Welzel J, Wilhelm K P, Wolff H H
Department of Dermatology, Medical University of Lübeck, Germany.
Contact Dermatitis. 1996 Sep;35(3):163-8. doi: 10.1111/j.1600-0536.1996.tb02335.x.
It has been reported that occlusive treatment of irritated skin results in a reduction of barrier repair activities in hairless mice. In contrast, the clinically observed benefit of occlusion in the treatment of hand eczema and other chronic skin diseases with a perturbed barrier function is well-known. While the beneficial effect of occlusion has been proven for the treatment of psoriasis there are no controlled clinical studies of the effect of occlusion on irritated human skin. We have therefore evaluated the effect of various occlusive treatments on repair of the human skin permeability barrier under controlled experimental conditions. Barrier perturbation was induced either by application of sodium lauryl sulfate (SLS) or by repeated tape stripping. This was followed by treatment with different occlusive and semipermeable dressings, partly after pre-treatment with petrolatum. Repair of water barrier function was evaluated by daily measurements of transepidermal water loss (TEWL) for 1 week. SLS irritation and tape stripping led to a 6-fold increase in TEWL as a sign of severe water barrier perturbation, followed by a stepwise decrease over the following days. Occlusion did not significantly delay barrier repair as measured by TEWL. Only in tape-stripped skin did TEWL stay at high levels during treatment with self-adhesive dressings. This may be explained by damage of newly formed stratum corneum caused by changing of these membranes. Our results indicate that, in contrast to earlier observations in hairless mouse skin, permeability barrier repair activities are not significantly delayed by occlusive treatment in human skin.
据报道,对无毛小鼠受刺激的皮肤进行封闭处理会导致屏障修复活性降低。相比之下,临床上观察到的封闭疗法对手部湿疹和其他屏障功能受损的慢性皮肤病治疗有益,这是众所周知的。虽然封闭疗法对银屑病治疗的有益效果已得到证实,但尚无关于封闭对人类受刺激皮肤影响的对照临床研究。因此,我们在可控的实验条件下评估了各种封闭处理对人体皮肤渗透屏障修复的影响。通过涂抹十二烷基硫酸钠(SLS)或反复胶带剥离诱导屏障扰动。之后,部分在凡士林预处理后,用不同的封闭性和半透性敷料进行治疗。通过连续1周每日测量经表皮水分流失(TEWL)来评估水屏障功能的修复情况。SLS刺激和胶带剥离导致TEWL增加6倍,这是严重水屏障扰动的迹象,随后在接下来的几天里逐步下降。通过TEWL测量,封闭处理并未显著延迟屏障修复。仅在胶带剥离的皮肤中,使用自粘敷料治疗期间TEWL维持在高水平。这可能是由于更换这些敷料对新形成的角质层造成损伤所致。我们的结果表明,与之前在无毛小鼠皮肤中的观察结果相反,封闭处理在人体皮肤中不会显著延迟渗透屏障修复活性。