Löffler H, Effendy I
Department of Dermatology, University of Marburg, Germany.
Contact Dermatitis. 1999 May;40(5):239-42. doi: 10.1111/j.1600-0536.1999.tb06056.x.
The relevance of the irritant skin reaction of individuals with an atopic history (atopic dermatitis, rhinoconjunctivitis or atopic asthma) to sodium lauryl sulfate (SLS), a widely used irritant, is still controversial. The aim of this study was to evaluate transepidermal water loss (TEWL) as an indicator of stratum corneum integrity, before and after SLS patch testing, in various groups of atopic individuals with and without atopic dermatitis. 95 volunteers were divided into 4 groups: (1) individuals with active atopic dermatitis; (2) individuals with a history of atopic dermatitis but without active skin lesions; (3) individuals with rhinoconjunctivitis or atopic asthma without any symptoms at the time of testing; (4) healthy individuals serving as controls. The volunteers were patch-tested at the unaffected volar side of the forearm with aqueous SLS 0.5% for 48 h. TEWL was measured before application and after removal of the patch. Individuals with active atopic dermatitis showed a significantly higher TEWL value after SLS and a tendency to a higher basal TEWL as compared to the 3 other groups. There were no significant differences in TEWL between individuals who were classified as atopic but without active dermatitis, individuals with rhinoconjunctivitis or atopic asthma and healthy controls, either at the basal or at the post-SLS measurement. Enhanced skin susceptibility is only present in individuals with active dermatitis. The skin susceptibility of atopic individuals might therefore be increased as soon as the skin becomes eczematous, suggesting a reduced epidermal integrity probably caused by the endogenous atopy and/or respiratory allergens. When interpreting the atopy score in relation to skin susceptibility, the actual condition of the skin should hence be taken into consideration.
有特应性病史（特应性皮炎、鼻结膜炎或特应性哮喘）的个体对广泛使用的刺激性物质月桂醇硫酸酯钠（SLS）的刺激性皮肤反应的相关性仍存在争议。本研究的目的是评估在SLS斑贴试验前后，将经表皮水分流失（TEWL）作为角质层完整性指标，用于各类有或无特应性皮炎的特应性个体。95名志愿者被分为4组：（1）患有活动性特应性皮炎的个体；（2）有特应性皮炎病史但无活动性皮肤损害的个体；（3）在测试时无任何症状的鼻结膜炎或特应性哮喘个体；（4）作为对照的健康个体。志愿者在前臂未受影响的掌侧用0.5%的水性SLS进行斑贴试验48小时。在贴剂应用前和去除后测量TEWL。与其他3组相比，患有活动性特应性皮炎的个体在SLS试验后TEWL值显著更高，且基础TEWL有升高趋势。在基础状态或SLS试验后测量时，被归类为特应性但无活动性皮炎的个体、患有鼻结膜炎或特应性哮喘的个体与健康对照之间的TEWL没有显著差异。增强的皮肤易感性仅存在于患有活动性皮炎的个体中。因此，一旦皮肤出现湿疹，特应性个体的皮肤易感性可能会增加，这表明表皮完整性降低可能是由内源性特应性和/或呼吸道过敏原引起的。在解释与皮肤易感性相关的特应性评分时，因此应考虑皮肤的实际状况。
