Department of Dermatology, Venerology and Allergology, Clinical Research Center for Hair and Skin Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
Institute of Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
J Eur Acad Dermatol Venereol. 2022 Aug;36(8):1191-1200. doi: 10.1111/jdv.18123. Epub 2022 Apr 13.
Several skin diseases are characterized by epidermal alterations affecting epidermal thickness. Reference values of epidermal thickness in healthy humans and knowledge of possible differences regarding age, sex, skin phototype, and ethnic origin are essential in research and in clinical practice. The objectives of this systematic review were to provide epidermal thickness reference values for healthy human skin and describe possible effects of measurement methods, age, sex, ethnic origin, and skin phototype. A combined search in the databases Medline and Embase, and other sources were conducted. Searches covered a period from 1946 to 3 June 2020. Included studies were primarily observational and interventional studies providing means and spread values of epidermal thickness estimates in healthy humans, with clear reporting of skin area, age, and measurement method, and optional reporting of sex, ethnic origin, and skin phototype. Data were extracted per skin area and pooled in random-effects models. A total of 142 studies were included in the qualitative synthesis and 133 in the meta-analysis. Pooled epidermal thickness estimates were calculated for 37 skin areas. The lowest epidermal thickness of 31.2 (95% CI 27.8-34.6) μm was reported for the penis and the highest of 596.6 (95% CI 443.9-749.3) μm for the plantar aspect of the foot. Differences in epidermal thickness estimates obtained by histology, optical coherence tomography, and laser scanning microscopy were minor. High-frequency ultrasonography produces systematically higher values. The epidermis was thinner in aged skin. Differences between sexes and among ethnic origins were minor. Epidermal thickness reference values are provided for 37 skin areas. In conclusion, the epidermis tends to become thinner by ageing and does not seem to be influenced by sex. Histology, optical coherence tomography, and laser scanning microscopy might be used interchangeably to measure epidermal thickness, whereas high-frequency ultrasound should not be used.
几种皮肤疾病的特征是表皮改变，影响表皮厚度。了解健康人体表皮厚度的参考值以及年龄、性别、皮肤光型和种族差异的知识，对于研究和临床实践都是至关重要的。本系统评价的目的是提供健康人体皮肤表皮厚度的参考值，并描述测量方法、年龄、性别、种族和皮肤光型可能产生的影响。通过 Medline 和 Embase 数据库以及其他来源进行了综合检索。搜索涵盖了 1946 年至 2020 年 6 月 3 日的时间段。纳入的研究主要是观察性和干预性研究，提供了健康人群表皮厚度估计的均值和标准差，明确报告了皮肤面积、年龄和测量方法，并可选报告了性别、种族和皮肤光型。根据皮肤区域提取数据，并在随机效应模型中进行汇总。定性综合分析共纳入 142 项研究，荟萃分析共纳入 133 项研究。汇总了 37 个皮肤区域的表皮厚度估计值。阴茎的表皮最薄，为 31.2（95%CI 27.8-34.6）μm；足底表皮最厚，为 596.6（95%CI 443.9-749.3）μm。组织学、光学相干断层扫描和激光扫描显微镜获得的表皮厚度估计值差异较小。高频超声产生的数值系统偏高。随着年龄的增长，表皮会变薄。性别和种族之间的差异较小。为 37 个皮肤区域提供了表皮厚度参考值。总之，随着年龄的增长，表皮趋于变薄，似乎不受性别的影响。组织学、光学相干断层扫描和激光扫描显微镜可相互替换用于测量表皮厚度，而高频超声则不应使用。
