Epidermal Pathogenesis of Inflammatory Dermatoses

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

“…[8][9][10][11] This has lent support to the alternative ''outside-in'' hypothesis that an intrinsic defect in skin barrier function is responsible for the pathogenesis of AD. 31 This study of white and African American children found that children with AD have abnormal skin barrier function in normal-appearing nonlesional skin, as assessed by TEWL. Moreover, TEWL correlates with AD disease severity.…”

Sampling of disease biomarkers from skin for theranostic applications

“…These diseases significantly and dramatically alter skin's biomolecular composition [1,2] which is otherwise tightly regulated in healthy skin [3,4]. The local dermal biomolecular composition thus holds significant value for diagnosing dermatological conditions as well as following up on the efficacy of topical and systemic therapies.…”

“…Subjectivity of histology can be effectively addressed by quantitative assessment of pathological changes in skin's molecular composition [1,2], e.g., modulation of inflammatory proteins, changes in lipid content, and gene expression. Skin's unique molecular profile, therefore, represents an appealing but distant clinical opportunity.…”

Can excessive washing really be regarded as the major cause of atopic dermatitis?

“…However, it is demonstrated that barrier damage induced, for example, by skin stripping causes the release and production of cytokines, such as IL-1a, IL-1b, and TNF-a, indicating that barrier disruption alone leads to cytokine production and inflammation [4]. Moreover, in the absence of stratum corneum, the increased penetration of allergens through the epidermis could promote the initiation of an inflammatory response within the stratum granulosum by inducing the release of proinflammatory cytokines from keratinocytes [5].…”