title: Nonlesional skin in atopic dermatitis is seemingly healthy skin - observations using noninvasive methods.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a chronic and relapsing skin disorder, which is characterized by abnormal skin barrier function within the entire skin surface. Several noninvasive bioengineering methods have been commonly used to quantify disease severity. High-frequency ultrasonography (HF-USG) is an important contribution to this field.
  
  
  OBJECTIVE
  To evaluate noninvolved skin during the external treatment in relation to involved regions in patients with AD skin using noninvasive methods.
  
  
  METHODS
  Transepidermal water loss (TEWL), capacitance and erythema assessment and HF-USG were performed in 55 AD patients within 2 regions (involved and uninvolved skin) before and after therapy. The clinical severity of the disease process was based on the eczema area and severity index (EASI) score. A control group consisting of 15 subjects was also included.
  
  
  RESULTS
  On the basis of 4 bioengineering methods our study revealed that uninvolved skin in AD presents subclinical disturbances and significantly changes during therapy. The HF-USG detects inflammation in the upper dermis in AD patients in the form of a hypoechoic band, which may also be observed to a lesser extent within normal-appearing skin.
  
  
  CONCLUSIONS
  Nonlesional skin differs significantly from lesional skin in AD and from skin of healthy subjects. Noninvasive methods are able to measure subclinical skin disturbances within normal-appearing skin, which are not evaluated using standard clinical scores. They are objective and may facilitate communication between different research groups.
authors.affiliation: Department of Dermatology, Poznan University of Medical Sciences, Poland.
authors.forename: Adriana
authors.initials: A
authors.lastname: Polańska
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Dańczak-Pazdrowska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Silny
authors.forename: Dorota
authors.initials: D
authors.lastname: Jenerowicz
authors.forename: Karolina
authors.initials: K
authors.lastname: Olek-Hrab
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Osmola-Mańkowska
keywords: atopic dermatitis; capacitance; high frequency ultrasonography; seemingly healthy skin; skin ultrasonography; transepidermal water loss