Sensitive Skin: Lessons From Transcriptomic Studies

Abstract

In 2016, a special interest group from the International Forum for the Study of Itch defined sensitive skin (SS) as a syndrome that manifests with the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) after stimuli that should not cause a reaction, such as water, cold, heat, or other physical and/or chemical factors. The pathophysiology of sensitive skin is still poorly understood, but the symptoms described suggest inflammation and peripheral innervation. Only two publications have focused on sensitive skin transcriptomics. In the first study, the authors performed a microarray comparison of SS and non-sensitive skin (NSS) samples and showed differences in the expression of numerous genes in SS and NSS samples. Moreover, in the SS samples, two clusters of genes were identified, including upregulated and downregulated genes, compared to NSS samples. These results provide some interesting clues for the understanding of the pathophysiology of SS. The second study compared SS and NSS samples using RNA-seq assays. This method allowed the identification of long non-coding RNAs (lncRNAs) and differentially expressed mRNAs and provided a comprehensive profile in subjects with SS. The results showed that a wide range of genes may be involved in the pathogenesis of SS and suggested pathways that could be associated with them. In this paper, we discuss these two studies in detail and show how transcriptomic studies can help understand the pathophysiology of sensitive skin. We call for new transcriptomic studies on larger populations to be conducted before putative pathogenic mechanisms can be detected and analyzed to achieve a better understanding of this complex condition.

Relationship between sensitive skin and sleep disorders, fatigue, dust, sweating, food, tobacco consumption or female hormonal changes: Results from a worldwide survey of 10 743 individuals

“…Some genetic studies have shown that a wide range of genes may be involved in the pathogenesis and suggested potentially associated pathways. 29 Nonetheless, the effect of exposome is probably very high. As shown in the present study, sensitive skin is not only related to contact-based environmental factors but also to systemic exposome factors.…”

“…Because subjects with sensitive skin had a two‐fold increase in the familial history of sensitive skin, genetic factors may play a role. Some genetic studies have shown that a wide range of genes may be involved in the pathogenesis and suggested potentially associated pathways 29 . Nonetheless, the effect of exposome is probably very high.…”

Sensitive Skins May Be Neuropathic Disorders: Lessons from Studies on Skin and Other Organs

“…Two transcriptomic studies have been performed to compare skin samples of patients with sensitive skin and controls using DNA microarray [55] or RNA sequencing [56]. Although the small sample size could make the results debatable, the authors showed the involvement of innervation and Merkel cells in the pathophysiology of sensitive skin [57]. They also suggested keratinocytic involvement and a putative role of innate immunity [57] or adiponectin deficiency in sensitive skin [55].…”

“…Although the small sample size could make the results debatable, the authors showed the involvement of innervation and Merkel cells in the pathophysiology of sensitive skin [57]. They also suggested keratinocytic involvement and a putative role of innate immunity [57] or adiponectin deficiency in sensitive skin [55].…”

Understanding the Sensitive Skin Subject to Achieve a More Holistic Diagnosis

“…Phototype I-IV [21] Fair skin, susceptible to sunburn [5,16] Susceptibility to blushing and/or flushing [5,16] Skin pigmentation [5,48] Dry skin [16,21,46,47] Ethnicity a [14] Gender [5,9,16,21,49] Menstrual cycle [5,18,50] Age [5,51,52] Incontinence [53] Familial and genetic links [21,[54][55][56] a The perception of sensitive genital skin is significantly higher among African-Americans compared to Caucasians.…”