sodium-dodecyl-sulfate and Hand-Dermatoses

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

There is increasing evidence that reactive oxygen species play an important role in the development of both irritant and allergic contact dermatitis.. To assess the potential of topical antioxidants to prevent the development of experimentally induced irritant contact dermatitis.. We evaluated the effect of a cream containing a combination of antioxidants on sodium lauryl sulfate-induced irritant contact dermatitis in the repetitive washing test. As readout parameters for skin barrier function and cutaneous inflammation stratum corneum hydration, cutaneous blood flow and transepidermal water loss were assessed in 25 volunteers with bioengineering methods.. In comparison with the cream base and a frequently used barrier cream, the antioxidant cream had high radical scavenging activity and effectively protected the skin from chemical-induced irritation.. The superiority of the cream with antioxidants to the cream base suggests that reactive oxygen species, at least in part, play a role in the development of irritant contact dermatitis.

Topics: Antioxidants; Dermatitis, Irritant; Double-Blind Method; Hand Dermatoses; Humans; Phytotherapy; Plant Extracts; Reactive Oxygen Species; Resedaceae; Skin Cream; Sodium Dodecyl Sulfate; Tocopherols; Ubiquinone

The purpose of the present study was to compare 2 experimental models of moisturizer efficacy on the recovery of irritated skin on the hands and the volar forearms. 12 healthy volunteers had their hands immersed in sodium lauryl sulfate (SLS) 10 min 2x daily for 2 days, and at the same time the volunteers had patch tests with SLS (0.125%, 0.25% and 0.5%) applied on their forearms for 24 h. After irritation of the skin, the volunteers had a moisturizer applied on one arm/hand 3x daily for the following 9 days. The other arm/hand served as untreated control. Evaluation was done on days (D) 1, 3, 5, 8 and 12 by transepidermal water loss, electrical capacitance, laser Doppler flowmetry and DermaSpectrometry. Both models were found useful, and the moisturizer was found to accelerate regeneration of the skin barrier function in both the hands (D8, p<0.05) and the volar forearms (0.5% SLS, D5 and D8, p<0.01). When the forearm model is used in the present set-up, a relatively high concentration of SLS (>0.25%) should be used and evaluation measurements are best performed on D5-D8. The forearm model proved reliable and easy to handle and we suggest that this model is used in future studies on moisturizer evaluation.

Topics: Adult; Dermatitis, Irritant; Dose-Response Relationship, Drug; Electric Conductivity; Emollients; Erythema; Female; Forearm; Hand Dermatoses; Humans; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Severity of Illness Index; Single-Blind Method; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Treatment Outcome; Water Loss, Insensible

We evaluated the effect of subclinical irritation on the cutaneous reaction elicited by cumulative short-term (30-min) application of sodium lauryl sulphate (SLS), by measuring transepidermal water loss (TEWL) and assigning visual scores. 11 healthy adult volunteers, free of skin disease and with no history of atopic dermatitis, were treated with SLS solution (1%, 2%, 5%, 7.5%). On a Monday, we applied 80 microliters of 1% SLS solution and deionized water (control), using large aluminium chambers with filter paper discs, for 30 min. We measured TEWL values 2 x before and after patch application of control and 1% SLS solution, and then applied 80 microliters of SLS solution (2%, 5%, 7.5%) using filter paper discs. From Tuesday to Friday, we applied 80 microliters of each solution, using filter paper discs, and measured TEWL before and after open application of test solutions. Compared with each corresponding group, TEWL values of SLS patch groups (S-2.0, S-5.0, S-7.5) were higher than those of water patch groups (W-2.0, W-5.0, W-7.5), respectively. TEWL values of each groups increased stepwise and the final (hour 97) TEWL values were higher than those of baseline (hour 0) TEWL. The mean visual scores of the vehicle control were lower than those of other test groups, but there were no statistically significant differences in visual scores between each test group. These findings suggested that impaired skin barrier function, elicited by subclinical irritation from short-duration contact with some irritants, might augment the cumulative irritant contact dermatitis caused by repeated open exposure to other surfactants.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Chronic Disease; Dermatitis, Contact; Dermatitis, Irritant; Female; Hand Dermatoses; Humans; Irritants; Male; Middle Aged; Patch Tests; Sodium Dodecyl Sulfate; Time Factors; Water Loss, Insensible

The effects of softened fabrics on the skin were evaluated by a forearm wet and dry test, under conditions simulating real-life skin contact with fabrics. 15 volunteers with sensitive skin according to dermatological assessment and their own recognition entered a double-blind 12 day, 3 sessions per day, forearm wetting and drying test, using cotton fabrics washed with a powder detergent and softened or not with a liquid fabric conditioner. To simulate conditions of skin damage, a dilute solution of sodium lauryl sulfate was applied under patch to the forearm before the start of the study. Skin effects were evaluated by visual grading (redness, dryness and smoothness), by noninvasive skin stripping and measuring of Chroma C* (squamometry), and by instrumental measurements (capacitance, transepidermal water loss, and colorimetry). Both the unsoftened and softened fabrics induced no deleterious effects on control or previously irritated skin. Furthermore, a mild beneficial effect was observed with the softened fabrics, particularly on previously irritated skin. The study findings suggest that softened fabrics may exert a reduced frictional effect on the skin.

Topics: Adult; Colorimetry; Dermatitis, Contact; Dermatitis, Irritant; Detergents; Double-Blind Method; Epidermis; Erythema; Gossypium; Hand Dermatoses; Humans; Laundering; Middle Aged; Patch Tests; Sodium Dodecyl Sulfate; Textiles; Water Loss, Insensible

Topics: Calibration; Consumer Product Safety; Dermatitis, Irritant; Detergents; Hand Dermatoses; Humans; Irritants; Product Labeling; Sodium Dodecyl Sulfate

Hand eczema (HE) is a multifactorial disease, comprising different aetiological conditions and different morphologies. There are two aetiologically distinct groups of HE recognised: exogenous, such as contact dermatitis (allergic and/or irritant HE) and endogenous, such as the classic hyperkeratotic HE. Differences in the skin barrier properties of these two conditions could theoretically be expected.. To examine whether differences exist in the lipid profile and the susceptibility of the stratum corneum (SC) in patients with allergic/irritant HE and those with hyperkeratotic HE.. Using cyanoacrylate, SC samples were taken from 23 patients with allergic/irritant HE and 15 with hyperkeratotic HE for lipid analysis by high-performance thin-layer chromatography (HPTLC). Samples were also taken from adjacent, unaffected skin. Severity of HE was assessed by the Hand Eczema Severity Index (HECSI), and skin barrier susceptibility was assessed by measuring transepidermal water loss (TEWL) after a 24-hour patch test with sodium lauryl sulfate (SLS).. No statistically significant difference was found between groups for the lipid analysis or for skin susceptibility to SLS. We found a significantly higher HECSI score for hyperkeratotic HE compared with irritant or allergic HE (P = 0.02).. There appears to be no difference in skin barrier between allergic/irritant HE (exogenous eczema) and hyperkeratotic HE (endogenous eczema) with regard to SC lipids or susceptibility to SLS.

Topics: Adult; Aged; Ceramides; Chromatography, High Pressure Liquid; Eczema; Epidermis; Female; Hand Dermatoses; Humans; Irritants; Keratosis; Male; Middle Aged; Patch Tests; Skin; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible; Young Adult

Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin.. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers.. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels.. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups.. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents.

Topics: Acetic Acid; Adult; Aged; Dermatitis, Allergic Contact; Dermatitis, Occupational; Detergents; Female; Food Industry; Fruit; Hand Dermatoses; Humans; Male; Middle Aged; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible; Young Adult

We investigated the biological response of regular human skin to alcohol-based disinfectants and detergents in a repetitive test design. Using non-invasive diagnostic tools such as transepidermal water loss, laser-Doppler flowmetry and corneometry, we quantified the irritative effects of a propanol-based hand disinfectant (Sterillium), its propanol mixture (2-propanol 45% w/w and 1-propanol 30% w/w), sodium lauryl sulfate (SLS) 0.5% and distilled water. The substances were applied in a 2-D patch test in a repetitive occlusive test design to the back. Additionally, we performed a wash test on the forearms that was supposed to mimic the skin affection in the normal daily routine of health care workers. In this controlled half-side test design, we included the single application of the hand rub, SLS 0.5% and water as well as a tandem application of the same substances. Patch test and wash test showed similar results. The alcohol-based test preparations showed minimal irritation rather comparable to the application of water. However, the detergent SLS produced stronger barrier disruption, erythema and dryness than the alcohol-based preparations. There was no additional irritation at the combined use of SLS and disinfectants. By contrary, there was even a decrease in barrier disruption and erythema induced by the tandem application of SLS followed by alcohol-based disinfection compared with the use of SLS alone. These findings show a less irritant effect of alcohol-based disinfectants on the skin than detergents. Our study shows that there is no summation of irritating effects of a common detergent and propanol and that the combination of washing and disinfection has a rather protective aspect compared with washing alone.

Topics: Adolescent; Adult; Dermatitis, Irritant; Dermatitis, Occupational; Detergents; Disinfectants; Erythema; Female; Hand Dermatoses; Hand Disinfection; Health Personnel; Humans; Laser-Doppler Flowmetry; Male; Middle Aged; Patch Tests; Quaternary Ammonium Compounds; Regional Blood Flow; Skin; Sodium Dodecyl Sulfate; Water; 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

Hand disinfection with short-chain aliphatic alcohols, so-called "rub-ins" is the method of choice for cross-infection prevention in health care environments, but their irritant potential is not well known. Skin tolerance is a major compliance factor, and a high proportion of health care workers suffer from low-grade irritant contact dermatitis. Therefore, assessment of the irritancy of the skin disinfectant n-propanol 60%, and comparative 100% and 0% solutions, was performed in the setting of experimental low-grade ICD. ICD was induced by overnight patch exposure to H2O, and to 0.3% sodium dodecyl sulfate (SDS), in 12 probands, followed by repeated open exposure to the test substances. Outcome variables were transepidermal water loss (TEWL), and skin surface capacitance. On skin sites pre-irritated by SDS, all n-propanol concentrations (100%, 60%, 0%) increased TEWL. However, a clear divergence appeared between pure n-propanol, and the lower concentrations. In contrast to pure n-propanol, n-propanol 60% and 0% had no significant effect on TEWL on H2O-pre-irritated skin sites. Capacitance of pre-irritated skin sites was increased by exposure to H2O-containing n-propanol solutions (60% and 0%). These results show a clear difference between the irritant potential of n-propanol 100% on one side, and n-propanol 60% and 0% on the other side. The level of pre-existent skin irritation is a pertinent factor in susceptibility to irritation, as the irritant potential of n-propanol 60%, the concentration used in daily practice, and n-propanol 0% (water) became significant only on detergent-irritated skin. Thus, preventive skin care may be a constructive approach in increasing tolerance of modern hand disinfection practices.

Topics: 1-Propanol; Adult; Dermatitis, Contact; Disinfectants; Female; Hand Dermatoses; Humans; Male; Patch Tests; Sodium Dodecyl Sulfate; Statistics, Nonparametric; Water

Protective gloves are used in the workplace to protect the hands from occupational hazards, but side effects from glove use are frequently reported. Among these side effects, irritant skin reactions are common.. The present study was undertaken to investigate whether applying a moisturizer to compromised skin before wearing an occlusive glove could reduce skin irritation.. Healthy volunteers had both hands immersed in a sodium lauryl sulfate solution twice daily for 2 days. After each immersion, one hand had a moisturizer applied and both hands were put in occlusive gloves for 2 hours. Skin barrier function was evaluated by transepidermal water loss, skin hydration was measured by electrical capacitance and inflammation was evaluated by colorimetry.. The moisturizer had a statistically significant positive effect on both the water barrier function and the hydration level of the skin. Although not statistically significant, less inflammation was observed on the moisturizer-treated hand.. The findings suggest that use of a moisturizer under an occlusive glove may diminish irritation from exposure to a detergent followed by glove wearing.

Topics: Adult; Dermatitis, Allergic Contact; Emollients; Epidermis; Female; Gloves, Protective; Hand Dermatoses; Humans; Male; Occupational Exposure; Reference Values; Sodium Dodecyl Sulfate; Surface-Active Agents

Topics: Adult; Dermatitis, Irritant; Dermatitis, Occupational; Female; Hand Dermatoses; Hand Disinfection; Humans; Male; Soaps; Sodium Dodecyl Sulfate

It has been reported that occlusive treatment of irritated skin results in a reduction of barrier repair activities in hairless mice. In contrast, the clinically observed benefit of occlusion in the treatment of hand eczema and other chronic skin diseases with a perturbed barrier function is well-known. While the beneficial effect of occlusion has been proven for the treatment of psoriasis there are no controlled clinical studies of the effect of occlusion on irritated human skin. We have therefore evaluated the effect of various occlusive treatments on repair of the human skin permeability barrier under controlled experimental conditions. Barrier perturbation was induced either by application of sodium lauryl sulfate (SLS) or by repeated tape stripping. This was followed by treatment with different occlusive and semipermeable dressings, partly after pre-treatment with petrolatum. Repair of water barrier function was evaluated by daily measurements of transepidermal water loss (TEWL) for 1 week. SLS irritation and tape stripping led to a 6-fold increase in TEWL as a sign of severe water barrier perturbation, followed by a stepwise decrease over the following days. Occlusion did not significantly delay barrier repair as measured by TEWL. Only in tape-stripped skin did TEWL stay at high levels during treatment with self-adhesive dressings. This may be explained by damage of newly formed stratum corneum caused by changing of these membranes. Our results indicate that, in contrast to earlier observations in hairless mouse skin, permeability barrier repair activities are not significantly delayed by occlusive treatment in human skin.

Topics: Adult; Animals; Bandages; Chronic Disease; Dermatitis, Irritant; Eczema; Emollients; Female; Hand Dermatoses; Humans; Irritants; Male; Mice; Mice, Hairless; Middle Aged; Occlusive Dressings; Permeability; Petrolatum; Polyethylenes; Polytetrafluoroethylene; Polyurethanes; Psoriasis; Skin; Sodium Dodecyl Sulfate; Water Loss, Insensible; Wound Healing

The purpose of this study was to determine whether 24 hour patch testing with 0.5% sodium lauryl sulphate (SLS) could reliably predict skin susceptibility to an irritant when compared with the alkali resistance test (ART), a widely used method employing sodium hydroxide. After having given informed consent, 40 patients (age range from 20 to 60 years) with an active irritant contact dermatitis (ICD), 40 patients in whom ICD had cleared, as well as 40 healthy volunteers serving as controls were tested. The skin responses to SLS were assessed both visually and by measurement of transepidermal water loss (TEWL) as an indicator of stratum corneum integrity. SLS significantly increased the erythema scores and TEWL in patients with healed ICD, and the increase of TEWL was even more pronounced in patients with active ICD. By contrast, a decrease in alkali resistance was found in patients with active ICD only but not in patients with healed ICD. The data obtained indicate that the SLS test, unlike ART, may provide a non-invasive tool predicting a possible constitutional skin susceptibility or indicating a subclinically impaired epidermal barrier function. However, because of the relatively high interindividual variation, a cut-clear statement concerning the skin susceptibility cannot be made by this test. On the other hand, the ART seems only to be useful for following and documenting the healing period following ICD.

Topics: Adult; Dermatitis, Contact; Female; Hand Dermatoses; Humans; Male; Middle Aged; Patch Tests; Skin; Sodium Dodecyl Sulfate; Sodium Hydroxide; Water Loss, Insensible

Patch testing and safety evaluation processes to assess the allergic or irritant potential of substances are usually performed on normal skin. However, the reactivity of compromised skin may be different. Consequently, it is important to have a test procedure which acts as a model for compromised skin and which reproduces on the target sites the cumulative insult which results from repeated exposure, working temperatures, hydration and the action of surfactants. The procedure described uses regular immersion of forearm skin in an aqueous solution of sodium dodecyl sulphate until an identifiable alteration of skin condition is produced. In this first report, the model system has been described in detail and the influence of skin compromise on the response to 3 irritants, citral, sodium dodecyl sulphate and nonanoic acid, has been assessed. The irritation potential of the materials varied, but each irritant produced a greater degree of reaction on skin compromised to be within the normal clinical range one might expect from housework.

Topics: Acyclic Monoterpenes; Adult; Dermatitis, Irritant; Fatty Acids; Female; Forearm; Hand Dermatoses; Humans; Immersion; Male; Middle Aged; Models, Biological; Monoterpenes; Patch Tests; Skin; Sodium Dodecyl Sulfate; Terpenes; Time Factors; Vitamin A

Basic physiological characteristics were examined in the uninvolved skin of 39 patients with hand eczema and in 39 healthy controls. Susceptibility to sodium lauryl sulphate (SLS)-induced irritant dermatitis was evaluated by the application of a single 24-h SLS patch test to the upper arm. Transepidermal water loss (TEWL) was measured by an evaporimeter, skin thickness by ultrasound A-scan, blood flow by laser-Doppler flowmetry and skin colour by a chroma meter using the L*a*b* system of the Commission Internationale de l'Eclairage (CIE). No difference in basal TEWL values was found between patients and controls. A decreased skin thickness was found in those with hand eczema as compared to the controls. The hand eczema patients had significantly increased L* and decreased b*-values compared to controls, indicating a more 'fair' skin. Susceptibility to SLS was increased only in patients with acute eczema, indicating that the presence of an active eczema increases the reactivity to irritants of distant uninvolved skin.

Topics: Acute Disease; Adult; Body Water; Color; Dermatitis, Contact; Eczema; Female; Hand Dermatoses; Humans; Male; Middle Aged; Patch Tests; Regional Blood Flow; Skin; Sodium Dodecyl Sulfate

Minimum eliciting levels of nickel have been estimated in 25 nickel-sensitive subjects, and of chromium in 14 chromium-sensitive subjects by patch tests with aqueous solutions of the respective metals. The minimum level of each metal required to provoke a patch test reaction was considerably greater than that found in fabric washing powder solutions and was in the majority of patients tested of the order of 112 ppm nickel (0.05% nickel sulphate) or 885 ppm hexavalent chromium (0.25% potassium dichromate). One nickel-sensitive subject and one chromium-sensitive subject reacted to 1 ppm of the respective metal. Fabric washing powder did not significantly alter the patch test reaction to nickel sulphate or provoke reactions in nickel- or chromium-sensitive subjects. EDTA significantly reduced the number and severity of patch test reactions to nickel sulphate but not those to potassium dichromate or trivalent chromium.

Topics: Chlorides; Chromates; Chromium; Chromium Compounds; Dermatitis, Contact; Detergents; Eczema; Edetic Acid; Female; Hand Dermatoses; Humans; Male; Nickel; Patch Tests; Potassium Dichromate; Sodium Dodecyl Sulfate; Surface-Active Agents; Water

Topics: Adolescent; Adult; Aged; Benzalkonium Compounds; Cantharidin; Eczema; Female; Hand Dermatoses; Humans; Hydrochloric Acid; Irritants; Male; Mercury; Middle Aged; Patch Tests; Phenols; Skin Tests; Sodium Dodecyl Sulfate; Trichloroacetic Acid

Topics: Adult; Benzalkonium Compounds; Cantharidin; Croton Oil; Drug Hypersensitivity; Eczema; Female; Hand Dermatoses; Humans; Hydrochloric Acid; Irritants; Male; Mercury; Middle Aged; Occupations; Phenols; Potassium; Saponins; Sex Factors; Skin; Skin Tests; Sodium Dodecyl Sulfate; Thigh; Trichloroacetic Acid