Ghadially R
Dermatology Service, Veterans Affairs Medical Center; and Department of Dermatology, University of California, San Francisco, CA 94121, USA.
Am J Contact Dermat. 1998 Sep;9(3):162-9.
This report examines our present knowledge of the epidermal permeability barrier as it pertains to irritant contact dermatitis and discusses how altered barrier function may affect the clinical manifestations of irritant contact dermatitis in the aged.
Altered barrier function affects the ability of an irritant to penetrate the stratum corneum and produce deleterious effects on both stratum corneum and epidermis. Moreover, a damaged epidermis can be expected to produce a defective stratum corneum, thus resulting in a vicious cycle. Furthermore, although basal transepidermal water loss has traditionally been used as an assessment of barrier function, evidence suggests that dynamic tests of barrier function are more reliable indicators of barrier function in the clinical setting of additive, repetitive, or chronic insults. Finally, barrier disruption per se has now been shown to produce both a cytokine response and an increase in epidermal Langerhans' cell density. Thus, barrier disruption not only alters penetrance of contactants, but also may prime the inflammatory response. Studies of aged epidermal permeability barrier function provide a greater understanding of the modified response to irritants in the aged.
本报告审视了我们目前关于表皮渗透屏障与刺激性接触性皮炎相关的知识，并讨论了屏障功能改变如何影响老年人刺激性接触性皮炎的临床表现。
屏障功能改变影响刺激物穿透角质层的能力，并对角质层和表皮产生有害影响。此外，受损的表皮预计会产生有缺陷的角质层，从而导致恶性循环。此外，尽管传统上基底经表皮水分流失被用作屏障功能的评估指标，但有证据表明，在累积性、重复性或慢性损伤的临床环境中，屏障功能的动态测试是屏障功能更可靠的指标。最后，现已证明屏障破坏本身会产生细胞因子反应并增加表皮朗格汉斯细胞密度。因此，屏障破坏不仅会改变接触物的穿透性，还可能引发炎症反应。对老年表皮渗透屏障功能的研究有助于更深入了解老年人对刺激物的改变反应。
