title: Noninvasive bioengineering assessment of the skin barrier function in patients with chronic venous insufficiency.
abstract: BACKGROUND
  Chronic venous insufficiency (CVI) comprises all symptoms caused by permanent venous and capillary hypertension. While the clinical manifestations of the disease have been well characterized, there is little knowledge on the skin barrier function in the affected patients.
  
  
  OBJECTIVE
  The aim of the study was to assess noninvasively the barrier function in patients with CVI stage C2 and stage C4 according to the CEAP classification in comparison with healthy controls (stage C0).
  
  
  METHODS
  Thirty patients with CVI without concomitant diseases and 15 healthy, aged-matched controls were recruited for the study. The skin barrier function was assessed by measuring transepidermal water loss (TEWL), capacitance and skin colour symmetrically on the calf, medial and lateral malleolus, posterior arch (arcus venosus) and volar forearm.
  
  
  RESULTS
  Compared with the forearm, there was a tendency for increased TEWL and significant reduction of capacitance on all measurement sites on the lower limb. Compared with the control group, the patients with CVI had significantly higher TEWL values on all measurement sites on the lower extremities while no difference in capacitance between patients and controls was observed.
  
  
  CONCLUSIONS
  Changes in the epidermal barrier function in patients with CVI are readily detectable by bioengineering methods as early as stage C2 and are manifested by significantly increased TEWL. Our results suggest that the reduced stratum corneum hydration in patients with CVI is due to anatomical differences rather than venous disease. These findings may help better understand the factors contributing to disease progression and its complications.
authors.affiliation: Department of Dermatology, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany. irena.angelova-fischer@uk-sh.de
authors.forename: I
authors.initials: I
authors.lastname: Angelova-Fischer
authors.forename: D
authors.initials: D
authors.lastname: Wuthe
authors.forename: D
authors.initials: D
authors.lastname: Zillikens
authors.forename: B
authors.initials: B
authors.lastname: Kahle
mesh_terms: D000368:Aged; D057005:Bioengineering / Q000379:methods; D002908:Chronic Disease; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000503:physiopathology*; D012880:Skin Pigmentation / Q000502:physiology; D014648:Varicose Veins / Q000503:physiopathology; D014689:Venous Insufficiency / Q000503:physiopathology*; D014870:Water Loss, Insensible / Q000502:physiology*