Comparison of Transepidermal Water Loss, Capacitance and pH Values in the Skin between Intrinsic and Extrinsic Atopic Dermatitis Patients

Abstract

Atopic dermatitis (AD), with the prevalence rate of around 10 to 15%, is characterized by an intensely pruritic skin lesions with typical distribution and morphology. Recently, AD is divided into extrinsic type (ADe) and intrinsic type (ADi) according to the laboratory findings and associated diseases. ADe is well-known for high IgE level, positive response to food-or aero-allergens, whereas ADi has clinically similar skin lesions and distribution patterns of AD with normal serum IgE levels, negative in vitro test for environmental or food allergens and without associated atopic diseases. To instrumentally evaluate the differences of skin involvement and functions between ADi and ADe, we checked the transepidermal water loss (TEWL), capacitance and pH in both types of childhood AD and age-matched control. The proportion of ADi was around 20% in all AD patients (10/51). Our experiment suggested possible differences between ADi and ADe. Antecubital fossa is a famous involvement site of childhood type of AD, where both types of AD patients showed higher TEWL and decreased capacitance. ADe patients showed increased TEWL in all sites and lower hydration in 4 sites, whereas ADi patients showed no significant differences of TEWL and hydration in forehead, cheek, and back of leg.

Extrinsic and intrinsic types of atopic dermatitis

“…According to their review paper, the frequency of intrinsic AD was 10-45%. More recently, the incidence of extrinsic AD and intrinsic AD were reported as follows: 73% vs 27% [18] and 63% vs 37% [15] in German children, 88% vs 12% in Hungarian adults [7], 78.2% vs 21.8% in Dutch patients from 13 to 37 years of age [4], and approximately 80% vs 20% in Korean [19]. These data are in accordance with the empirical knowledge that about 20% of AD patients show normal IgE levels and lack of sensitization towards environmental allergens.…”

Intrinsically defective skin barrier function in children with atopic dermatitis correlates with disease severity

“…Previous studies predominantly included white or Asian subjects, and data on African American children is lacking, despite the high prevalence of AD in this group. 23 Except for a single report from an Asian population, 24 attempts to investigate TEWL in AD subgroups based on allergic sensitization have also not been made.…”

The examination of biophysical skin parameters (transepidermal water loss, skin hydration and pH value) in different body regions in Polish ponies

“…These methods include the examination of transepidermal water loss, corneometry, as well as measuring skin pH and Correspondence to: M. Szczepanik, e-mail: kryll@poczta.onet.pl erythema intensity. The methods were at first used in human medicine (Fluhr et al 2006, Grupta et al 2008 and are now widely applied in various diseases such as topic dermatitis (Eberlein-König et al 2000, Choi et al 2003, Rudolph et al 2004, Grupta et al 2008, contact dermatitis (Laudańska 2003) and in assessing the efficiency of locally applied medicines (Biro et al 2003, Lofler et al 2003, Aschoff et al 2008. Recently, much research involving the assessment of skin biophysical parameters has been published (Dirschka et al 2005, Fluhr et al 2006, Hightower et al 2008, Oh and Oh 2009, Cornegliani et al 2011.…”