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420 The effects of bathing, showering and petrolatum on skin barrier function
Epidermal Structure and Barrier Function | ABSTRACTS 420
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The effects of bathing, showering and petrolatum on skin barrier function E Bolton1, A Ferguson2, B Simpson2, J Al-naqeeb2 and E Simpson3 1 Creighton University SOM, Council Bluffs, IA, 2 OHSU Department of Dermatology, Portland, OR and 3 Oregon Health and Science University, Portland, OR Sparse data exist to guide recommendations regarding the frequency, length, and type of bathing for patients with chronic skin diseases like atopic dermatitis. The objective of this study was to compare the effects of a bath vs shower on skin hydration and barrier permeability in normal adult volunteers. We further evaluated whether petrolatum after a bath improves barrier parameters compared to petrolatum alone. Fifteen healthy participants were randomized in a split-body clinical trial to receive a simulated bath or shower. Transepidermal water loss (TEWL) and capacitance measurements were taken from the volar forearm at timed intervals for 45 minutes. In a separate study, petrolatum was applied immediately after a bath and compared to an arm receiving petrolatum alone. Bathing showed a superior effect on increasing barrier permeability over showering as measured by TEWL (p¼0.001). Bathing was not superior to showering with regard to hydration (p¼0.07) with hydration increases in both groups returning to baseline within 10 minutes. In the second study, application of petrolatum immediately after bathing blunted the increase in permeability. The effects of petrolatum on hydration after bathing could not be measured due to petrolatum interference with accurate capacitance measurements. Bathing increases skin barrier permeability more than showering which may have implications for optimizing absorption of topical anti-inflammatory therapy. Skin hydration and permeability increases seen with bathing or showering diminish rapidly, thus topical anti-inflammatories or emollients should be applied immediately after water exposure. Whether petrolatum immediately after bathing increases hydration compared to petrolatum alone remains to be answered.
Elevated serum IgE level, but not TARC and LDH, may reflect the impairment of stratum corneum barrier function in healthy individuals; Results of crosssectional study of 1141 Japanese healthy individuals E Akasaka1, K Hara1, M Takahashi1, T Fukui1, A Korekawa1, H Nakano1, I Takahashi2, S Nakaji2 and D Sawamura1 1 Department of Dermatology, Hirosaki University Graduate School of Medicine, Japan and 2 Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan The serum levels of thymus and activation-regulated chemokine (TARC), immunoglobulin E (IgE), and lactate dehydrogenase (LDH) were known to reflect the disease severity of atopic dermatitis (AD). AD is characterized by impaired epidermal barrier function and atopic dry skin, however, it has not been fully elucidated whether these parameters correlated with the impairment of skin barrier function even in healthy individuals. In this study, we investigated serum levels of TARC, IgE, and LDH, and values of transepidermal water loss (TEWL) and stratum corneum hydration (SCH) in 1141 Japanese healthy individuals. Serum IgE levels were inversely correlated with SCH values, on the other hands serum TARC and LDH levels were not correlated with TEWL and SCH values in the healthy individuals, unlike patients with AD. To the best of our knowledge, this is a largest cross-sectional study of TEWL and SCH values in healthy subjects. Our study provided some novel evidence about the correlation between skin barrier function and serum levels of TARC, IgE, and LDH in healthy subjects.
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The distribution and ultrastructure of the touch dome in human hairy skin Y Kabata1, M Orime2, T Ushiki1 and R Abe2 1 Division of Microscopic Anatomy, Niigata University Graduate School of Medical and Dental Sciences, Niigata-shi, Japan and 2 Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigatashi, Japan The touch dome is a mechanoreceptor in mammalian hairy skin and is characterized by the accumulation of Merkel cell-neurite complexes at the epidermal base. The touch dome often exists in sensitive parts of sensation; the abdomen in rats, the paw in cats. The shape of the touch dome varies depending on the species; the rat touch dome is clearly observed as a round elevation with a bristle, while, in humans, it is difficult to identify by its surface appearance and HE-stained section because of its obscure shape with a slight elevation. We previously clarified the three-dimensional structure of the human touch dome scanning electron microscopy (SEM) (Orime, JID 2013). We further examined the distribution, frequency and shape of the human touch dome in different parts of the human body. Human skin were obtained from donated bodies for routine dissection. Skin pieces (3x3 mm in size) were treated with a KOH-collagenase method for separation of the epidermis from the dermis. We observed the basal surface of the separated epidermis in an SEM and examined the shape, size, and frequency of the touch dome. By SEM, the touch dome was clearly determined as a concave area with neural components bordered by a thick epidermal ridge. There are 5 to 10 Merkel cells are observed in one touch dome, and the unmyelinated nerve terminal ended on them. The size of the touch dome tends to be smaller in the forearm than in the abdomen, whereas the number is larger in the forearm than in the abdomen. There is one touch dome per 68 square mm in the abdomen, and one per 35 square mm in the forearm. Our results suggested that the regional frequency of touch dome might correlate a sensitivity of sensation.
Sensitive skin is highly frequent in atopic dermatitis and correlates with disease severity markers but not necessarily with skin barrier assessments T Yatagai, T Shimauchi, H Yamaguchi, J Sakabe, M Aoshima, S Ikeya, K Tatsuno, T Fujiyama, T Ito and Y Tokura Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan Sensitive skin (SS) is a condition of cutaneous hypersensitivity to environmental factors. Lactic acid stinging test (LAST) is commonly used to assess SS and composed of four distinct sensations (pain, burning sensation, itch, and crawly feeling) to be evaluated. Several studies have suggested a link between SS and skin barrier dysfunction particularly in patients with atopic dermatitis (AD). However, factors associated with SS remain elusive. To investigate the AD-associated clinical and laboratory markers that correlate with the sensitive skin, 42 Japanese AD patients and 10 healthy subjects (HS) were enrolled. AD patients were divided into extrinsic (high IgE levels; EAD) and intrinsic (normal IgE levels; IAD) types. Filaggrin (FLG) gene mutations were evaluated in 21 patients. We conducted 1% LAST by assessing the four distinct sensations. The frequencies of LAST-positive subjects were 54.8% and 10.0% in AD and HS, respectively (P¼0.0137). EAD patients showed a significantly (P¼0.0258) higher frequency of positive LAST (65.6%) than did IAD patients (20.0%). The crawly feeling score positively correlated with VAS of pruritus, total serum IgE, Dermatophagoides farinae (DF)specific IgE, CCL17/TARC, and LDH. The pain score also positively correlated with DFspecific IgE, TARC, and LDH. The burning sensation or itch score was not associated with any values. Notably, neither the value of TEWL nor the presence or absence of FLG mutations correlated with LAST positivity or any sensation scores. Thus, our findings suggest that SS is associated with AD severity, but not with barrier condition represented by TEWL or FLG mutations.
Sphingolipid derivatives induces autophagic responses in cultured human fibroblasts and reconstituted 3D skin model K Yoo1, Y Hur2, S Kim1, M Kim1, J Park1, B Park1, J Lim1, H Kim3, G Nam4 and S Jeong4 1 Neopharm Co., Ltd, Daejeon, Republic of Korea, 2 Korea Basic Science Institute, Ochang, Republic of Korea, 3 Seoul Medical Center, Seoul, Republic of Korea and 4 Seowon University, Daejeon, Republic of Korea Autophagy can be defined as a self-digestive process, targeting internal or damaged organelles and misfolded proteins to lysosomal degradation. While its major role can be defined as a survival mechanism under stress conditions, such as nutrient restriction, it can also induce cell death under certain conditions. Along with the clinical implications in various human diseases, including neurodegenerative diseases, infection, and cancer, recent studies also suggest a potential involvement of autophagy in skin aging. Possible defects in autophagy signaling has been reported in aged skin, which implies that stimulation of autophagic flux might be helpful for skin anti-aging. Based on the potential roles of sphingolipids in autophagy signaling, sphingolipid derivatives have synthesized and their effects on autophagy were assessed in cultured human skin fibroblasts. As a result, several new compounds were identified as having autophagy stimulating activities. To evaluate the potential anti-aging effects, reconstituted 3D skin model was used. Application of selected compounds resulted in an increased autophagy signaling in reconstituted skin and Massons-trichrome staining also showed an upregulated expression of dermal collagen in treated tissue. These results suggest that autophagy signaling is also related with skin aging and stimulation of autophagy might be a new target for skin anti-aging.
Dermokine b/g are essential for the early postnatal barrier function of the epidermis A Utsunomiya1, T Chino2, A Tokuriki2, N Utsunomiya1, VH Luong2, K Higashi3, K Saito4, N Oyama2 and M Hasegawa2 1 Fukui University, Fukui, Japan, 2 Dermatology, Fukui University, Fukui, Japan, 3 Dermatology, Fukui University, Osaka, Japan and 4 Sumitomo Chemical Co., Ltd., Osaka, Japan Dermokine (DMKN) family members consist of four splicing variants (a, b, g, and d) and are expressed specifically in the normal upper epidermis. The expression of b and g isoforms (DMKN b/g) is augmented in inflammatory skin disorders, such as atopic dermatitis and psoriasis. However, the in vivo function of DMKN b/g regarding the maintenance of skin homeostatic and architectural balance remain uncertain. The purpose of this study was to investigate the pathophysiological impact of DMKN b/g in skin by generating mice genetically deficient in these two molecules. We analyzed phenotypic differences in the skin morphology, pathology, and barrier function between DMKN b/g knockout (KO) mice and wild type littermates. The DMKN b/g KO mice didn’t show lethality at any developmental stages, nor did impairment of embryonic/postnatal growth and organ development. However, their skin morphology exhibited obvious scales and deep wrinkling by postnatal day 8, and spontaneously became normal thereafter. At the early neonatal stage, an ultramicroscopic structure of the superficial KO mouse skin revealed altered corneal lamellation with immature keratohyalin granules and fissure formation. Moreover, the KO mice showed significant increase of trans-epidermal water loss, but not dye diffusion. DMKN b/g deficiency in mice caused a subtle skin phenotype with transient hyperkeratosis, wrinkle formation, and persisted epidermal impermeability of water during the early neonatal stage, being reminiscent of the skin phenotype in atopic dermatitis. Our data suggests the possible involvement of spatial and temporal action of DMKN b/g, particularly at the early postnatal stage, in the corneo-epidermal barrier function.
www.jidonline.org S73
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The effects of bathing, showering and petrolatum on skin barrier function E Bolton1, A Ferguson2, B Simpson2, J Al-naqeeb2 and E Simpson3 1 Creighton University SOM, Council Bluffs, IA, 2 OHSU Department of Dermatology, Portland, OR and 3 Oregon Health and Science University, Portland, OR Sparse data exist to guide recommendations regarding the frequency, length, and type of bathing for patients with chronic skin diseases like atopic dermatitis. The objective of this study was to compare the effects of a bath vs shower on skin hydration and barrier permeability in normal adult volunteers. We further evaluated whether petrolatum after a bath improves barrier parameters compared to petrolatum alone. Fifteen healthy participants were randomized in a split-body clinical trial to receive a simulated bath or shower. Transepidermal water loss (TEWL) and capacitance measurements were taken from the volar forearm at timed intervals for 45 minutes. In a separate study, petrolatum was applied immediately after a bath and compared to an arm receiving petrolatum alone. Bathing showed a superior effect on increasing barrier permeability over showering as measured by TEWL (p¼0.001). Bathing was not superior to showering with regard to hydration (p¼0.07) with hydration increases in both groups returning to baseline within 10 minutes. In the second study, application of petrolatum immediately after bathing blunted the increase in permeability. The effects of petrolatum on hydration after bathing could not be measured due to petrolatum interference with accurate capacitance measurements. Bathing increases skin barrier permeability more than showering which may have implications for optimizing absorption of topical anti-inflammatory therapy. Skin hydration and permeability increases seen with bathing or showering diminish rapidly, thus topical anti-inflammatories or emollients should be applied immediately after water exposure. Whether petrolatum immediately after bathing increases hydration compared to petrolatum alone remains to be answered.
Elevated serum IgE level, but not TARC and LDH, may reflect the impairment of stratum corneum barrier function in healthy individuals; Results of crosssectional study of 1141 Japanese healthy individuals E Akasaka1, K Hara1, M Takahashi1, T Fukui1, A Korekawa1, H Nakano1, I Takahashi2, S Nakaji2 and D Sawamura1 1 Department of Dermatology, Hirosaki University Graduate School of Medicine, Japan and 2 Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan The serum levels of thymus and activation-regulated chemokine (TARC), immunoglobulin E (IgE), and lactate dehydrogenase (LDH) were known to reflect the disease severity of atopic dermatitis (AD). AD is characterized by impaired epidermal barrier function and atopic dry skin, however, it has not been fully elucidated whether these parameters correlated with the impairment of skin barrier function even in healthy individuals. In this study, we investigated serum levels of TARC, IgE, and LDH, and values of transepidermal water loss (TEWL) and stratum corneum hydration (SCH) in 1141 Japanese healthy individuals. Serum IgE levels were inversely correlated with SCH values, on the other hands serum TARC and LDH levels were not correlated with TEWL and SCH values in the healthy individuals, unlike patients with AD. To the best of our knowledge, this is a largest cross-sectional study of TEWL and SCH values in healthy subjects. Our study provided some novel evidence about the correlation between skin barrier function and serum levels of TARC, IgE, and LDH in healthy subjects.
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The distribution and ultrastructure of the touch dome in human hairy skin Y Kabata1, M Orime2, T Ushiki1 and R Abe2 1 Division of Microscopic Anatomy, Niigata University Graduate School of Medical and Dental Sciences, Niigata-shi, Japan and 2 Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigatashi, Japan The touch dome is a mechanoreceptor in mammalian hairy skin and is characterized by the accumulation of Merkel cell-neurite complexes at the epidermal base. The touch dome often exists in sensitive parts of sensation; the abdomen in rats, the paw in cats. The shape of the touch dome varies depending on the species; the rat touch dome is clearly observed as a round elevation with a bristle, while, in humans, it is difficult to identify by its surface appearance and HE-stained section because of its obscure shape with a slight elevation. We previously clarified the three-dimensional structure of the human touch dome scanning electron microscopy (SEM) (Orime, JID 2013). We further examined the distribution, frequency and shape of the human touch dome in different parts of the human body. Human skin were obtained from donated bodies for routine dissection. Skin pieces (3x3 mm in size) were treated with a KOH-collagenase method for separation of the epidermis from the dermis. We observed the basal surface of the separated epidermis in an SEM and examined the shape, size, and frequency of the touch dome. By SEM, the touch dome was clearly determined as a concave area with neural components bordered by a thick epidermal ridge. There are 5 to 10 Merkel cells are observed in one touch dome, and the unmyelinated nerve terminal ended on them. The size of the touch dome tends to be smaller in the forearm than in the abdomen, whereas the number is larger in the forearm than in the abdomen. There is one touch dome per 68 square mm in the abdomen, and one per 35 square mm in the forearm. Our results suggested that the regional frequency of touch dome might correlate a sensitivity of sensation.
Sensitive skin is highly frequent in atopic dermatitis and correlates with disease severity markers but not necessarily with skin barrier assessments T Yatagai, T Shimauchi, H Yamaguchi, J Sakabe, M Aoshima, S Ikeya, K Tatsuno, T Fujiyama, T Ito and Y Tokura Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan Sensitive skin (SS) is a condition of cutaneous hypersensitivity to environmental factors. Lactic acid stinging test (LAST) is commonly used to assess SS and composed of four distinct sensations (pain, burning sensation, itch, and crawly feeling) to be evaluated. Several studies have suggested a link between SS and skin barrier dysfunction particularly in patients with atopic dermatitis (AD). However, factors associated with SS remain elusive. To investigate the AD-associated clinical and laboratory markers that correlate with the sensitive skin, 42 Japanese AD patients and 10 healthy subjects (HS) were enrolled. AD patients were divided into extrinsic (high IgE levels; EAD) and intrinsic (normal IgE levels; IAD) types. Filaggrin (FLG) gene mutations were evaluated in 21 patients. We conducted 1% LAST by assessing the four distinct sensations. The frequencies of LAST-positive subjects were 54.8% and 10.0% in AD and HS, respectively (P¼0.0137). EAD patients showed a significantly (P¼0.0258) higher frequency of positive LAST (65.6%) than did IAD patients (20.0%). The crawly feeling score positively correlated with VAS of pruritus, total serum IgE, Dermatophagoides farinae (DF)specific IgE, CCL17/TARC, and LDH. The pain score also positively correlated with DFspecific IgE, TARC, and LDH. The burning sensation or itch score was not associated with any values. Notably, neither the value of TEWL nor the presence or absence of FLG mutations correlated with LAST positivity or any sensation scores. Thus, our findings suggest that SS is associated with AD severity, but not with barrier condition represented by TEWL or FLG mutations.
Sphingolipid derivatives induces autophagic responses in cultured human fibroblasts and reconstituted 3D skin model K Yoo1, Y Hur2, S Kim1, M Kim1, J Park1, B Park1, J Lim1, H Kim3, G Nam4 and S Jeong4 1 Neopharm Co., Ltd, Daejeon, Republic of Korea, 2 Korea Basic Science Institute, Ochang, Republic of Korea, 3 Seoul Medical Center, Seoul, Republic of Korea and 4 Seowon University, Daejeon, Republic of Korea Autophagy can be defined as a self-digestive process, targeting internal or damaged organelles and misfolded proteins to lysosomal degradation. While its major role can be defined as a survival mechanism under stress conditions, such as nutrient restriction, it can also induce cell death under certain conditions. Along with the clinical implications in various human diseases, including neurodegenerative diseases, infection, and cancer, recent studies also suggest a potential involvement of autophagy in skin aging. Possible defects in autophagy signaling has been reported in aged skin, which implies that stimulation of autophagic flux might be helpful for skin anti-aging. Based on the potential roles of sphingolipids in autophagy signaling, sphingolipid derivatives have synthesized and their effects on autophagy were assessed in cultured human skin fibroblasts. As a result, several new compounds were identified as having autophagy stimulating activities. To evaluate the potential anti-aging effects, reconstituted 3D skin model was used. Application of selected compounds resulted in an increased autophagy signaling in reconstituted skin and Massons-trichrome staining also showed an upregulated expression of dermal collagen in treated tissue. These results suggest that autophagy signaling is also related with skin aging and stimulation of autophagy might be a new target for skin anti-aging.
Dermokine b/g are essential for the early postnatal barrier function of the epidermis A Utsunomiya1, T Chino2, A Tokuriki2, N Utsunomiya1, VH Luong2, K Higashi3, K Saito4, N Oyama2 and M Hasegawa2 1 Fukui University, Fukui, Japan, 2 Dermatology, Fukui University, Fukui, Japan, 3 Dermatology, Fukui University, Osaka, Japan and 4 Sumitomo Chemical Co., Ltd., Osaka, Japan Dermokine (DMKN) family members consist of four splicing variants (a, b, g, and d) and are expressed specifically in the normal upper epidermis. The expression of b and g isoforms (DMKN b/g) is augmented in inflammatory skin disorders, such as atopic dermatitis and psoriasis. However, the in vivo function of DMKN b/g regarding the maintenance of skin homeostatic and architectural balance remain uncertain. The purpose of this study was to investigate the pathophysiological impact of DMKN b/g in skin by generating mice genetically deficient in these two molecules. We analyzed phenotypic differences in the skin morphology, pathology, and barrier function between DMKN b/g knockout (KO) mice and wild type littermates. The DMKN b/g KO mice didn’t show lethality at any developmental stages, nor did impairment of embryonic/postnatal growth and organ development. However, their skin morphology exhibited obvious scales and deep wrinkling by postnatal day 8, and spontaneously became normal thereafter. At the early neonatal stage, an ultramicroscopic structure of the superficial KO mouse skin revealed altered corneal lamellation with immature keratohyalin granules and fissure formation. Moreover, the KO mice showed significant increase of trans-epidermal water loss, but not dye diffusion. DMKN b/g deficiency in mice caused a subtle skin phenotype with transient hyperkeratosis, wrinkle formation, and persisted epidermal impermeability of water during the early neonatal stage, being reminiscent of the skin phenotype in atopic dermatitis. Our data suggests the possible involvement of spatial and temporal action of DMKN b/g, particularly at the early postnatal stage, in the corneo-epidermal barrier function.
www.jidonline.org S73