Suetake T, Sasai S, Zhen Y X, Ohi T, Tagami H
Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan.
Arch Dermatol. 1996 Dec;132(12):1453-8.
To characterize the functional properties of the stratum corneum (SC) of various scars.
A prospective cohort study.
University hospital medical center.
Thirty-two consecutive patients surgically treated for various skin diseases and 26 consecutive patients with hypertrophic scars or keloids.
Noninvasive bioengineering measurements of functional properties of the SC, such as transepidermal water loss (TEWL), high-frequency conductance, and SC turnover time.
The SC barrier function assessed by TEWL was found to be a better parameter for the functional evaluation of scars than the hydration state of the skin surface measured by high-frequency conductometry. In general, the SC on the scars of deeper wounds in the dermis took longer to normalize functionally than the SC on the scars of superficial wounds, especially on the high compared with the abdomen. Thus, elevated levels of TEWL observed on scars at the donor sites of split-thickness grafts normalized between 200 and 400 days in contrast to fewer than 50 days for those of subepidermal erosions. Both TEWL and high-frequency conductance remained high in hypertrophic scars and keloids, and the SC involved showed a faster turnover time than that of adjacent normal skin.
Scars, a proliferative change of the dermis, can be objectively evaluated according to functional abnormalities of the SC, because the dermis has a close relationship with the epidermis and with the SC. The functional characteristics of the SC of fresh scars and those of hypertrophic scars and keloids resemble those of retinoid-treated skin, rather than those found in epidermal hyperproliferative conditions such as psoriasis and dermatitis.
描述各种瘢痕角质层（SC）的功能特性。
一项前瞻性队列研究。
大学医院医疗中心。
32例因各种皮肤病接受手术治疗的连续患者以及26例肥厚性瘢痕或瘢痕疙瘩患者。
对SC功能特性进行无创生物工程测量，如经表皮水分流失（TEWL）、高频电导和SC更新时间。
与通过高频电导测量的皮肤表面水合状态相比，TEWL评估的SC屏障功能是瘢痕功能评估的更好参数。一般来说，真皮深层伤口瘢痕处的SC功能恢复正常所需时间比浅表伤口瘢痕处的SC更长，尤其是与腹部相比高位部位。因此，与表皮下糜烂瘢痕相比，厚皮片供区瘢痕处观察到的TEWL升高水平在200至400天之间恢复正常，而表皮下糜烂瘢痕则少于50天。肥厚性瘢痕和瘢痕疙瘩中的TEWL和高频电导均保持较高水平，且受累的SC更新时间比相邻正常皮肤更快。
瘢痕作为真皮的增殖性改变，可根据SC的功能异常进行客观评估，因为真皮与表皮及SC关系密切。新鲜瘢痕、肥厚性瘢痕和瘢痕疙瘩的SC功能特征类似于维甲酸治疗后的皮肤，而非银屑病和皮炎等表皮过度增殖性疾病的特征。
