Gfesser M, Abeck D, Rügemer J, Schreiner V, Stäb F, Disch R, Ring J
Department of Dermatology and Allergy Biederstein, Technical University Munich, Germany.
Dermatology. 1997;195(4):332-6. doi: 10.1159/000245983.
Altered epidermal barrier function as determined by transepidermal water loss (TEWL) is a typical feature in patients with atopic eczema (AE).
The purpose of this study was to assess the kinetics of epidermal regeneration after barrier perturbation induced by two different stimuli, namely acetone treatment (removal of stratum corneum lipids) and tape stripping (removal of the nonviable stratum corneum).
Fifteen patients with AE and 12 nonatopic healthy controls were investigated. An area of 9.0 cm2 of clinically normal skin of the forearm flexural side was treated by acetone or tape stripping in a way that an increase in TEWL of 3.5-4.0 times the pretreatment value was achieved. TEWL was recorded directly after perturbation (tO), after 15 min (tl), 3 h (t2), 6 h (t3), 24 h (t4), 48 h (t5), 72 h (t6) and 96 h (t7).
The speed of epidermal regeneration was faster after acetone treatment, both in the patient and the control groups, with no significant difference between the two. However, after tape stripping at points t2, t5 and t6, TEWL values relative to tO were significantly lower in atopic skin as compared to normal skin (p < 0.05).
The faster regeneration of barrier function after tape stripping in patients with AE may be the result of a persisting mild disturbance of barrier function. It may be speculated that repair mechanisms are permanently activated, and therefore barrier recovery is faster. However, a complete restoration of the epidermal barrier function is not achieved, perhaps because of the decreased content of ceramides in atopic skin.
经表皮水分流失（TEWL）测定的表皮屏障功能改变是特应性皮炎（AE）患者的典型特征。
本研究旨在评估由两种不同刺激诱导的屏障扰动后表皮再生的动力学，这两种刺激分别是丙酮处理（去除角质层脂质）和胶带剥离（去除无活力的角质层）。
对15例AE患者和12例非特应性健康对照者进行研究。在前臂屈侧临床正常皮肤的9.0 cm²区域，通过丙酮或胶带剥离进行处理，使TEWL增加至预处理值的3.5 - 4.0倍。在扰动后即刻（t0）、15分钟后（t1）、3小时后（t2）、6小时后（t3）、24小时后（t4）、48小时后（t5）、72小时后（t6）和96小时后（t7）直接记录TEWL。
在患者组和对照组中，丙酮处理后表皮再生速度更快，两组之间无显著差异。然而，在胶带剥离后的t2、t5和t6时间点，与正常皮肤相比，特应性皮肤中相对于t0的TEWL值显著更低（p < 0.05）。
AE患者胶带剥离后屏障功能再生更快可能是屏障功能持续存在轻度紊乱的结果。可以推测修复机制被永久激活，因此屏障恢复更快。然而，可能由于特应性皮肤中神经酰胺含量降低，表皮屏障功能未完全恢复。
