Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
J Dermatol Sci. 2018 Jan;89(1):33-39. doi: 10.1016/j.jdermsci.2017.10.011. Epub 2017 Nov 2.
Sensitive skin is a condition of cutaneous hypersensitivity to environmental factors. Lactic acid stinging test (LAST) is commonly used to assess sensitive skin and composed of four distinct sensations (pain, burning sensation, itch, and crawly feeling). A link between sensitive skin and barrier dysfunction has been proposed in atopic dermatitis (AD) patients. However, clinical and laboratory factors that are associated with sensitive skin remain unelucidated.
To investigate relationship between sensitive skin and AD-associated markers.
Forty-two Japanese AD patients and 10 healthy subjects (HS) were enrolled. AD patients were divided into extrinsic (EAD; high IgE levels) and intrinsic (IAD; normal IgE levels) types. We conducted 1% LAST by assessing the four distinct sensations and calculated the frequencies of sensitive skin in EAD, IAD, and HS. We also performed clinical AD-related tests, including transepidermal water loss (TEWL), visual analogue scale (VAS) of pruritus, and quality of life, and measured laboratory markers, including blood levels of IgE, CCL17/TARC, lactate dehydrogenase (LDH) and eosinophil counts, and concentration levels of serum Th1/Th2 cytokines. Filaggrin (FLG) mutations were examined in 21 patients. These values were subjected to correlation analyses with each of the four sensation elements.
According to the standard criteria for LAST positivity, the frequencies of LAST-positive subjects were 54.8% and 10.0% in AD and HS, respectively (P=0.014). EAD patients showed a significantly (P=0.026) higher frequency of positive LAST (65.6%) than did IAD patients (20.0%). Among the four LAST sensation elements, the crawly feeling and pain scores positively correlated with VAS of pruritus, total serum IgE, mite-specific IgE, CCL17/TARC, and/or LDH. There was no association of the LAST scores with serum Th1/Th2 cytokine levels. Notably, neither TEWL nor FLG mutations correlated with LAST positivity or any sensation scores.
The frequency of sensitive skin is higher in EAD than in IAD. Sensitive skin is associated with AD severity, but not necessarily with barrier condition.
敏感皮肤是一种对环境因素过敏的皮肤状况。乳酸刺痛试验（LAST）常用于评估敏感皮肤，包括四种不同的感觉（疼痛、烧灼感、瘙痒和爬行感）。有人提出，特应性皮炎（AD）患者的敏感皮肤与屏障功能障碍有关。然而，与敏感皮肤相关的临床和实验室因素仍不清楚。
研究敏感皮肤与 AD 相关标志物之间的关系。
纳入 42 例日本 AD 患者和 10 例健康对照者（HS）。AD 患者分为特应性（EAD；高 IgE 水平）和非特应性（IAD；正常 IgE 水平）。我们通过评估四种不同的感觉进行 1%LAST，并计算 EAD、IAD 和 HS 中敏感皮肤的频率。我们还进行了与 AD 相关的临床测试，包括经皮水分丢失（TEWL）、瘙痒视觉模拟评分（VAS）和生活质量，并测量了实验室标志物，包括 IgE、CCL17/TARC、乳酸脱氢酶（LDH）和嗜酸性粒细胞计数的血水平，以及血清 Th1/Th2 细胞因子的浓度水平。在 21 例患者中检测了丝聚合蛋白（FLG）突变。这些值与每个感觉元素进行了相关性分析。
根据 LAST 阳性的标准标准，AD 和 HS 中 LAST 阳性者的频率分别为 54.8%和 10.0%（P=0.014）。EAD 患者的 LAST 阳性频率明显高于 IAD 患者（65.6% vs 20.0%，P=0.026）。在 LAST 的四种感觉元素中，爬行感和疼痛评分与瘙痒 VAS、总血清 IgE、螨特异性 IgE、CCL17/TARC 和/或 LDH 呈正相关。LAST 评分与血清 Th1/Th2 细胞因子水平无相关性。值得注意的是，TEWL 或 FLG 突变与 LAST 阳性或任何感觉评分均无相关性。
EAD 中的敏感皮肤频率高于 IAD。敏感皮肤与 AD 严重程度有关，但与屏障状况无关。
