of the nonviable stratum corneum).


METHODS
Fifteen patients with AE and 12 nonatopic healthy controls were investigated. An area of 9.0 cm2 of clinically normal skin of the forearm flexural side was treated by acetone or tape stripping in a way that an increase in TEWL of 3.5-4.0 times the pretreatment value was achieved. TEWL was recorded directly after perturbation (tO), after 15 min (tl), 3 h (t2), 6 h (t3), 24 h (t4), 48 h (t5), 72 h (t6) and 96 h (t7).


RESULTS
The speed of epidermal regeneration was faster after acetone treatment, both in the patient and the control groups, with no significant difference between the two. However, after tape stripping at points t2, t5 and t6, TEWL values relative to tO were significantly lower in atopic skin as compared to normal skin (p < 0.05).


CONCLUSIONS
The faster regeneration of barrier function after tape stripping in patients with AE may be the result of a persisting mild disturbance of barrier function. It may be speculated that repair mechanisms are permanently activated, and therefore barrier recovery is faster. However, a complete restoration of the epidermal barrier function is not achieved, perhaps because of the decreased content of ceramides in atopic skin.
Gfesser
M
M
Department of Dermatology and Allergy Biederstein, Technical University Munich, Germany.
Abeck
D
D
Rügemer
J
J
Schreiner
V
V
Stäb
F
F
Disch
R
R
Ring
J
J
D000096:Acetone / Q000494:pharmacology; D000328:Adult; D002476:Cellophane / Q000494:pharmacology; D002518:Ceramides / Q000032:analysis / Q000378:metabolism; D003876:Dermatitis, Atopic / Q000378:metabolism / Q000503:physiopathology*; D004817:Epidermis / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050356:Lipid Metabolism; D008055:Lipids / Q000032:analysis; D008297:Male; D012038:Regeneration / Q000502:physiology*; D012997:Solvents / Q000494:pharmacology; D014870:Water Loss, Insensible / Q000187:drug effects / Q000502:physiology*
D002518:Ceramides; D008055:Lipids; D012997:Solvents; D000096:Acetone; D002476:Cellophane