Study of Skin Barrier Function in Psoriasis: The Impact of Emollients

Maroto-Morales, Daniel; Montero‐Vílchez, Trinidad; Arias‐Santiago, Salvador

doi:10.3390/life11070651

Cited by 24 publications

(27 citation statements)

References 31 publications

(49 reference statements)

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“…Emollients restore physical barrier function by forming a lipid-rich layer that prevents water loss from the skin, and by facilitating water binding in the stratum corneum [ 241 ]. Their application to psoriatic plaques reduces transepidermal water loss, plaque scaling and pruritis, and also normalises epidermal markers of differentiation and proliferation [ 242 , 243 ]. Emollients are particularly used in conjunction with topical steroid therapy, as they increase drug penetration [ 242 ].…”

Section: Psoriasis Current Treatment and Future Directionsmentioning

confidence: 99%

Skin Barrier Dysregulation in Psoriasis

Andreas

Bereza-Malcolm

Lynch

et al. 2021

IJMS

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The skin barrier is broadly composed of two elements—a physical barrier mostly localised in the epidermis, and an immune barrier localised in both the dermis and epidermis. These two systems interact cooperatively to maintain skin homeostasis and overall human health. However, if dysregulated, several skin diseases may arise. Psoriasis is one of the most prevalent skin diseases associated with disrupted barrier function. It is characterised by the formation of psoriatic lesions, the aberrant differentiation and proliferation of keratinocytes, and excessive inflammation. In this review, we summarize recent discoveries in disease pathogenesis, including the contribution of keratinocytes, immune cells, genetic and environmental factors, and how they advance current and future treatments.

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Section: Psoriasis Current Treatment and Future Directionsmentioning

confidence: 99%

Skin Barrier Dysregulation in Psoriasis

Andreas

Bereza-Malcolm

Lynch

et al. 2021

IJMS

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“…Emollients are recommended in guidelines for treating psoriasis 23 . Recently, a study reported a beneficial effect of emollients on skin barrier function in psoriatic skin 24 . Here, we show that emollients alone can decrease the immune infiltrate (mostly CD8+ cells) in the dermis after only 4 weeks of applications.…”

Section: Discussionmentioning

confidence: 47%

Impact of topical emollient, steroids alone or combined with calcipotriol, on the immune infiltrate and clinical outcome in psoriasis

Heim

Irondelle

Cardot‐Leccia

et al. 2022

Experimental Dermatology

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Psoriasis is a chronic inflammatory disease whereby long‐term disease control remains a challenge for the patients. Latest evidence suggests that combined topical treatment with steroids and vitamin D analogue foam (Calcipotriol/Betamethasone) is efficient in long‐term management of the disease and reducing the number of relapses. Its effects on cellular inflammation and cytokine production remain to be explored. We set out to examine the effect of topical therapies on cellular infiltrate and cytokine profile in the lesional skin of psoriasis patients. This was a monocentric, double‐blind, randomized trial with 30 patients. Patients were treated with the combined Calcipotriol/Betamethasone foam, Betamethasone foam alone, Clobetasol Propionate ointment or placebo. 4 mm skin biopsies from lesional and non‐lesional sites were taken before and 4 weeks after treatment. Cellular infiltrate, IFNγ and IL‐17 were studied by immunofluorescence. Each patient was their own control. Evolution in skin inflammation was studied in parallel with changes in patient's epidermal thickness and their tPASI clinical score. Lesional skin was characterized by increased epidermal thickness, increased number of IL‐17 and IFNγ producing CD8+ T cells, NK cells and neutrophils. All treatment reduced epidermal thickness and improved patients tPASI scores. Only the combined Calcipotriol/Betamethasone foam completely abolished epidermal and dermal influx of CD8+ T cells, reduced number of CD8 + IFNγ+ cells (but not CD8 + IL‐17+ cells) and significantly reduced the number of MPO+ neutrophils which were predominantly IL‐17+. None of the treatments had effect on NK cells. We have shown the combined topical treatment with Calcipotriol/Betamethasone foam to be effective in reducing cellular influx into lesional skin of psoriasis patients and this effect to be superior to emollient or Betamethasone alone. Its previously described efficacy in the clinic may be attributed to its unique and rapid ability to inhibit both adaptive CD8+ T cell and innate immune neutrophilia influx into the skin, which was not observed for the other treatments.

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“…It has been reported that through hydrating the stratum corneum, emollients enhance the absorption of topical corticosteroids [8]. Moreover, research demonstrates that use of emollients decreases transepidermal water loss in psoriatic patients [9], which is usually high due to lesions characterized by a damaged skin barrier.…”

Section: Discussionmentioning

confidence: 99%

The role of the adjuvant aesthetic therapy in the lives of patients with psoriatic disease

Majchrzycka¹,

Adamska²,

Rachwalska³

et al. 2022

pdia

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Introduction: Psoriasis is a chronic inflammatory disease of the skin, which greatly impairs the patients' self-esteem and consequently leads to a deterioration in their quality of life. Numerous therapeutic options available, when combined, enable to maintain a satisfactory control of the psoriatic lesions. Aesthetic dermatology also provides physicians with tools for targeting the disease symptoms, such as mesotherapy, sonophoresis and chemical peels. Aim: The main aim of the study was to quantify the effect of psoriasis on patients' lives, particularly their selfesteem and everyday life. Moreover, a follow-up survey was used to assess the patients' knowledge on professional and at-home care treatments. Material and methods: The sample consisted of 45 inpatients admitted to the Dermatology Clinic of the Heliodor Święcicki Clinical Hospital of the Poznan University of Medical Sciences due to a psoriasis flare-up. Data were collected through the DLQI questionnaire, survey, personal interview and physical examination. Results: A vast majority of the respondents reported a strong negative impact of the disease on their self-esteem and this impact was stronger among women. Furthermore, almost all of the patients denied ever receiving aesthetic treatments. Conclusions: In accordance with previous research, this study also shows that skin imperfections drastically influence the perception of a patient in the society, therefore acknowledging and combining appropriate therapeutic methods should be a matter of vital importance.

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Study of Skin Barrier Function in Psoriasis: The Impact of Emollients

Cited by 24 publications

References 31 publications

Skin Barrier Dysregulation in Psoriasis

Skin Barrier Dysregulation in Psoriasis

Impact of topical emollient, steroids alone or combined with calcipotriol, on the immune infiltrate and clinical outcome in psoriasis

The role of the adjuvant aesthetic therapy in the lives of patients with psoriatic disease

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