Background: No biomarkers have been identified that can classify subtypes of hand eczema (HE). Although skin biopsies represent the gold standard for investigations of the skin, the invasive technique is not favorable when investigating skin from sensitive areas. Recent advances in the use of skin-tape strips for molecular investigations enable noninvasive investigations of HE.Objective: By using whole transcriptome sequencing (WTS), the molecular profile of HE according to different localizations on the hands, etiologies, and clinical/ morphological subtypes was investigated.Methods: Thirty adult, Danish HE patients, 12 with and 18 without concurrent atopic dermatitis (AD), as well as 16 controls were included. Tape strip samples were collected from lesional, nonlesional, and healthy skin. Total RNA was extracted and WTS was performed.
Results:The largest molecular difference of HE patients with and without AD was found in nonlesional skin areas and included a downregulation of CXCL8 for HE patients without AD. Differences between allergic and irritant contact dermatitis included epidermal biomarkers such as EPHA1.
Conclusion:Skin tape strip samples could be used to assess the gene expression profile of HE on different localizations of the hands. The skin tape strip method identified new molecular markers that showed promising result for the identification of HE subtypes.atopic hand eczema, contact dermatitis, subtypes of hand eczema, tape stripping, transcriptomics
| INTRODUCTIONHand eczema (HE) is a prevalent disease with a 1-year prevalence of 9% in the general population. 1 It may affect quality of life, impact work ability, 2,3 and require treatment periodically or continuously, depending on severity and chronicity. 4 HE may be a result of different etiologies, 5 which complicates both effective treatment and prevention. HE can be a part of atopic dermatitis (AD), and/or environmental factors such as exposure to allergens and/or irritants may result in allergic contact dermatitis (ACD) and/or irritant contact dermatitis (ICD) on the hands. The skin impairment of AD also makes the skin more vulnerable to irritants, sometimes leading to a mixed pattern of AD and ICD.Abbreviations: ACD, allergic contact dermatitis; AD, atopic dermatitis; DEG, differentially expressed gene; GO, gene ontology; HECSI, hand eczema severity index; HE +AD , hand eczema with atopic dermatitis; HE -AD , hand eczema without atopic dermatitis; HE, hand eczema; ICD, irritant contact dermatitis; WTS, whole transcriptome sequencing.