Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong.
J Dermatolog Treat. 2021 Feb;32(1):45-48. doi: 10.1080/09546634.2018.1442551. Epub 2020 Oct 7.
Symptomatology and severity of atopic dermatitis (AD) can be objectively measured with equipment. This study aimed to compare skin measurements and investigate their correlations with various clinical severity scores.
Skin hydration (SH), transepidermal water loss (TEWL), pH, erythema, pigmentation, and ITA (individual typology angle) were measured (using Delfin, Courage + Khazaka, and Mettler Toledo equipment), and correlated with Patient-Oriented Eczema Measure (POEM, a short-term subjective-symptom score), Scoring Atopic Dermatitis (SCORAD, a short-term subjective-symptom and objective-sign score), Nottingham Eczema Severity Score (NESS, a long-term subjective-symptom score), Children Dermatology Life Quality Index (CDLQI, a short-term subjective-symptom score) with Spearman's rho coefficient.
80 sets of clinical scores from eczema patients (mean age: 10.8 ± 4.9 years; 44.6% male) were evaluated. The POEM, objective SCORAD, CDLQI correlated well with each other. Skin pH ranged from 4.3 to 7.0 (mean 5.7 ± 0.61). Skin pH was correlated with Objective SCORAD components, including area (rho = 0.269, = .036), erythema (rho = 0.302, = .018), and lichenification (rho = 0.365, = .026) and with the usage frequency of topical antibiotics. Skin pH was also correlated with other skin measurements, including SH (Delfin equipment: rho = -0.38, < .001). SH and TEWL as measured by Delfin equipment correlated better with a number of symptoms and signs than Courage + Khazaka equipment. Other clinical measurements including erythema, melanin, and skin color did not demonstrate strong correlations with clinical symptom scores.
Skin pH (using Mettler Toledo), SH, and TEWL (using Delfin equipment) correlated well with various clinical symptomatology scores. Less acidic pH appears to be associated with worse clinical scores of symptomatology, and increase usage of topical antibiotics, These findings not only support the supplementary usage of equipment in aiding objective documentation of clinical symptomatology in eczema therapeutic research but also the advocacy of maintaining more acidic skin and avoiding alkaline soap and emollient products.
特应性皮炎（AD）的症状和严重程度可以通过设备进行客观测量。本研究旨在比较皮肤测量值，并研究它们与各种临床严重程度评分的相关性。
使用 Delfin、Courage+Khazaka 和 Mettler Toledo 设备测量皮肤水分（SH）、经皮水分丢失（TEWL）、pH 值、红斑、色素沉着和 ITA（个体类型角），并将其与患者导向湿疹测量（POEM，短期主观症状评分）、评分特应性皮炎（SCORAD，短期主观症状和客观体征评分）、诺丁汉湿疹严重程度评分（NESS，长期主观症状评分）和儿童皮肤病生活质量指数（CDLQI，短期主观症状评分）进行相关性分析，采用 Spearman rho 系数。
评估了 80 组湿疹患者的临床评分（平均年龄：10.8±4.9 岁；男性占 44.6%）。POEM、客观 SCORAD 和 CDLQI 彼此之间相关性良好。皮肤 pH 值范围为 4.3 至 7.0（平均值 5.7±0.61）。皮肤 pH 值与客观 SCORAD 成分相关，包括面积（rho=0.269，p=0.036）、红斑（rho=0.302，p=0.018）和苔藓样变（rho=0.365，p=0.026），以及外用抗生素的使用频率。皮肤 pH 值还与其他皮肤测量值相关，包括 Delfin 设备的 SH（rho=-0.38，p<0.001）。Delfin 设备测量的 SH 和 TEWL 与许多症状和体征的相关性优于 Courage+Khazaka 设备。其他临床测量值，包括红斑、黑色素和肤色，与临床症状评分之间没有很强的相关性。
皮肤 pH 值（使用 Mettler Toledo）、SH 和 TEWL（使用 Delfin 设备）与各种临床症状评分相关性良好。较低的 pH 值似乎与更严重的临床症状评分相关，并且增加了外用抗生素的使用。这些发现不仅支持在湿疹治疗研究中辅助客观记录临床症状时使用设备，还支持维持更酸性皮肤和避免碱性肥皂和保湿产品的主张。
