Impairment of Skin Barrier Function is not Inherent in Atopic Dermatitis Patients: A Prospective Study Conducted in Newborns

Abstract

We conducted a cohort study to determine whether the barrier dysfunction of the stratum corneum that facilitates the penetration of various exacerbating agents from the environment is inherent in atopic dermatitis patients as suggested by some dermatologists. Clinical observation and biophysical measurements of the skin were performed on the cheek and on the flexor forearm of 24 newborn infants once between 2 and 14 days postnatally and 1, 3, and 6 months later. Nineteen had atopic family histories. Most of the infants had physiologic neonatal xerosis that was observed as a reduced high-frequency conductance without any impairment in the stratum corneum barrier function assessed by transepidermal water loss. Four of the 24 neonates developed atopic dermatitis around 2 to 3 months after birth. In all of them, barrier impairment noted as increased transepidermal water loss was observed only after the development of skin lesions. During their neonatal period, their transepidermal water loss and skin surface hydration state were indistinguishable from those of the neonates whose skin remained lesion-free during the observation period. Therefore, we concluded that the barrier impairment found in atopic dermatitis is not inherent but represents a phenomenon secondary to dermatitic skin changes.

An in vitro Skin Penetration Model for Compromised Skin: Estimating Penetration of Polyethylene Glycol [¹⁴C]-PEG-7 Phosphate

“…In most of these studies a significant quantitative correlation between TEWL and percutaneous absorption was demonstrated. The TEWL of full-term neonates has been reported to be <10 g/m 2 /h, similar to that of healthy adults [3,18]. However, preterm infants have an immature epidermal barrier with a much thinner SC and higher TEWL as reported by Agren et al [19] in a study of 13 preterm infants born at 24 and 25 weeks of gestation.…”

“…Based on comparable TEWL values, it is well known in the scientific literature that full-term infant skin barrier is similar to that observed in adult intact skin [3,4,5,18]. Several methods have been used to quantify the functional maturity of the skin barrier in term and preterm infants, including measurements of transdermal fluid loss, carbon dioxide emission rates, and drug absorption.…”

Epidermal Barrier: Negative Changes in Atopic Dermatitis and Positive Changes Induced by Short-term Suberythemal Ultraviolet B Irradiation

“…A study demonstrated that the impaired function of the SC only occurred after the observed infants developed AD. These changes were not observed soon after birth (from 4 to 12 days) when the skin surface showed only xerotic changes regardless of the later development of AD or atopic family background [34,35]. This showed that the impairments of SC functions found in AD patients result from the inflammation of the skin, which is thought to be present in the atopic dry skin [8].…”

Differences in the stratum corneum of Indonesian infants and adults

“…17, 18 Full-term neonates are reported to have sufficient barrier function of the skin. 19, 20 Recent studies have indicated that healthy neonates at the first 24 hours after birth have a much higher TEWL value than adults. 21, 22 Nikolovski et al reported that infants (3 to 12 months of age) showed much higher TEWL values on their arm skin than adults.…”