title: Impairment of skin barrier function is not inherent in atopic dermatitis patients: a prospective study conducted in newborns.
abstract: We conducted a cohort study to determine whether the barrier dysfunction of the stratum corneum that facilitates the penetration of various exacerbating agents from the environment is inherent in atopic dermatitis patients as suggested by some dermatologists. Clinical observation and biophysical measurements of the skin were performed on the cheek and on the flexor forearm of 24 newborn infants once between 2 and 14 days postnatally and 1, 3, and 6 months later. Nineteen had atopic family histories. Most of the infants had physiologic neonatal xerosis that was observed as a reduced high-frequency conductance without any impairment in the stratum corneum barrier function assessed by transepidermal water loss. Four of the 24 neonates developed atopic dermatitis around 2 to 3 months after birth. In all of them, barrier impairment noted as increased transepidermal water loss was observed only after the development of skin lesions. During their neonatal period, their transepidermal water loss and skin surface hydration state were indistinguishable from those of the neonates whose skin remained lesion-free during the observation period. Therefore, we concluded that the barrier impairment found in atopic dermatitis is not inherent but represents a phenomenon secondary to dermatitic skin changes.
authors.affiliation: Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan. katsukon@mail.tains.tohoku.ac.jp
authors.forename: Katsuko
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: O'goshi
authors.forename: Hachiro
authors.initials: H
authors.lastname: Tagami
mesh_terms: D001692:Biological Transport; D002610:Cheek; D003876:Dermatitis, Atopic / Q000503:physiopathology*; D004817:Epidermis / Q000502:physiology*; D005260:Female; D005542:Forearm; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012879:Skin Physiological Phenomena; D014870:Water Loss, Insensible