Perturbation and Recovery of the Skin Barrier Function After Tape Stripping and Sodium Lauryl Sulfate Irritation / 대한피부과학회지

BACKGROUND: The main function of the stratum corneum is to serve as a barrier preventing the penetration of irritants and transepidermal water loss (TEWL). Previous studies have shown that the cutaneous barrier disruption by application of acetone or sodium lauryl sulfate (SLS) and tape stripping leads to various metabolic changes. Recent studies showed that there was some difference in the recovery rate between tape-stripped groups and acetone-treated groups, and an individual irritant not only exerted rather specific morphologic effects on the cellular components of the keratinocyte but also induced distinct morphological alterations of the different components of the stratum corneum. In other words, this data suggested that individual irritants could show different cutaneous barrier recoveries. OBJECTIVE: This study was done to compare the recovery rate after cutaneous barrier disruption between a tape-stripped group and a SLS irritated group, and to test the relationship among baseline TEWL, TEWL after the SLS irritation, recovery of TEWL, and number of strippings needed to increase TEWL up to 20g/m2/h. METHODS: The permeability barrier of normal human skin was disrupted by tape stripping and patch of SLS and the recovery rate was assessed by measure of TEWL and erythema (E-) index. RESULTS: The number of tape strippings needed to increase TEWL up to 20g/m2/h was 32.7+-9.6 (20-50). The recovery rate of TEWL was 56.85+-17.97% twenty-four hours after tape stripping and 51.55+/-24.73% after patch removal, and 82.70+/-8.70% and 76.61+/-11.14% four days after tape stripping and patch removal. There was no significant difference in the recovery rate of TEWL after the two methods of epidermal barrier perturbation. All the correlations among baseline TEWL, TEWL after the SLS irritation, recovery of TEWL, and number of strippings were not significant statistically. E-index after the tape stripping was 12.07+/-2.95 and higher than that after removal of SLS, 11.20+/-2.51. There was irregular recovery of E-index in the SLS irritated group, but not irregular in the tape-stripped group. There was no significant difference in the recovery rate between the two groups. CONCLUSION:There was no significant difference in the recovery rates of TEWL and E-index between the tape-stripped group and the SLS irritated group. We suggest that TEWL measurements may be more desirable than the measurement of E-index in the study of perturbation and recovery of the skin barrier function.

A Case of Allergic Contact Dermatitis to Ophthalmic Ointment / 대한피부과학회지

Neomycin is one of the aminoglycoside antibiotics and not uncommonly causes allergic contact dermatitis. Wool alcohol is one of the most widely used lanolin bases and rarely has been reported to cause allergic contact dermatitis. A 63-year-old male presented with a pruritic, erythematous swelling on the right periorbital area. He had a cataract operation on his right eye 10 days ago and has applied several eye drops and topical antibacterial agents. Patch test with Korean standard antigens and ophthalmic preparations revealed strong positive reactions to neomycin sulfate and the Maxitrol ointment composed of dexamethasone, neomycin sulfate and polymyxin B, and positive reaction to wool alcohol. Neomycin may be the major causative agent to produce allergic contact dermatitis, and wool alcohol also has some relation to it.

Cutaneous Irritation to Alpha Hydroxy Acids in Normal Human Skin / 대한피부과학회지

BACKGROUND: Alpha hydroxy acids (AHAs) are known to diminish corneocyte cohesion at the innermost levels of the stratum corneum and have been used in the treatment of various disorders of keratinization. However, their effect on skin barrier function and their irritant potential is not fully understood. OBJECTIVE: Our study was done to evaluate the skin irritancy of AHAs in normal human skin. METHODS: Patches with 1%, 5% and 10% solutions of lactic acid (LA) and glycolic acid (GA) were applied to the volar forearm of 20 healthy volunteers for 24 hours using large Finn chambers with filter paper. Visual scores, erythema (E-) index and transepidermal water loss (TEWL) were measured at 30 min, 24 h and 48 h after removal of the patches. RESULTS: The results are summarized as follows. 1. Visual scores were 0.1+/-0.3 (1%), 0.5+/-0.6 (5%) and 1.1+/-0.8 (10%) at 24 h after removal of LA, and were 0.2+/-0.4 (1%), 0.6+/-0.6 (5%) and 1.0+/-0.7 (10%) at 24 h after removal of GA. They were increased in proportion to the concentrations and there were significant differences in skin responses between the control and each concentration of the solutions. 2. E-indices were 9.1+/-2.1 (control), 8.8+/-1.8 (1%), 9.0+/-2.6 (5%) and 10.5+/-3.9 (10%) at 24 h after removal of LA, and were 9.4+/-1.8 (control), 9.3+/-2.3 (1%), 10.0+/-3.0 (5%) and 11.1+/-3.5 (10%) at 24 h after removal of GA. They were not increased in the patch areas of 1% and 5% solutions in both the LA and GA group, but were significantly increased in the patch areas of 10% solutions in both the LA and GA group. 3. TEWL values were 7.3+/-2.3 (control), 8.3+/-4.0 (1%), 9.8+/-4.5 (5%) and 16.7+/-9.1 (10%) at 24 h after removal of LA, and were 8.1+/-3.2 (control), 7.8+/-3.8 (1%), 8.6+/-3.0 (5%) and 10.9+/-4.1 (10%) at 24 h after removal of GA. They were not increased in the patch areas of 1% LA, 1% GA and 5% LA, but there were high significant differences between the controls and 10% solutions of both LA and GA. CONCLUSION: Visual scores were increased in all concentrations of AHAs tested, but the increase in E-index and TEWL values were not significant or minimal in 1% and 5% solutions of AHAs. These findings suggest that AHAs could be classified as non-corrosive irritants.

A Case of Cefotiam-Induced Contact Urticaria Syndrome / 대한피부과학회지

Contact urticaria refers to a wheal-and-flare response occurring on the application of chemicals to intact skin. When contact urticaria is accompanied by systemic symptoms, it is known as the urticaria syndrome. Fourteen cases of cefotiam-induced contact urticaria have been reported in the foreign literature, but no such case, as far as we know, has been described in the Korean dermatology literature. We report a case of contact urticaria syndrome occurring in a 23-year-old nurse due to occupational contact exposure to cefotiam. She experienced generalized urticaria, itching of the skin, difficulty in breathing, and abdominal pain, when she was preparing an injection of cefotiam. An open patch test showed positive reactions to cefotiam, cefmetazole, and ceftriaxone. Since avoiding cefotiam, the symptoms disappeared and did not recurred.

A Case of Allergic Contact Dermatitis to Cephalosporins / 대한피부과학회지

Cephalosporins are B-lactam antibiotics. They are usually bactericidal in action and act by inhibiting mucopeptide synthesis in the bacterial cell wall. Cephalosporins have been used widely in Korea. However, allergic contact dermatitis to cephalosporins has not been reported in the Korean dermatologiy literature. We report a case of allergic contact dermatitis due to cephalosporins in a 23-year-old nurse who suffered from itchy, erythematous patches and plaques with numerous fissures on both hands. A patch test with ceftriaxone and a prick test with cefotiam were positive.

A Case of Sebaceous Adenoma

We report an uncommon case of sebaceous adenoma in a 36-year-old male who had a solitary, well-de6ned, 0.5×0.8cm sized, round, erythematous nodule on the right side of his forehead. Microscopically, the nodule was composed of poorly developed sebaceous lobules that were irregular in size and shape in the deep reticular dermis. The lobules were composed of mature sebaceous cells in the center and undifferentiated basaloid cells at the periphery. In most lobules, the two types of cells occured in approximately equal proportions. We excised the lesion completely and no evidence of recurrence was observed for 2 years.

Cutaneous Irritation to Sodium Lauryl Sulfate and Sodium Lauroyl Glutamate / 대한피부과학회지

BACKGROUND: Sodium lauryl sulfate(SLS) is the most widely utilized model for studying acute and cumulative irritation. Sodium lauroyl glutamate(SLG) has exhibited a low irritation potential and an anti-irritating effect on other anionic surfactants. OBJECTIVE: Our study was done to compare the skin irritancy of SLS and SLG using non-in- vasive techniques. METHODS: Patches with 1% SLS and SLG solution were applied to the volar forearm of 20 healthy volunteers for 24 h. Finn chambers with 8mm(20pl) and 12mm(60pl) inner diameters were used. Visual scores, transepidermal water loss(TEWL) and an erythema(E)-index were measured at 30 min after removal of the patches, and every 24hours(h) up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.20+0.30(8mm) and 0.73+0.34(12mm) at 24 h after removal of 1% SLS and were 0.15+0.29(8mm) and 0.30+0.41(12mm) at 24 h after removal of 1% SLG. They were increased at 30 min and 24 h after removal and decreased towards normal at 4 days after removal. By chamber size, the skin response with large Firin chamber(12mm) increased more significantly than with the small Finn chamber(8mm). In the small Finn chamber, there were no significant differences in the skin response between 1% SLS and 1% SLG. In the large Finn chamber, the skin response with 1% SLS increased more significantly than with 1% SLG. 2. TEWL values were 11.14+4.77(8mm) and 20.48+10.61(12mm) at 24 h after removal of 1 % SLS and were 10.38+3.99 and 14.87+7.46 at 24 h after removal of 1% SLG. They were increased at 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as the visual scores. Also, on comparison between 1% SLS and 1% SLG, their results were the same as the visual scores. 3. E-index was 10.05+2.70(8mm) and 11.15+2.56(12mm) at 24 h after removal of 1% SLS and was 10.15+2.16 and 10.60+2.26 at 24 h after removal of 1% SLG. They were increased at 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as the visual scores. In the small and large Finn chamber, there were no significant differences in the skin response between 1% SLS and 1% SLG. CONCLUSION: SLS is more irritating than SLG. The large Finn chamber may be more suitable to yield positive irritant reactions than the small Finn chamber. Also, TEWL measurements may be a more accurate and sensitive method than the E-index.