sodium-dodecyl-sulfate and Dermatitis--Atopic

Hard domestic water has been reported to worsen atopic eczema (AE) and may contribute to its development in early life.. To review the literature on the relationship between the effect of water hardness (high calcium carbonate; CaCO. We systematically searched databases (MEDLINE, Embase, Cochrane CENTRAL, GREAT and Web of Science) from inception until 30/6/2020. Human and animal observational and experimental studies were included. The primary outcomes were risk of AE and skin barrier function. Studies were meta-analysed using a random effects model. Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.. Sixteen studies were included. Pooled observational data from seven studies on 385,901 participants identified increased odds of AE in children exposed to harder versus softer water (odds ratio 1.28, 95% CI 1.09, 1.50; GRADE certainty: very low). Two mechanistic studies in humans reported higher deposition of the detergent sodium lauryl sulphate in those exposed to harder versus softer water. Two randomized controlled trials comparing water softeners with standard care did not show a significant difference in objective AE severity with softened water (standardized mean difference 0.06 standard deviations higher, 95% CI 0.16 lower to 0.27 higher; GRADE certainty: moderate).. There was a positive association between living in a hard water (range: 76 to > 350 mg/L CaCO

Topics: Animals; Calcium Carbonate; Dermatitis, Atopic; Detergents; Humans; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water; Water Softening

The stratum corneum's (SC) functions include protection from external hazardous environments, prevention of water loss and regulation of body temperature. While intact skin absorption studies are abundant, studies on compromised skin permeability are less common, although products are often used to treat affected skin. We reviewed literature on percutaneous absorption through abnormal skin models. Tape stripping is used to disrupt water barrier function. Studies demonstrated that physicochemical properties influence the stripping effect: water-soluble drugs are more affected. Abrasion did not affect absorption as much. Freezing is commonly used to preserve skin. It does not seem to modify water absorption, but still increases the penetration of compounds. Comparatively, heating the skin consistently increased percutaneous absorption. Removing SC lipids may increase percutaneous absorption of drugs. Many organic solvents are employed to delipidize. Delipidization with chloroform-methanol increased hydrophilic compound permeability, but not lipophilic. Acetone pre-treatment enhanced hydrophilic compound penetration. More data is needed to determine influence on highly lipophilic compound penetration. Sodium lauryl sulfate (SLS) induces irritant dermatitis and is frequently used as a model. Studies revealed that SLS increases hydrophilic compound absorption, but not lipophilic. However, skin irritation with other chemicals increases lipophilic penetration as much as hydrophilic. Animal studies show that UV exposure increases percutaneous absorption whereas human studies do not. Human studies show increased penetration in psoriatic and atopic dermatitis skin. The data summarized here begin to characterize flux alteration associated with damaged skin. Understanding the degree of alteration requires interpretation of involved conditions and the enlarging of our database to a more complete physicochemical spectrum.

Topics: Animals; Dermatitis, Atopic; Dermatitis, Irritant; Disease Models, Animal; Fatty Acids, Essential; Humans; Permeability; Skin; Skin Absorption; Sodium Dodecyl Sulfate

During recent years several highly developed non-invasive methods for evaluation of skin physiology and pathology have been introduced. Against this background, the present studies were undertaken with the primary aim of assessing the effects of various skin care products on some properties of the skin. Skin topography was measured by profilometry on skin replicas, friction with a newly developed friction instrument, capacitance with a Corneometer, and barrier function both with an Evaporimeter to assess transepidermal water loss (TEWL) and by application of an irritant followed by measurement of the resulting irritative reaction. Initially some of the techniques were used to further characterize the differences between dry atopic skin and normal skin. Dry skin exhibits increased values of roughness parameters and a reduced number of topographical peaks. TEWL is increased, indicating impaired barrier function. The friction and capacitance are lower and correlate significantly to each other, whereas TEWL does not appear to relate to either of these parameters. The use of a scrub cream removes the outermost part of the stratum corneum, resulting in a smoother skin. Application of moisturizers modifies the frictional response of the skin. The friction instrument gave results comparable to those of panelists trained in sensory evaluation. The study suggests that measurement of skin friction can be used to predict the degree of liking of moisturizers. Furthermore, moisturizers increase the skin hydration. They provide water directly to the skin from their water phase. Skin hydration also increases with increased degree of occlusion, as measured as a decrease in TEWL. Moisturizers may also alter the diffusional resistance of the stratum corneum and reduce the skin susceptibility to the surfactant sodium lauryl sulphate (SLS). Lipids in moisturizers may influence already developed SLS-induced irritation. A significantly lower degree of irritation was found in areas treated with canola oil and its sterol-enriched fraction than in an area treated with water. These findings emphasize that skin care products do not only form an inert, epicutaneous layer, but that they may penetrate and influence the structure and function of the skin.

Topics: Adolescent; Adult; Biophysical Phenomena; Biophysics; Dermatitis, Atopic; Dermatologic Agents; Diffusion; Emollients; Female; Friction; Galvanic Skin Response; Humans; Irritants; Lipids; Male; Middle Aged; Permeability; Skin; Skin Care; Skin Physiological Phenomena; Soaps; Sodium Dodecyl Sulfate; Water; Water Loss, Insensible

The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and atopic dermatits were studied and compared. In healthy volunteers increased baseline TEWL and increased light reflection from the skin, interpreted as "fair" skin, was found to be associated with increased susceptibility to SLS. Hand eczema patients were found to have fairer and thinner skin than matched controls. Increased susceptibility to SLS was found only in patients with acute eczema. Patients with atopic dermatitis had increased baseline TEWL as well as increased skin susceptibility as c

Topics: Colorimetry; Dermatitis, Atopic; Eczema; Galvanic Skin Response; Hand Dermatoses; Humans; Irritants; Patch Tests; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

Atopic dermatitis (AD) is a common, chronic dermatosis, with onset of disease often manifesting in early infancy. Past studies evaluating the early use of moisturisers in the prevention of AD had mixed results.. To compare the incidence of moderate or severe AD and total incidence of AD in a cohort of 'at-risk' infants treated with moisturisers from the first 2 weeks of life, to a similar group without moisturisers.. We performed a single-centre, prospective, parallel-group, randomised study in infants with at least 2 first-degree relatives with atopy. Subjects were randomised into either a treatment group with moisturisers or a control group without moisturisers. Participants were assessed at 2, 6, and 12 months for AD and if present, the severity was assessed using SCORAD index. We also compared the overall incidence of AD, trans-epidermal water loss (TEWL), stratum corneum (SC) hydration, pH, and incidence of food and environmental sensitisation and allergies between both groups. Genotyping for loss-of-functions mutations in the FLG gene was conducted.. A total of 200 subjects were recruited, with 100 subjects in each arm. There was no significant difference in incidence of moderate or severe AD, and total incidence of AD at 12 months between the treatment and control groups. There was a lower mean SCORAD in the treatment group than in the control group, but no significant difference in TEWL, SC hydration, and skin pH. No significant side-effects were reported.. The early use of moisturisers in 'at-risk' infants does not reduce the incidence of moderate-to-severe AD and overall incidence of AD in infancy.

Topics: Age Factors; Cohort Studies; Dermatitis, Atopic; Dermatologic Agents; Drug Combinations; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Ointments; Propylene Glycols; Risk Factors; Skin Cream; Sodium Dodecyl Sulfate

Atopic dermatitis is a common skin disease characterized by eczematous eruptions and impaired skin barrier function. Patients, as well as their families, frequently report reductions in quality of life. Pruritus, lack of sleep, and impaired social functioning all contribute to this reduction. A skincare regimen of gentle cleansing and daily moisturization is integral to managing atopic dermatitis. While there are a multitude of reports supporting the use of moisturizers, there is a paucity regarding the use of cleansers, especially cleansers formulated with ingredients known to improve skin hydration. A clinical study was conducted to assess the tolerability and cosmetic acceptability of a body wash formulated with the filaggrin break-down products arginine and pyrrolidone carboxylic acid in subjects with atopic dermatitis-prone skin (Cetaphil® RestoraDerm® Body Wash). The results of this study indicate that Cetaphil RestoraDerm Body Wash was well tolerated, reduced itch, improved quality of life, and was well-liked by subjects with atopic dermatitis-prone skin.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cosmetics; Dermatitis, Atopic; Drug Combinations; Female; Filaggrin Proteins; Humans; Male; Middle Aged; Propylene Glycols; Quality of Life; Skin Care; Soaps; Sodium Dodecyl Sulfate; Young Adult

Atopic dermatitis (AD) is characterized by barrier abnormalities, including insufficient ceramides in the stratum corneum (SC).. To measure the effects of a new moisturizer (CRM) containing a ceramide precursor in improving skin barrier function in patients with controlled atopic dermatitis.. In this randomized, intra-individual comparison, investigator-blinded study, CRM was applied to the test area of one lower leg for 27 days (the other leg remained as untreated control). Evaluations at baseline and day 28 included transepidermal water loss (TEWL), skin hydration by corneometry, dryness severity, Raman spectroscopy, and collection of adverse events.. After 4 weeks of treatment, results showed a significantly greater reduction of TEWL and clinical dryness scores, and increased skin hydration (all p < 01) in the CRM-treated than untreated area. A significantly higher level of ceramide (p < 05) and a trend toward increased water content was observed with Raman in the SC for CRM than for the control. There were no related AEs.. Skin barrier function and hydration were significantly improved after CRM treatment.

Topics: Adolescent; Adult; Aged; Body Water; Ceramides; Dermatitis, Atopic; Double-Blind Method; Drug Combinations; Emollients; Epidermis; Female; Humans; Male; Middle Aged; Propylene Glycols; Skin Physiological Phenomena; Sodium Dodecyl Sulfate; Spectrum Analysis, Raman

In this in vivo human study we assessed the influence of skin damage by sodium lauryl sulphate (SLS) on percutaneous penetration of polyethylene glycols (PEGs) of different molecular weights (MW). Percutaneous penetration of PEGs was determined using tape stripping of the stratum corneum (SC). The forearm skin of volunteers was pretreated with 5% w/w SLS for 4 h, and 24 h later patches with PEGs were applied for 6 h. The penetration parameters were deduced by data regression to Fick's law for unsteady-state diffusion. The trans-epidermal water loss (TEWL) increased after SLS treatment from 6.3 +/- 2.1 to 17.9 +/- 8.7 g/m(2)/h. The diffusion coefficient for all PEGs was increased in the SLS-damaged skin. The increase was smaller for higher MW. In addition, the partition coefficient of PEGs between SC and water was larger in the SLS-compromised skin and showed a tendency to increase with MW. The permeability coefficient decreased gradually with increasing MW of PEGs in both control and SLS-compromised skin. SLS caused a threefold increase in the permeability coefficient for all MWs ranging in control skin from 0.34 to 0.70 x 10(-5) cm/h and in the SLS-compromised skin from 1.20 to 2.09 x 10(-5) cm/h for MW of 590-282 Da. The results of this study show the deleterious effect of SLS on the skin barrier for hydrophilic PEGs. A defective skin barrier will facilitate absorption of other chemicals and local skin effects.

Topics: Adolescent; Adult; Cell Membrane Permeability; Dermatitis, Atopic; Female; Humans; Male; Middle Aged; Polyethylene Glycols; Skin; Skin Absorption; Sodium Dodecyl Sulfate; Surface-Active Agents

Patients with atopic skin show a defective barrier function both in rough and in clinically normal skin, with an increasing risk of developing contact dermatitis. Moisturizing creams are often used in the treatment of dry skin. The purpose of this study was to investigate the influence of treatment with a urea-containing moisturizer on the barrier properties of atopic skin. Fifteen patients with atopic dermatitis treated one of their forearms twice daily for 20 days with a moisturizing cream. Skin capacitance and transepidermal water loss (TEWL) were measured at the start of the study and after 10 and 20 days. On day 21 the skin was exposed to sodium lauryl sulphate (SLS) and on day 22 the irritant reaction was measured non-invasively. Skin capacitance was significantly increased by the treatment, indicating increased skin hydration. The water barrier function, as reflected by TEWL values, tended to improve (P = 0.07), and the skin susceptibility to SLS was significantly reduced, as measured by TEWL and superficial skin blood flow (P < 0.05). Thus, it seems that certain moisturizers could improve skin barrier function in atopics and reduce skin susceptibility to irritants. The mechanism and the clinical relevance need further investigation.

Topics: Adult; Dermatitis, Atopic; Dermatitis, Contact; Emollients; Female; Galvanic Skin Response; Humans; Male; Middle Aged; Single-Blind Method; Sodium Dodecyl Sulfate; Water Loss, Insensible

The aim of this study was to establish the effect on barrier function in atopic dermatitis of topical evening primrose oil in an amphiphilic and a stable water-in-oil emulsion. The studies were vehicle-controlled in two populations of 20 atopic subjects. Barrier function was assessed in terms of transepidermal water loss and stratum corneum hydration after a 4-week treatment period and a 1-week treatment-free period. A barrier function test with sodium lauryl sulphate (SLS) and nicotinic acid ester was also carried out. Evening primrose oil proved to have a stabilising effect on the stratum corneum barrier, but this was apparent only with the water-in-oil emulsion, not the amphiphilic emulsion. The choice of vehicle is therefore an extremely important factor in the efficacy of topically applied evening primrose oil.

Topics: Administration, Topical; Adolescent; Adult; Dermatitis, Atopic; Dermatologic Agents; Double-Blind Method; Emulsions; Fatty Acids, Essential; Female; gamma-Linolenic Acid; Humans; Linoleic Acids; Male; Nicotinic Acids; Oenothera biennis; Pharmaceutical Vehicles; Plant Oils; Skin; Skin Absorption; Sodium Dodecyl Sulfate; Water Loss, Insensible

It was the aim of our studies to estimate predictively the individual eczema risk for persons due to repetitive contact with washing-active substances, by a barrier function test on clinically healthy skin over 2 weeks. Within the scope of the study 3 groups with different atopy scores were compared. As washing solutions, 0.1 m SLS and a slightly acid soap-free washing emulsion were used in comparison to tap water. Prior to the 1st washing procedure, on days 3, 5, 8, 10, and 12, the transepidermal water loss, the horny layer moisture, and the skin blood flow were measured as parameters of barrier function, as well as the inflammatory reaction. The results prove that the atopy score has only limited validity as a predictive method for the acceptance of washing-active substances. The repetitive washing test, however, seems to be more adequate for evaluating the individual barrier function as well as the eczema risk. Irritation by a washing procedure may be greatly influenced by choice of the washing solution.

Topics: Adult; Dermatitis, Atopic; Dose-Response Relationship, Drug; Eczema; Emulsions; Evaluation Studies as Topic; Female; Hand Disinfection; Humans; Middle Aged; Predictive Value of Tests; Risk Factors; Severity of Illness Index; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Time Factors; Water; Water Loss, Insensible

Twenty-four-hour occlusive exposures of 1% aqueous sodium lauryl sulfate (SLS) produced unique functional and histological responses in patients with atopic dermatitis. Disruption of the stratum corneum barrier, measured by transepidermal water loss, was much greater and longer lasting than in normal controls. In contrast to controls the histologic pattern induced reproduced the typical features of the disease with spongiosis, exocytosis of mononuclear cells and a perivenular infiltrate containing eosinophils. The perivascular infiltrate consisted of CD1a+, CD4+ and HLA-DR+ cells, which was much greater and more persistent in atopics. Eosinophilic major basic protein was abundant in atopics but absent in controls. SLS provocation of atopic dermatitis is a striking experimental example of Koebnerization, in which disruption of the stratum corneum barrier as well as cytokine activation of keratinocytes reproduces the clinical diseases.

Topics: Adolescent; Adult; Biopsy, Needle; Child; Dermatitis, Atopic; Female; Humans; Ichthyosis; Immunohistochemistry; Inflammation; Male; Middle Aged; Patch Tests; Reference Values; Sensitivity and Specificity; Sodium Dodecyl Sulfate; Statistics, Nonparametric; Surface-Active Agents

There has been much interest in recent years in the replacement of the Draize rabbit skin test for the identification of chemical skin irritants. A considerable effort has gone into the development of cell culture based assays. However, where ethical and safety considerations permit, the most obvious alternative is to use man himself. Data obtained using a suitable assay based on the endpoint of concern in the species of concern should be accurate and will represent a vital data base on which to develop sound in vitro assays. Thus, it is important to ensure the data produced in human assays is representative for man generally. To this end we have chosen to examine a number of variables and in this work report the effect of atopic status on the results obtained in a recently described human 4-h patch test. 30 atopic (defined by specific IgE to common allergens and by elevated total IgE) and 28 non-atopic volunteers were tested in this human 4-h patch test using 20% sodium dodecyl sulfate (SDS), 10% hydrochloric acid (HCl) and undiluted cocotrimethyl ammonium chloride (coco TAC). The level of irritant reaction was higher for SDS in the atopic panel, but was similar for HCl and coco TAC. The rank order of irritancy was the same in both panels. The results indicate that, whilst the intensity of reactions may be higher in atopics, their pattern of responses is similar to non-atopics. There is no evidence to indicate that they should either be deliberately included or excluded from the test panels recruited on a routine basis.

Topics: Animal Testing Alternatives; Case-Control Studies; Consumer Product Safety; Dermatitis, Atopic; Dermatitis, Irritant; Female; Human Experimentation; Humans; Hydrochloric Acid; Male; Patch Tests; Quaternary Ammonium Compounds; Sensitivity and Specificity; Sodium Dodecyl Sulfate

Basal transepidermal water loss, skin thickness, blood flow and skin colour were examined before and after exposure of 28 patients with atopic dermatitis and 28 healthy controls to sodium lauryl sulphate. Transepidermal water loss was measured with an evaporimeter, skin thickness by ultrasound A-scanning, blood flow by laser Doppler flowmetry and skin colour by a chroma meter using the L*, a* and b* values, respectively. Patients with atopic dermatitis were found to have higher basal transepidermal water loss than controls (p less than 0.0001), and had an inclination towards an increased basal skin thickness (p = 0.056). No statistically significant differences were found with respect to basal blood flow or skin colour. The skin response to sodium lauryl sulphate was found to be statistically significantly increased in atopic patients compared with controls when evaluated by visual scoring and by increase in skin thickness, but not by increase in transepidermal water loss, blood flow or skin colour.

Topics: Adult; Dermatitis, Atopic; Disease Susceptibility; Drug Eruptions; Female; Humans; Male; Severity of Illness Index; Skin; Skin Pigmentation; Skinfold Thickness; Sodium Dodecyl Sulfate; Water Loss, Insensible

A total of 330 patients with eczematous lesions were tested with 27 topical substances. Among the 88 patients with leg ulcers, 85 (2%) were allergic to one or more substances present in one out of two cases of allergy to wool alcohol. Among the 242 patients suffering from eczematous dermatitis, the percentage of allergic reactions reached 54.6%. A great number of allergic reactions of cetyl alcohol (11.2%), chloramphenicol (10%) and sodium lauryl sulfate (6.4%) was observed. These allergens are not included in the European standard series adopted by the ICDRG. The findings are discussed and compared with data taken from the literature.

Topics: Adult; Alcohols; Chloramphenicol; Clinical Trials as Topic; Cosmetics; Dermatitis, Atopic; Drug Compounding; Drug Eruptions; Eczema; Evaluation Studies as Topic; Humans; Leg Ulcer; Methanol; Middle Aged; Ointments; Patch Tests; Sodium Dodecyl Sulfate

The cutaneous sensitivity to benzalkonium chloride, sodium lauryl sulphate and potash soap was determined in 54 monozygotic and 46 dizygotic twin pairs. Comparing the intra-pair reaction strength a higher degree of concordance was found among monozygotic than among dizygotic twins, and even more so when monozygotic twins were compared with matched controls.

Topics: Adolescent; Adult; Benzalkonium Compounds; Clinical Trials as Topic; Dermatitis, Atopic; Diseases in Twins; Female; Humans; Irritants; Male; Patch Tests; Pregnancy; Soaps; Sodium Dodecyl Sulfate; Twins, Dizygotic; Twins, Monozygotic

Diaper dermatitis (DD) is the most common acute inflammatory skin disease. It has a serious effect on children's and families' quality of life. We aimed to screen and evaluate the efficacy of different formulas for relieving the diaper dermatitis symptoms by developing a kind of diaper dermatitis-like reconstructed human skin equivalent in vitro.. We developed the human skin equivalent for diaper dermatitis with 0.2% Sodium lauryl sulfate (SLS). The diaper dermatitis-like human skin equivalent was characterized by high level of inflammation, such as overexpression of interleukin-1α (IL-1α), and impaired skin barrier. Four formulas with potential of anti-inflammation and promotion of skin barrier function were topically applied on the diaper dermatitis-like human skin equivalent surface. The afterward protection efficacy was evaluated by endpoints of IL-1α, tissue viability, and skin barrier function.. The chemical irritant induced high release of IL-1α, impaired tissue viability, and skin barrier function. The cream prepared with potential of anti-inflammation and skin protection could effectively decrease and relive the impact of irritant with decreased level of IL-1α and the higher tissue viability than the placebo exposure.. The results showed that diaper dermatitis-like human skin equivalent induced by SLS can mimic the skin irritation response of the diaper rash.

Topics: Anti-Inflammatory Agents; Cells, Cultured; Cosmetics; Dermatitis, Atopic; Diaper Rash; Humans; Interleukin-1alpha; Keratinocytes; Models, Biological; Protective Agents; Skin; Skin Cream; Sodium Dodecyl Sulfate

Living in a hard water area is associated with an increased risk of atopic dermatitis (AD). Greater skin barrier impairment after exposure to surfactants in wash products, combined with the high calcium levels of hard water and/or high chlorine levels, is a compelling mechanism for this increase. The purpose of this study was to investigate this mechanism in individuals with and without a predisposition to skin barrier impairment. We recruited 80 participants: healthy control subjects and AD patients with and without FLG mutations. The skin of each participant was washed with sodium lauryl sulfate in water of varying hardness levels and chlorine concentrations, rinsed, and covered with chambers to determine the effects of surfactant residues. Sites washed with hard water had significantly increased sodium lauryl sulfate deposits. These deposits increased transepidermal water loss and caused irritation, particularly in AD patients carrying FLG mutations. A clear effect of chlorine was not observed. Water softening by ion-exchange mitigated the negative effects of hard water. Barrier impairment resulting from the interaction between hard water and surfactants is a contributory factor to the development of AD. Installation of a water softener in early life may be able to prevent AD development. An intervention study is required to test this hypothesis.

Topics: Adult; Case-Control Studies; Dermatitis, Atopic; Female; Filaggrin Proteins; Healthy Volunteers; Humans; Intermediate Filament Proteins; Male; Middle Aged; Mutation; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water; Water Loss, Insensible; Young Adult

Sacran, a polysaccharide isolated from the alga Aphanothece sacrum (Suizenji-nori), has unique physical and physiological characteristics. In a previous study, we reported that sacran improves skin conditions in individuals who suffer from atopic dermatitis (AD), focusing on its trapping function against extrinsic stimuli compared with hyaluronic acid (HA). First, we examined the penetration of sacran through stratum corneum (SC) with an impaired barrier function using immature reconstructed human epidermal equivalents. Sacran penetrates the SC to living cell layers of the epidermis, which suggested that sacran would attenuate adverse influences in keratinocytes caused by extracellular factors such as irritants or proinflammatory cytokines such as interleukin 1α (IL-1α). Sacran markedly reduced the cell damage induced by a nonionic detergent, sodium lauryl sulfate (SLS). Moreover, sacran restored the elevation of intracellular reactive oxygen species (ROS) levels stimulated by SLS and by IL-1α. These effects of sacran were superior to those of HA. In order to investigate the restoration effects of sacran, the influence of sacran on the physical properties of lipid bilayers was evaluated by measuring the order parameter using the ESR spin-labeling method. Because sacran failed to cause changes in the order parameters of liposomes and HaCaT keratinocytes, these results indicate that sacran does not interact with lipid bilayers although it restored changes in the order parameter caused by SLS. The sum of these results demonstrates that sacran reduces the influence of extracellular stimuli by its trapping effects. We conclude that the improving action of sacran is based on its trapping effect.

Topics: Biological Products; Cyanobacteria; Dermatitis, Atopic; Dermatitis, Irritant; Dermatologic Agents; Epidermis; Humans; Interleukin-1alpha; Keratinocytes; Polysaccharides; Protective Agents; Reactive Oxygen Species; Skin; Sodium Dodecyl Sulfate

Topics: Case-Control Studies; Dermatitis, Atopic; Diffusion; Humans; Models, Biological; Permeability; Skin; Sodium Dodecyl Sulfate; Spectrum Analysis, Raman; Surface-Active Agents; Time Factors; Water; Water Loss, Insensible

Topics: Dermatitis, Atopic; Filaggrin Proteins; Humans; Intermediate Filament Proteins; Mutation; Skin; Sodium Dodecyl Sulfate

Filaggrin is key for the integrity of the stratum corneum. Mutations in the filaggrin gene (FLGnull) play a prominent role in atopic dermatitis (AD) pathogenesis. People with AD have increased susceptibility to irritants. However, little is known about the effect of filaggrin genotype and AD phenotype on irritant response and skin regeneration.. To investigate the role of FLGnull and AD groups for skin reaction and recovery after sodium lauryl sulfate (SLS) irritation.. This is a case-control study comprising 67 subjects, including healthy controls and patients with and without FLGnull and AD. Reactivity to different doses of SLS at 24, 48, 72 and 145 h after SLS application was measured by transepidermal water loss (TEWL) and laser Doppler flowmetry (LDF). Reactivity was assessed univariately and by pattern analysis.. All patient groups showed a higher degree of skin-barrier disruption and inflammation than did controls in response to SLS. Assessing reactivity by the delta value of the area under the curve for both TEWL and LDF showed significant differences between healthy controls and those with the AD phenotype, irrespective of filaggrin mutation. The poorest regeneration was among those with the AD phenotype. The two AD phenotype groups were separated by multivariate technique, due to earlier inflammatory reactivity among subjects with FLGnullplus AD compared with the AD phenotype alone.. Both skin reaction and regeneration were significantly different between the patient population and the healthy controls. Additionally, response severity and regeneration depended more on AD phenotype than on filaggrin genotype, whereas the response was more rapid among the FLGnullplus AD individuals.

Topics: Adolescent; Adult; Aged; Case-Control Studies; Dermatitis, Atopic; Dermatitis, Irritant; Dose-Response Relationship, Drug; Female; Filaggrin Proteins; Genotype; Humans; Intermediate Filament Proteins; Irritants; Male; Middle Aged; Mutation; Phenotype; Random Allocation; Regeneration; Skin Physiological Phenomena; Sodium Dodecyl Sulfate; Water Loss, Insensible; Young Adult

Topics: Dermatitis, Atopic; Female; Filaggrin Proteins; Humans; Intermediate Filament Proteins; Male; Mutation; Regeneration; Skin Physiological Phenomena; Sodium Dodecyl Sulfate

Dermal exposure to alkaline agents may lead to skin barrier damage and irritant contact dermatitis. The objective of this study was to investigate the effects of cumulative exposure to 0.5% sodium lauryl sulphate (SLS) and 0.15% NaOH on the barrier function and natural moisturising factor (NMF) levels in atopic dermatitis and healthy volunteers with known filaggrin genotype. The skin response was monitored by measurement of erythema and transepidermal water loss. The stratum corneum NMF levels were determined by high-performance liquid chromatography. Repeated exposure to 0.5% SLS and/or 0.15% NaOH in atopic dermatitis resulted in more severe impairment of the skin barrier function. Cumulative exposure to the irritants reduced significantly NMF in both the atopic and healthy controls group. The pronounced decrease of NMF after repeated single and sequential irritant exposure may be a pathogenetically relevant factor for development of chronic irritant contact dermatitis in both healthy and atopic individuals.

Topics: Administration, Cutaneous; Adult; Aged; Case-Control Studies; Dermatitis, Atopic; Dermatitis, Irritant; Erythema; Female; Filaggrin Proteins; Genetic Predisposition to Disease; Humans; Hydrogen-Ion Concentration; Intermediate Filament Proteins; Irritants; Male; Middle Aged; Mutation; Phenotype; Risk Factors; Skin; Skin Irritancy Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Time Factors; Water; Water Loss, Insensible; Young Adult

Topics: Dermatitis, Atopic; Dermatologic Agents; Drug Combinations; Humans; Nonprescription Drugs; Propylene Glycols; Sodium Dodecyl Sulfate

The aim of the study was to disclose interactions between epidermal barrier, skin irritation and sensitization in healthy and diseased skin. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were assessed in adult patients with atopic dermatitis (AD), rosacea and healthy controls. A 4-h patch test with seven concentrations of sodium lauryl sulphate was performed to determine the irritant threshold (IT). Contact sensitization pattern was revealed by patch testing with European baseline series. Subjects with a lower IT had higher TEWL values and lower SCH. Subjects with positive allergic reactions had significantly lower IT. In AD, epidermal barrier deterioration was detected on both volar forearm and nasolabial fold, while in rosacea, impeded skin physiology parameters were observed on the facial skin only, suggesting that barrier impediment is restricted to the face in rosacea, in contrast with AD where the abnormal skin physiology is generalized.

Topics: Adult; Case-Control Studies; Dermatitis, Atopic; Dermatitis, Contact; Epidermis; Female; Humans; Irritants; Male; Middle Aged; Patch Tests; Permeability; Rosacea; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

Atopic dermatitis (AD) is a pruritic, chronic inflammatory skin disease that affects 10-20% of children and 1-3% of adults worldwide. Recent studies have indicated that the ability of Th2 cytokines, such as interleukin-4 (IL-4) to regulate skin barrier function may be a predisposing factor for AD development. The present studies examined the ability of increased Th2 activity to affect cutaneous barrier function in vivo and epidermal thickening. Mice that express a constitutively active Signal Transducer and Activator of Transcription 6 (STAT6VT) have increased Th2 cells and a predisposition to allergic inflammation were used in these studies, they demonstrate that topical treatment with the irritant sodium lauryl sulfate (SLS) caused increased transepidermal water loss and epidermal thickening in STAT6VT mice over similarly treated wild-type mice. The proliferation marker Ki-67 was increased in the epidermis of STAT6VT compared to the wild-type mice. However, these differences do not appear to be linked to the addition of an irritant as control-treated STAT6VT skin also exhibited elevated Ki-67 levels, suggesting that the increased epidermal thickness in SLS-treated STAT6VT mice is primarily driven by epidermal cell hypertrophy rather than an increase in cellular proliferation. Our results suggest that an environment with increased Th2 cytokines results in abnormal responses to topical irritants.

Topics: Animals; Cell Proliferation; Cellular Microenvironment; Dermatitis, Atopic; Genetic Predisposition to Disease; Hypertrophy; Irritants; Ki-67 Antigen; Mice; Mice, Inbred C57BL; Mice, Transgenic; Skin; Sodium Dodecyl Sulfate; STAT6 Transcription Factor; T-Lymphocyte Subsets; Th1-Th2 Balance; Th2 Cells

The emollient aqueous cream BP is frequently used for the treatment of atopic dermatitis (AD), yet it is associated with a high rate of adverse cutaneous reactions. It contains the harsh anionic surfactant sodium lauryl sulphate, a known negative environmental factor associated with the exacerbation of AD.. To investigate the effect of aqueous cream BP on stratum corneum (SC) integrity and skin barrier function in volunteers with a predisposition to a defective skin barrier.. Thirteen volunteers with a previous history of AD (no symptoms for 6 months) applied aqueous cream BP twice daily to the volar side of one forearm for 4 weeks. The other forearm was left untreated as a control. Permeability barrier function and SC integrity were determined before and after treatment by measuring transepidermal water loss (TEWL) in conjunction with tape-stripping. For comparison, 13 volunteers with current AD were recruited for assessment, without treatment, of SC integrity and skin barrier function at unaffected sites.. Topical application of aqueous cream BP resulted in significant elevation of baseline TEWL and a concomitant decrease in SC integrity. Measurements made after no treatment in volunteers with current AD, at unaffected sites, suggest that application of aqueous cream BP negatively affects the skin barrier towards the damaged state associated with onset of flares of the disease.. Aqueous cream BP used as a leave-on emollient caused severe damage to the skin barrier in volunteers with a previous history of AD. Aqueous cream BP should not be used as a leave-on emollient in patients with AD.

Topics: Adult; Cohort Studies; Dermatitis, Atopic; Disease Susceptibility; Drug Eruptions; Emollients; Epidermis; Female; Forearm; Humans; Male; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible

Prevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of AD and possibly food allergy and asthma. Correcting skin barrier defects from birth may prevent AD onset or moderate disease severity.. We sought to determine the feasibility of skin barrier protection as a novel AD prevention strategy.. We enrolled 22 neonates at high risk for developing AD in a feasibility pilot study using emollient therapy from birth.. No intervention-related adverse events occurred in our cohort followed up for a mean time of 547 days. Of the 20 subjects who remained in the study, 3 (15.0%) developed AD, suggesting a protective effect when compared with historical controls. Skin barrier measurements remained within ranges seen in normal-appearing skin.. No conclusions regarding efficacy can be made without a control group.. Skin barrier repair from birth represents a novel and feasible approach to AD prevention. Further studies are warranted to determine the efficacy of this approach.

Topics: Asthma; Dermatitis, Atopic; Drug Combinations; Emollients; Feasibility Studies; Female; Follow-Up Studies; Food Hypersensitivity; Humans; Infant, Newborn; Male; Pilot Projects; Primary Prevention; Propylene Glycols; Prospective Studies; Risk Assessment; Skin Absorption; Sodium Dodecyl Sulfate; Treatment Outcome

Chronic irritant hand dermatitis is an issue for healthcare workers and may negatively impact infection control.. We examined the effects of a G to A transition at position -308 on the tumour necrosis factor-α (TNF-α) gene on chronically damaged skin of healthcare workers during exposure and recovery from repetitive hand hygiene, after intensive treatment, and on the irritant response in normal skin.. In 68 healthcare workers with irritant hand dermatitis, we genotyped TNF-α-308 and measured the epidermal response via quantitative digital imaging, erythema, dryness, and barrier integrity.. Excess hand erythema decreased with hand hygiene exposure and increased during time off for AA/GA genotypes, but had opposite effects for GG. AA/GA had smaller reductions in dryness with lotion treatment and larger reductions in excess erythema than GG. The atopic diathesis and heightened neurosensory irritation resulting from water and lactic acid significantly influenced the responses. Repeated exposure to water and sodium lauryl sulfate (0.05, 0.1%) produced higher erythema in normal skin for AA/GA than for GG.. This study provides evidence that the TNF-α polymorphism at -308 and an atopic history impact the severity of irritation and recovery from exposure and response to treatment for common hand skin products in both chronic irritant hand dermatitis and normal skin.

Topics: Adult; Dermatitis, Atopic; Dermatitis, Irritant; Dermatitis, Occupational; Epidermis; Erythema; Female; Hand Disinfection; Health Personnel; Humans; Male; Middle Aged; Occupational Exposure; Polymorphism, Genetic; Severity of Illness Index; Sodium Dodecyl Sulfate; Tumor Necrosis Factor-alpha; Young Adult

Involved regions of the skin in patients with atopic dermatitis (AD) have been shown to have higher transepidermal water loss (TEWL), indicating a compromised skin barrier. Whether uninvolved skin also has diminished barrier characteristics is controversial.. To study the penetration of sodium lauryl sulphate (SLS) into uninvolved skin of patients with AD compared with the skin of control subjects.. Percutaneous penetration was assessed using the tape stripping technique on the stratum corneum (SC). Twenty patients with AD and 20 healthy subjects were exposed to 1% SLS for 4 h on the mid-volar forearm. After the end of exposure the SC was removed by adhesive tape. The amount of SLS was determined in each consecutive strip. Fick's second law of diffusion was used to deduce the diffusivity and the partition coefficient of SLS between water and the SC.. The SC thickness was similar in both groups; however, the TEWL was higher in patients with AD compared with that of the control group (mean+/-SD 8.4+/-4.3 and 6.3+/-2.0 g m-2 h-1, respectively). There was a correlation between SC thickness and TEWL in control subjects but no correlation was found in patients with AD. The diffusivity of SLS through uninvolved AD skin was higher compared with normal skin (mean+/-SD 12.7+/-5.8x10(-9) and 6.2+/-3.0x10(-9) cm-2 h-1, respectively), while the partition coefficient between SC and water was lower (mean+/-SD 137+/-64 and 196+/-107, respectively).. The results show a different penetration profile of SLS into the SC of patients with AD compared with control subjects. This indicates that even noninvolved skin in patients with AD has altered barrier characteristics, emphasizing the importance of skin protection and prevention of skin contact with chemicals.

Topics: Adolescent; Adult; Case-Control Studies; Dermatitis, Atopic; Female; Humans; Male; Middle Aged; Skin Absorption; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

There is evidence that a higher skin susceptibility may induce nonspecific erythematous or weak positive reactions to contact allergens in patch testing.. To evaluate whether simultaneous application of sodium lauryl sulphate (SLS) along with diagnostic patch tests with contact allergens can provide information regarding skin irritability which may help to discriminate allergic from nonspecific irritant reactions to contact allergens.. Between July 2001 and June 2003, this prospective study collected patch test data of 5971 patients from 19 centres in Germany and Austria in the Information Network of Departments of Dermatology (IVDK). In addition to contact allergens (standard series and eight known 'problematic' allergens with a low reaction index and a high positivity ratio: 1,3-diphenylguanidine, amerchol L-101, benzalkonium chloride, benzoyl peroxide, cocamidopropyl betaine, octyl gallate, phenyl mercuric acetate and propylene glycol), patches with SLS 0.5% and 0.25% aq. were applied. Reactions to the allergens and to SLS were analysed at the IVDK data centre. The association between an erythematous or positive reaction to a certain allergen and an irritant reaction to SLS was assessed with logistic regression analysis, at the same time controlling for the influence of age and sex.. Of the 29 allergens of the standard series, 23 and 21 gave a higher percentage of nonspecific erythematous reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, in comparison with SLS-negative patients. All eight 'problematic' allergens gave an increased percentage of nonspecific erythematous reactions. Similarly, 22 and 21 allergens of the standard series gave a higher percentage of positive allergic reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, and seven of the eight 'problematic' allergens gave a higher percentage of positive allergic reactions (exception: octyl gallate). For most allergens, the markers of skin reaction (reaction index and positivity ratio) were worse in SLS-positive patients. Differences were more pronounced when testing with SLS 0.25% than with SLS 0.5%.. Because there is a convincing association between skin irritability (evaluated by SLS test) and the degree of skin reaction to contact allergens, the SLS test may help in deciding whether a doubtful erythematous or weakly 'positive' skin reaction should be interpreted as allergic or irritant.

Topics: Adult; Allergens; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Occupational; Diagnosis, Differential; Diagnostic Errors; Erythema; Female; Humans; Male; Patch Tests; Predictive Value of Tests; Prospective Studies; Sodium Dodecyl Sulfate

The pathomechanism of atopic eczema is complex. Two of the most important exogenous factors for atopic eczema are allergenic and irritant substances. In this study we investigate the combined effect of topical aeroallergens and irritation on the skin of atopic individuals. We performed patch testing with several aeroallergens (atopy patch test) and with an irritant, sodium lauryl sulphate, on clinically unaffected skin of 30 sensitized patients with atopic eczema. Application was conducted alone and as a consecutive application. Healthy volunteers served as controls. Evaluation was made by measurement of transepidermal water loss 2 h after removal of the patches. In atopic patients, we found increased levels of transepidermal water loss induced by the aeroallergens as well as by sodium lauryl sulphate. The most impressive barrier disruption was seen after application of house dust mite, followed by cat dander and grass pollen. However, the consecutive application of aeroallergens and sodium lauryl sulphate led to a highly pronounced increase in transepidermal water loss. Hence, in sensitized atopic subjects the combined effect of aeroallergens and detergents may cause severe skin problems, and this may be relevant in daily practice.

Topics: Adolescent; Adult; Allergens; Dermatitis, Atopic; Female; Humans; Irritants; Male; Middle Aged; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents

The aim of study was to determine usefulness of the method of continuous TEWL measurement in the evaluation of skin barrier function in physiological conditions and in allergic contact dermatitis (ACD) and atopic dermatitis (AD).. Study was conducted on a group of 86 persons: 48 patients with allergic contact dermatitis, 18 with atopic dermatitis and 20 healthy individuals. Measurements of transepidermal water loss were made using custom-constructed device for continuous TEWL measurement. In each person the measurements of TEWL were made 4 times: measurement 0 (baseline)--before occlusion with 1% lauryl sulphate for 24 h, measurement 1-15 minutes after SLS patch removal, measurement 2-30 minutes after measurement 1 and measurement 3-30 minutes after measurement 2. Obtained data were statistically analyzed.. TEWL ratio values obtained in measurement 0 were as follows in individual groups of patients: 13.20 +/- 8.25 in the AD patients, 10.09 +/- 8.29 in ACD patients and 9.02 +/- 5.99 in control group. Analogous TEWL values in the subsequent measurements were: in measurement 1--16.08 +/- 11.17; 11.63 +/- 6.43; 17.39 +/- 12.41, in measurement 2--23.72 +/- 14.58; 14.71 +/- 6.46; 17.55 +/- 8.25, measurement 3--24.09 +/- 14.93; 16.34 +/- 6.32; 18.44 +/- 8.26. TEWL ratio values were higher in both groups of patients as compared to control group but not statistically significant (p = 0.1778). After 24 h exposition to SLS, TEWL ratio values increased in all examined groups as compared to baseline (0) measurement. All measurements, except for measurement No 1 in AD group of patients, showed statistically significant differences. The highest increase of TEWL values were observed in group of AD patients.. Delay in skin reaction to SLS in patients with atopic dermatitis provides evidence for different properties of water barrier of the skin in this group as compared to healthy individuals. Increasing tendency in TEWL values 1 hour after SLS removal might reflect persistent damage to water barrier of the skin by detergent. Method of continuous assessment of water barrier of epidermis, through the possibility of multiple measurement by TEWL in examined periods of time, decreased the risk of mistake and increased accuracy of measurement. Measurement of TEWL values allows for assessment of otherwise unnoticed damage to water barrier of the skin.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Dermatitis, Atopic; Female; Humans; Male; Middle Aged; Patch Tests; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

Hand eczema is a common skin disease. Because of its variable etiologies and clinical manifestations, it is difficult to determine the etiology from the clinical manifestation. Among the contact allergens, nickel is the most common. Patients with hand eczema and a nickel allergy have a poorer prognosis than patients without a nickel allergy. The reason is still uncertain; suggestions include persistent exposure to nickel or a weak skin barrier. The purpose of our study was to identify the characteristic clinical manifestations by etiology and to compare the skin barrier state between patients with nickel allergies and those without them. Ninety-three patients were classified into 4 types; irritation contact type, allergic contact type, atopic type and mixed type. After the sodium lauryl sulfate (SLS) test to compare the skin barrier state, visual score and transepidermal water loss (TEWL) were measured and analyzed statistically. From this study, it was not possible to ascertain a statistical difference, however a few characteristic clinical manifestations according to etiology can be stated. There was no difference in the visual scoring system or the TEWL after the SLS irritation test between the nickel-allergy group and the non-allergy group. Therefore, we believe that the poor prognosis of hand eczema with nickel allergy may be due to the nickel allergy itself rather than skin barrier state.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Eczema; Female; Hand Dermatoses; Humans; Infant; Irritants; Male; Middle Aged; Nickel; Patch Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

Rice starch added to bath water was studied for its possible beneficial effects on impaired barrier function as evaluated by transepidermal water loss measurements. The forearm skin of healthy volunteers was irritated by sodium lauryl sulphate. Exposure to rice-starch-containing bath water--twice daily for 15 min--led to a 20% improvement on the healing capacity of damaged skin. The beneficial effect was also observed for a rice-starch-containing lipid-free bath formulation, and an oil-in-water bath lotion enriched with evening primrose oil. Skin barrier function in patients with atopic dermatitis also improved after the addition of starch powder to bath water. Rice starch in powder or formulated in a bath product can therefore be recommended as a skin repair bathing additive for barrier damaged skin, particularly in the case of atopic dermatitis patients.

Topics: Adult; Baths; Dermatitis, Allergic Contact; Dermatitis, Atopic; Female; Humans; Hydrotherapy; Middle Aged; Oryza; Phytotherapy; Plant Preparations; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Wound Healing

We constructed an immunotoxin, composed of an antibody directed against the high-affinity IgG receptor CD64 and Ricin-A, with the aim of resolving chronic inflammation through elimination of activated macrophages. In vitro, this immunotoxin proved very efficient in inducing apoptosis in activated macrophages, leaving resting and low CD64-expressing macrophages unaffected. We examined the activity of our immunotoxin in a sodium lauryl sulfate (SLS)-induced cutaneous inflammation model, using transgenic mice expressing human CD64. Upon intradermal injection of the immunotoxin (IT), cutaneous inflammation resolved in 24 h. This was demonstrated histologically by clearance of all CD64-expressing macrophages, followed by clearance of other inflammatory cells. Clinical parameters associated with inflammation, such as local skin temperature and vasodilation, also decreased.

Topics: Animals; Antibodies, Monoclonal; Apoptosis; Body Temperature; Chronic Disease; Dermatitis; Dermatitis, Atopic; Humans; Immunotoxins; Injections, Intradermal; Interferon-gamma; Macrophage Activation; Macrophages; Mice; Mice, Transgenic; Receptors, Fc; Receptors, IgG; Ricin; Skin; Sodium Dodecyl Sulfate; Time Factors; U937 Cells; Vasodilation

Atopic dermatitis is an allergic skin disease characterized by elevated total and antigen-specific serum IgE and IgG4 levels. In acute and chronic cutaneous inflammation, large cellular infiltrates including T cells, dendritic cells and macrophages are found, especially in the dermis. These cells play an important part in the regulation of local inflammatory reactions. Receptors binding IgG (FcgammaR) are involved in dendritic cell and macrophage function. In this study, we examined the in vivo distribution and cellular expression of the three classes of leucocyte FcgammaR in human skin during acute and chronic cutaneous inflammation in atopic dermatitis. Atopy patch test skin was used as a model for acute inflammation in atopic dermatitis, while chronic lesional skin was used to investigate FcgammaR expression in chronically inflamed skin. In atopy patch test sites no increase in the number of CD1a+ dendritic cells and a slight increase in macrophages compared with non-lesional skin was observed. Our results showed increased expression of FcgammaRI (CD64) and FcgammaRIII (CD16) in acutely inflamed skin as well as in chronically inflamed lesional skin, compared with healthy and non-lesional atopic dermatitis skin. FcgammaRI was expressed by RFD1+, RFD7+ and CD68+, but not by CD1a+ dermal dendritic cells. RFD1+ dendritic cells and CD68+ macrophages were the main FcgammaRIII-expressing cells during the acute inflammatory reaction. The significant increase in expression of FcgammaRIII (CD16) and FcgammaRI (CD64) probably results from upregulation of the receptors on resident cells. Insight into the presence of FcgammaR+ cells in human skin during inflammation is important both for our understanding of skin immune reactions and the development of new therapeutic concepts.

Topics: Acute Disease; Adult; Chronic Disease; Dendritic Cells; Dermatitis, Atopic; Humans; Immunoenzyme Techniques; Macrophages; Receptors, Fc; Receptors, IgG; Skin; Sodium Dodecyl Sulfate

Malassezia spp. yeast habituating the skin of healthy humans can be a source of allergens for patients with atopic dermatitis. We proposed a method for obtaining allergen-containing preparation by trimming outer cell wall proteins with 1% sodium dodecyl sulfate. The resultant preparation contained 36 and 67 kD proteins known as Malassezia allergens. IgE antibodies to these proteins were detected in the sera of young people with atopic dermatitis.

Topics: Adult; Allergens; Antigens, Fungal; Cell Wall; Child; Child, Preschool; Dermatitis, Atopic; Fungal Proteins; Humans; Malassezia; Sodium Dodecyl Sulfate

The relevance of the irritant skin reaction of individuals with an atopic history (atopic dermatitis, rhinoconjunctivitis or atopic asthma) to sodium lauryl sulfate (SLS), a widely used irritant, is still controversial. The aim of this study was to evaluate transepidermal water loss (TEWL) as an indicator of stratum corneum integrity, before and after SLS patch testing, in various groups of atopic individuals with and without atopic dermatitis. 95 volunteers were divided into 4 groups: (1) individuals with active atopic dermatitis; (2) individuals with a history of atopic dermatitis but without active skin lesions; (3) individuals with rhinoconjunctivitis or atopic asthma without any symptoms at the time of testing; (4) healthy individuals serving as controls. The volunteers were patch-tested at the unaffected volar side of the forearm with aqueous SLS 0.5% for 48 h. TEWL was measured before application and after removal of the patch. Individuals with active atopic dermatitis showed a significantly higher TEWL value after SLS and a tendency to a higher basal TEWL as compared to the 3 other groups. There were no significant differences in TEWL between individuals who were classified as atopic but without active dermatitis, individuals with rhinoconjunctivitis or atopic asthma and healthy controls, either at the basal or at the post-SLS measurement. Enhanced skin susceptibility is only present in individuals with active dermatitis. The skin susceptibility of atopic individuals might therefore be increased as soon as the skin becomes eczematous, suggesting a reduced epidermal integrity probably caused by the endogenous atopy and/or respiratory allergens. When interpreting the atopy score in relation to skin susceptibility, the actual condition of the skin should hence be taken into consideration.

Topics: Adolescent; Adult; Aged; Dermatitis, Atopic; Female; Humans; Male; Middle Aged; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

Electrical bioimpedance can reflect structural and chemical changes of the skin and the oral mucosa in the beta-dispersion frequency range. From our measured multifrequency data set, four physically distinct indices have been formulated to distinguish the electrical properties for different anatomical locations and to detect different reactions and conditions of the skin and the oral mucosa. In comparison with the skin, the differences for various anatomical regions were greater in the oral cavity, which showed as well a different impedance pattern after irritant responses. We conclude that the impedance technique is able to classify and quantify different responses and conditions, preferably by using contralateral reference sites, or following a site in time; however, mapping of baseline properties facilitates the use of the method even if a large part of the skin or the oral mucosa is involved. The method has the potential of becoming a diagnostic decision support tool.

Topics: Adult; Dermatitis, Atopic; Electric Impedance; Female; Humans; Irritants; Male; Mouth Mucosa; Skin; Sodium Dodecyl Sulfate

Predictive testing of chemicals to assess their acute skin irritation potential is an important part of the assessment of their toxicological profile. It is possible, where safety and ethical considerations can be met, to do this work in groups of human volunteers. Previously, the relative responsiveness of atopics and non-atopics has been evaluated. The results showed that atopics (defined broadly by high IgE reactivity) were a little more susceptible to skin irritation, but not significantly so. In the present work, the relative reactivity of a skin atopic group versus a non-atopic group was examined in more detail. Sodium lauryl sulfate (SLS) was applied at a range of concentrations and exposure times, such that a fairly constant degree of skin irritation was produced. At various time points, the irritation response was measured by visual assessment, chromametry, laser Doppler flowmetry and transepidermal water loss. Using all of the methods of assessment, the reactions in atopics were similar to or a little less than those seen in non-atopics. The conclusion is that atopics and non-atopics will give similar results in a predictive human test for acute skin irritation. Furthermore, the pattern of response obtained from short duration exposure should be predictive of that following longer durations of (single) exposure.

Topics: Acute Disease; Adolescent; Adult; Dermatitis, Atopic; Dermatitis, Irritant; Female; Humans; Laser-Doppler Flowmetry; Male; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible

Patients with atopic dermatitis may experience exacerbations of eczema triggered by various inflammatory stimuli. One mechanism may be IgE-mediated reactions to dermatophytes since these patients are more likely to acquire skin infections with dermatophytes and may become sensitized.. This study investigates IgE-sensitization to fungi in patients with atopic dermatitis and compares the biologic activity of culture filtrates and cellular fungal extracts. The following allergen extracts were provided as culture filtrates and cellular extracts: Candida albicans, Fusarium moniliforme, and Penicillium notatum. In addition, Pityrosporum ovale and Trichophyton rubrum cultures were included in the test panel.. Fifteen patients with clinical findings suggesting dermatophytosis and 11 controls were selected. Each subject was tested by leukocyte histamine release and skin prick test to each fungal extract. The extracts were separated and reduced by sodium dodecylsulfate polyacrylamide gel electrophoresis and analyzed by IgE-immunoblotting with sera from all study subjects.. Fourteen patients (93%) reacted to one or several fungal extracts by releasing histamine when challenged in vitro. By immunoblotting experiments, patient sera showed binding to a wide range of components in all extracts. Patient sera recognized allergenic components shared by culture filtrates and cellular extracts but with higher frequent and greater intensity in culture filtrates. Although culture filtrates generated more frequent and potent IgE-reactions than the cellular extracts, the difference was not statistically significant. Biologic potency was similar when evaluated by skin prick tests and leukocyte histamine release.. Patients with atopic dermatitis may develop specific IgE-antibodies to a number of fungi as demonstrated by IgE-immunoblotting. In selected patients, fungi may trigger an IgE-mediated reaction that may contribute to the exacerbation of eczema. Approximately, one-half of the patients, however, produced IgE-antibodies to fungal (glyco)proteins without a significant histamine release or skin test response possibly because of nonspecific interaction with carbohydrate moieties on IgE and poor biologic activity of IgE antibodies directed to cross-reactive carbohydrate determinants of fungal glycoproteins. This warrants caution when interpreting clinical relevance of serologic measurements of fungal IgE-antibodies.

Topics: Adolescent; Adult; Allergens; Antibodies, Anti-Idiotypic; Antibodies, Fungal; Antigens, Fungal; Basophils; Candida albicans; Dermatitis, Atopic; Electrophoresis, Polyacrylamide Gel; Female; Fusarium; Humans; Immunization; Immunoblotting; Immunoglobulin E; Malassezia; Male; Middle Aged; Penicillium; Skin Tests; Sodium Dodecyl Sulfate; Trichophyton

Topics: Dermatitis, Atopic; Humans; Hypersensitivity, Immediate; Irritants; Sodium Dodecyl Sulfate; Surface-Active Agents

Skin hyperirritability to irritants as well as atopy are considered to be predisposing factors for contact dermatitis. The aim of the study was to evaluate whether these predictive factors are independent or whether they are so closely related that one could possibly replace the other 205 metalworker trainees underwent skin examination for skin atopy, including standardized questionnaire, clinical examination of the skin and a series of skin irritability tests. These tests included measurements of transepidermal water loss (TEWL) before and after irritation with 3 different irritants: sodium lauryl sulfate (SLS), dimethylsulfoxide (DMSO) and sodium hydroxide (NaOH). The results of the linear regression analysis demonstrate that skin atopy is not associated with increased skin irritability, as assessed by the irritability testing methods presented.

Topics: Adolescent; Adult; Dermatitis, Atopic; Dermatitis, Contact; Dermatitis, Irritant; Dermatitis, Occupational; Dimethyl Sulfoxide; Drug Hypersensitivity; Evaluation Studies as Topic; Humans; Male; Metallurgy; Multivariate Analysis; Regression Analysis; Skin Tests; Sodium Dodecyl Sulfate; Sodium Hydroxide; Switzerland; Water Loss, Insensible

The exacerbation of atopic dermatitis may be associated with infection of the skin with Staphylococcus aureus (S.aureus). S. aureus isolated from the skin of patients with atopic dermatitis secretes enterotoxin A, B, and toxic shock syndrome toxin 1. This is of interest because these patients may develop specific IgE antibodies against components from staphylococci.. The objective was to demonstrate IgE-sensitization to components of Staphylococcus aureus enterotoxins A and B (purified and partially purified), toxic shock syndrome toxin 1, and the bacterial cell component lipoteichoic acid, in patients with atopic dermatitis.. Blood samples from 34 patients with atopic dermatitis and 10 controls were tested by leukocyte histamine release to the enterotoxins and lipoteichoic acid. The toxins were separated by sodium dodecylsulfate polyacrylamide gel electrophoresis and analyzed by IgE-immunoblotting with sera from the same patients.. The majority of patients (96%) with clinical signs of skin infection produced specific IgE-antibodies to all three toxins. Nearly half of the patients produced IgE to enterotoxin A and B. Only 63% of the patients with atopic dermatitis showed cellular response judged by the release of histamine from patient basophils when challenged in vitro with the toxins. This may indicate clinically unimportant sensitization in a number of patients. The immunoblotting revealed that the major allergens of the toxins were 24 and 28 kD proteins. Partially purified toxins showed a higher frequency of leukocyte histamine release responses than purified toxin. The only obvious difference was a difference in the content of pure toxin of the two preparations. Lipoteichoic acid showed nonspecific activity.. These findings suggest that staphylococcal enterotoxins may act as specific allergens and induce IgE-antibodies to enterotoxins that may exacerbate the skin inflammation in some patients with atopic dermatitis.

Topics: Allergens; Antibody Specificity; Bacterial Toxins; Dermatitis, Atopic; Electrophoresis, Polyacrylamide Gel; Enterotoxins; Female; Humans; Immunoglobulin E; Male; Protein Binding; Sodium Dodecyl Sulfate; Staphylococcus aureus; Superantigens

No literature data are available on the skin reactivity of patients with respiratory atopy alone.. Our purpose was to assess skin reactivity to detergents in patients with allergic asthma, rhinitis, or both.. The skin of the volar aspect of the forearm of 19 subjects with allergic asthma or rhinitis (or both) was challenged with a single exposure to 0.5% sodium lauryl sulfate. The skin response was evaluated by transepidermal water loss (TEWL), capacitance, and echogenicity measurements. Results were compared with those obtained in 19 patients with atopic dermatitis (AD) and 20 healthy subjects.. In patients with AD preexposure TEWL values were higher than in healthy subjects, whereas capacitance values were lower. In this patient group, postexposure TEWL, capacitance, and echogenicity values showed more pronounced variations than in healthy subjects. Conversely, in patients with allergic asthma or rhinitis (or both), both baseline and postexposure TEWL, capacitance, and echogenicity values were similar to those in healthy subjects.. Patients with respiratory atopy without AD do not have the functional abnormalities characteristic of skin affected by AD, either under baseline conditions or after exposure to sodium lauryl sulfate.

Topics: Adult; Asthma; Dermatitis, Atopic; Detergents; Electric Conductivity; Female; Humans; Immunization; Male; Respiratory Hypersensitivity; Rhinitis, Allergic, Seasonal; Skin; Sodium Dodecyl Sulfate; Ultrasonography; Water Loss, Insensible

Topics: Animals; Data Display; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Edema; Fatty Acids; Humans; Hydrochloric Acid; Image Processing, Computer-Assisted; Mice; Mice, Hairless; Nickel; Patch Tests; Skin; Sodium Dodecyl Sulfate; Sodium Hydroxide; Ultrasonography

The aim of this study was to establish an objectively assessable procedure simulating simultaneous exposure to irritants and allergens in domestic and occupational environments, in order to evaluate differences in the reactivity to the combination of these substances in atopic and non-atopic nickel-sensitized subjects. Thirty-four nickel-sensitive patients, 20 of whom were affected by atopic dermatitis, underwent four patch tests with NiSO4 0.05% aq. on two adjacent sites of both volar forearms, with a 24-h application time. Two of the test sites were treated with sodium lauryl sulfate (SLS) 5% for 30 min, before application of the nickel sulfate preparation. Echographic recordings were performed by a 20-MHz B-scanner and processed by an image analysis program, providing a numerical representation of the picture data, based on the attribution of fictional values to the amplitudes of the echoes. The dermal inflammatory reaction was quantified by an amplitude band, marking the hypo-reflecting part of the dermis, whereas epidermal damage was assessed by a band highlighting the entrance echo. Pre-treatment with SLS of the skin area where nickel sulfate was subsequently applied greatly enhanced the allergic response at 24 and 72 h, both in subjects with atopic dermatitis and in subjects with allergic contact dermatitis. However, in atopics, the increase in the allergic reactivity after irritation of the skin was more pronounced both by clinical and by echographic evaluation. These observations stress the importance of the concurrent action of irritants and allergens in maintaining the dermatitis in atopics.

Topics: Adolescent; Adult; Dermatitis, Allergic Contact; Dermatitis, Atopic; Humans; Irritants; Middle Aged; Nickel; Skin; Sodium Dodecyl Sulfate; Ultrasonography

Past observations have shown increased irritancy in patients with "conditioned hyperirritability" due to active dermatitis, including atopic dermatitis (AD). In less active atopic conditions, irritancy levels are less certain. We have utilized 48-hour Finn Chamber testing with graded dilutions of sodium lauryl sulfate to detect irritancy thresholds in well-defined groups of patients with AD, inactive AD, and allergic respiratory disease with no dermatitis and in normal nonatopic subjects.. Significantly greater frequency of response to sodium lauryl sulfate in both AD groups and also in patients with allergic rhinitis with no dermatitis was seen. Effective concentrations of sodium lauryl sulfate causing irritation in 50% or more of subjects (ED50) ranged from 0.0625% to 0.31% in all atopic groups, percentages that were significantly lower than the normal ED50 of 0.60%. Response intensity was also significantly greater in each atopic group.. Our results showed significantly greater irritant responses in atopic subjects with no skin disease or in subjects with inactive AD and confirmed past findings that showed greatly increased irritancy in patients with active AD. We hypothesize that abnormal intrinsic hyperreactivity in inflammatory cells, rather than in skin cells, in atopic individuals predisposes to a lowered threshold of irritant responsiveness.

Topics: Adolescent; Adult; Dermatitis, Atopic; Dermatitis, Irritant; Female; Humans; Irritants; Male; Middle Aged; Patch Tests; Respiratory Hypersensitivity; Sodium Dodecyl Sulfate

In order to optimize patch test strategies and counselling in occupational dermatology, it is important to identify risk markers of contact sensitization. Since nickel is the most frequent contact allergen in European countries, we studied the potential of the irritant response to sodium lauryl sulfate (SLS) to predict nickel sensitization. In 100 patients subsequently tested in our patch test clinic with the standard patch test series of the German Contact Dermatitis Group (DKG), the atopy score as described by Diepgen et al. was determined and an SLS patch test was performed. Relative transepidermal water loss (TEWL), expressed as the ratio between the TEWL of the SLS-irritated and the control site, atopy score, age and sex were tested by logistic regression analysis for their association with patch test-proven nickel sensitization. Age, sex and relative TEWL were found to be significant predictors of nickel sensitization, whereas the atopy score was not. Patients with nickel sensitization were significantly younger (mean age 35.0 +/- 4.1 versus 46.2 +/- 2.1 years), more frequently of female gender (28.6% versus 3.9%) and had a significantly higher relative TEWL following SLS exposure (471.0 +/- 40.8% versus 344.0 +/- 16.2%). The mean atopy score of nickel-sensitized patients was slightly higher than that of patients not sensitized (6.0 +/- 1.3 versus 5.3 +/- 0.5), but the difference was not significant. In previous studies on larger patient samples, atopy was found to be a predictor of nickel allergy. This discrepancy may be explained by the smaller statistical power of our study.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dermatitis, Irritant; Female; Humans; Male; Middle Aged; Nickel; Patch Tests; Sodium Dodecyl Sulfate; Water Loss, Insensible

The susceptibility of the skin of patients with seborrhoeic dermatitis to surfactant irritation was investigated and compared to that of a group of normal subjects and patients with a history of atopic eczema. Responses to six concentrations of sodium lauryl sulphate (SLS), applied to forearm skin, were assessed clinically and measured by laser Doppler flowmetry. Analysis of dose-response curves showed statistically significant increased susceptibility to SLS-induced irritation in patients with seborrhoeic dermatitis and atopic eczema compared with normal subjects. Increased susceptibility to chemical irritation may be important in the pathogenesis of seborrhoeic dermatitis.

Topics: Adolescent; Adult; Blood Flow Velocity; Dermatitis, Atopic; Dermatitis, Irritant; Dermatitis, Seborrheic; Dose-Response Relationship, Drug; Female; Humans; Male; Skin; Sodium Dodecyl Sulfate

Peanuts are frequently a cause of food hypersensitivity reactions in children. Serum from nine patients with atopic dermatitis and a positive double-blind, placebo-controlled, food challenge to peanut were used in the process of identification and purification of the peanut allergens. Identification of a second major peanut allergen was accomplished with use of various biochemical and molecular techniques. Anion exchange chromatography of the crude peanut extract produced several fractions that bound IgE from the serum of the patient pool with positive challenges. By measuring antipeanut specific IgE and by IgE-specific immunoblotting we have identified an allergic component that has two closely migrating bands with a mean molecular weight of 17 kd. Two-dimensional gel electrophoresis of this fraction revealed it to have a mean isoelectric point of 5.2. According to allergen nomenclature of the IUIS Subcommittee for Allergen Nomenclature this allergen is designated, Ara h II (Arachis hypogaea).

Topics: 2S Albumins, Plant; Allergens; Amino Acid Sequence; Amino Acids; Antigens, Plant; Arachis; Child; Child, Preschool; Chromatography, Ion Exchange; Dermatitis, Atopic; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Food Hypersensitivity; Glycoproteins; Humans; Immunoblotting; Infant; Molecular Sequence Data; Plant Proteins; Sodium Dodecyl Sulfate

The susceptibility of the skin to various irritants was investigated with the aim of determining the role of the barrier function of the stratum corneum, skin dryness and whether a history of atopic dermatitis (AD) was a factor. The transepidermal water loss (TEWL) was measured using an evaporimeter and skin hydration using a Corneometer and by visual scoring. The group with a history of AD (n = 20) had a lower pre-exposure barrier function and a higher TEWL value following irritant exposure than the group with a history of allergic contact dermatitis (n = 18) and a control group (n = 18). Clinically dry skin was more susceptible than normal skin, though no difference was noted in the pre-exposure barrier function. The increased susceptibility to irritants in those with a past history of AD was probably due to impaired barrier function and/or the presence of a dry skin.

Topics: Adolescent; Adult; Dermatitis, Atopic; Dermatitis, Contact; Female; Humans; Ichthyosis; Irritants; Male; Middle Aged; Skin; Sodium Dodecyl Sulfate; Time Factors; Water Loss, Insensible

Topics: Administration, Oral; Dermatitis, Atopic; Drug Combinations; Drug Therapy, Combination; Fatty Alcohols; Fluocinolone Acetonide; Humans; Papaverine; Propylene Glycols; Sodium Dodecyl Sulfate

100 hospitalized patients with skin disease were patch tested with graded dilutions of nonanoic acid (NON), sodium lauryl sulfate (SLS) and benzalkonium chloride (BENZ). Smooth dose-response curves were obtained. The concentration needed to produce a discernible irritant reaction in 50% of the population (ID50) was found to be lower in cases of irritant than of allergic contact dermatitis; this finding warrants further study. Björnberg's observation that it is not possible to predict the strength of the reaction to one irritant by knowing the strength of the reaction to another was confirmed. Benzalkonium chloride caused a high frequency of pustular and/or bullous reactions with scarring as a sequela. It is suggested that this irritant could be replaced by nonanoic acid in experimental studies of topical irritancy, since the test reactions from nonanoic acid were reproducible, easy to read and left no staining or scarring.

Topics: Adolescent; Adult; Aged; Benzalkonium Compounds; Child; Dermatitis, Atopic; Dermatitis, Contact; Dose-Response Relationship, Drug; Fatty Acids; Female; Humans; Male; Middle Aged; Patch Tests; Skin Tests; Sodium Dodecyl Sulfate

The skin is more susceptible to irritation when an active eczematous process is present. This reduced threshold to irritation occurs in skin distant from the site of the eczematous skin. Data is presented to demonstrate the appearance of irritant dermatitis to lower concentrations of sodium lauryl sulfate during the presence of an allergic contact dermatitis in the guinea pig.

Topics: Animals; Dermatitis, Atopic; Dermatitis, Contact; Dinitrochlorobenzene; Drug Hypersensitivity; Female; Guinea Pigs; Patch Tests; Skin; Sodium Dodecyl Sulfate

A strong positive, allergic patch-test reaction was elicited in 15 patients with an established allergy for a particular allergen. Patches with a marginally irritating concentration of sodium lauryl sulfate (SLS) were applied at fixed distances. The SLS patch situated adjacent to the allergic reaction was significantly enhanced in 12 of 15 patients (P less than 0.01) compared to more distant SLS reactions ("spillover'). Only quantitative differences were observed in the histologic pictures of the different types of reaction. The infiltrate consisted of lymphocytes and histiocytes, mainly located perivascular in the upper dermis. T-cell subsets were assessed with monoclonal antibodies using an immunoperoxidase technique. The distribution of the different T cells was the same for both reaction types. T cells located outside the perivascular infiltrates (e.g., in the epidermal vesicles) were OKT-8-positive (cytotoxic/suppressor T lymphocytes). Immunofluorescence examination did not show different patterns for the allergic or "enhanced toxic' reactions with regard to the presence of immunoglobulins and complement. The "spillover' phenomenon may cause false-positive patch-test reactions.

Topics: Adult; Dermatitis, Atopic; False Positive Reactions; Female; Humans; Male; Middle Aged; Patch Tests; Skin Tests; Sodium Dodecyl Sulfate; T-Lymphocytes; T-Lymphocytes, Regulatory

Allergens eliciting weak positive reactions were retested to ascertain their reproducibility. Weak positive patch test reactions, concomitant to other weak or strong positive reactions, were retested after 3 weeks in 61 patients. 79 reactions were retested; 35 (44.3%) were negative. Allergens which are marginal irritants, e.g., formaldehyde, often gave weak positive reactions which were lost at retesting. In patients without dermatitis but with several strong positive reactions, lost reactions were frequently encountered, suggesting that strong reactions induced a state of hyperirritability. False positive reactions were often found in the proximity of strong reactions. We attempted to develop a nonspecific irritant (sodium lauryl sulfate) as a hyperirritability marker. A correlation between the score of this test and false positive reactions was not found. It is concluded that weak positive reactions should not be accepted as a proof of sensitization. The allergens eliciting these reactions should be retested at a later date.

Topics: Adolescent; Adult; Aged; Dermatitis, Atopic; Dermatitis, Contact; Diagnosis, Differential; Eczema; Female; Humans; Male; Middle Aged; Patch Tests; Skin Tests; Sodium Dodecyl Sulfate

Irritant reactions were induced on the forearms of 10 normal subjects with 10% aqueous sodium lauryl sulfate under patch test occlusion for 24 h. Test sites were observed at 24, 26, 28, 30, 48, 72 and 96 h and the degree of inflammation recorded. Inflammation was most prominent at 28 h and decreased in intensity over the time course of the study. Inflammation at 48 and 72 h was similar to when patches were removed. This suggests that inflammatory responses in skin for at least certain irritants like sodium lauryl sulfate do slowly decrease in intensity after 48 h. However, the inflammatory response may initially accelerate after patch test removal and remain intense for at least 48 h. Fading of irritant reactions by 48 or 72 h may not reliably distinguish irritant from allergic patch test reactions. This does not refute the usefulness of a delayed (96 h) reading since inflammation from sodium lauryl sulfate had decreased significantly by this time.

Topics: Adolescent; Adult; Dermatitis, Atopic; Dermatitis, Contact; Female; Humans; Male; Patch Tests; Skin Tests; Sodium Dodecyl Sulfate; Time Factors

Topics: Dermatitis, Atopic; Diphenhydramine; Drug Combinations; Fatty Alcohols; Humans; Propylene Glycols; Sodium Dodecyl Sulfate