Dry skin, barrier function, and irritant contact dermatitis in the elderly

2011 ◽  
Vol 29 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Florian Seyfarth ◽  
Sibylle Schliemann ◽  
Dimitar Antonov ◽  
Peter Elsner
2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Indi Chairunnisa ◽  
Linda Julianti Wijayadi ◽  
Sari Mariyati Dewi Nataprawira

Irritant contact dermatitis (DKI) is a non-immunologic skin inflammation reaction caused by contact with irritants. A janitor is a worker who does a lot of wet work that will repeatedly contact with irritants such as acids, bases, detergents, soap, water, solvents, etc., so that there will be damage to the skin barrier function that starts with loss of the lipid layer and Natural Moisturizing Factor (NMF) so it will reduce skin hydration levels and increase TransEpidermal Water Loss (TEWL). This makes the skin condition becomes dry and the skin defense decreases so that it is easier for DKI. The purpose of this study was to determine the description of skin hydration levels and the incidence of irritant contact dermatitis in janitors at Tarumanagara University. This research is descriptive with a cross-sectional design. A total of 60 people from the janitor became the subject of research. The level of skin hydration is measured by a chronometer. The incidence of DKI in the cleaning staff at Tarumanagara University was 10%, the level of skin hydration in the janitor at Tarumanagara University found hydration levels of dry skin on the right palm (76.7%), left palm (76.7%), back of the hand right (56.7%), and back of the left hand (56.7%). In subjects who experience DKI, levels of hydration of very dry skin on the palm (left-right) and hydration of dry skin on the back of the hand (left-right), and the factors that influence the occurrence of DKI are: gender (female), frequency of washing hands with soap per day, frequency and duration of contact with toilet and floor cleaning products per day and the use of personal protective equipment (PPE), and so it is recommended that cleaners always use PPE when working to prevent DKI and use moisturizers on dry skinABSTRAK:Dermatisis kontak iritan (DKI) adalah suatu reaksi peradangan kulit non-imunologik yang disebabkan oleh kontak dengan bahan iritan. Petugas kebersihan merupakan pekerja yang banyak melakukan pekerjaan basah yang  akan kontak berulang dengan bahan iritan seperti asam, basa, detergen, sabun, air, pelarut, dll, sehingga akan terjadi kerusakan fungsi sawar kulit yang dimulai dengan kehilangan lapisan lipid dan Natural Moisturizing Factor (NMF) sehingga akan menurunkan  kadar hidrasi kulit dan meningkatkan TransEpidermal Water Loss  (TEWL). Hal tersebut membuat kondisi kulit menjadi kering dan pertahanan kulit menurun sehingga lebih mudah terjadi DKI. Tujuan penelitian ini untuk mengetahui gambaran kadar hidrasi kulit dan kejadian dermatitis kontak iritan pada petugas kebersihan di Universitas Tarumanagara. Penelitian ini bersifat deskriptif dengan desain cross sectional. Sejumlah 60 orang dari petugas kebersihan menjadi subjek penelitian. Kadar hidrasi kulit diukur dengan alat korneometer. Angka kejadian DKI pada petugas kebesihan di Universitas Tarumanagara sebesar 10 %, Kadar hidrasi kulit pada petugas kebersihan di Universitas Tarumanagara didapatkan kadar hidrasi kulit  kering pada telapak tangan kanan (76,7%), telapak tangan kiri (76,7%), punggung tangan kanan (56,7%), dan punggung tangan kiri (56,7%). Pada subjek yang mengalami DKI didapatkan kadar hidrasi kulit sangat kering pada telapak tangan(kiri-kanan) dan hidrasi kulit kering  pada punggung tangan (kiri-kanan), dan faktor-faktor yang mempengaruhi kejadian DKI adalah: jenis kelamin (perempuan), frekuensi cuci tangan dengan sabun per hari, frekuensi dan lama kontak dengan produk pembersih toilet maupun lantai per hari dan penggunaan alat pelindung diri (APD), dan sehingga disarankan agar petugas kebersihan selalu memakai APD dengan lengkap saat bekerja untuk mencegah DKI dan menggunakan pelembab pada kulit yang kering


2020 ◽  
Vol 70 (4) ◽  
pp. 282-285
Author(s):  
J H Alfonso ◽  
A K Afanou ◽  
J-Ø Holm ◽  
E Stylianou

Abstract Protein contact dermatitis (PCD) often presents as chronic hand eczema (CHE) with an immediate hypersensitivity to protein proved by a positive skin prick test or by the presence of specific immunoglobulin E. This is frequently induced by occupational exposure to proteins in food workers, farmers, animal breeders, veterinarians and healthcare professionals. While skin barrier impairment is crucial in the pathogenesis of PCD, methods to assess skin barrier function such as trans-epidermal water loss and stratum corneum hydration are not widely used in clinical settings. We describe the diagnostic workup of occupational PCD due to Argentinean shrimps and discuss how the use of skin bioengineering methods including assessment of corneocytes morphology by Scanning Electron Microscopy provides with insightful information on skin barrier function. Diagnosis of PCD is time-consuming and a multidisciplinary team contributes to early diagnosis and proper occupational rehabilitation.


2014 ◽  
Vol 17 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Chihiro Kishi ◽  
Takeo Minematsu ◽  
Lijuan Huang ◽  
Yuko Mugita ◽  
Aya Kitamura ◽  
...  

Aging disrupts skin barrier function and induces xerosis accompanied by pruritus. In many cases, elderly patients complain of pruritus during skin hygiene care, a condition called aquagenic pruritus of the elderly (APE). To date, the pathophysiology and mechanism of action of APE have not been elucidated. We conducted the present study to test the hypothesis that hypo-osmotic shock of epidermal cells induces skin inflammation and elongation of C-fibers by nerve growth factor β (NGFβ) as a basic mechanism of APE. The dorsal skin of HWY rats, which are a model for disrupted skin barrier function, was treated with distilled water (hypotonic treatment [Hypo] group) or normal saline (isotonic treatment [Iso] group) by applying soaked gauze for 7 days. Untreated rats were used as a control (no-treatment [NT] group). Histochemical and immunohistochemical analyses revealed inflammatory responses in the epidermis and the dermal papillary layer in the Hypo group, while no alterations were observed in the Iso or NT groups. Induction of expression and secretion of NGFβ and elongation of C-fibers into the epidermis were found in the Hypo group. In contrast, secretion of NGFβ was significantly lower and elongation of C-fibers was not observed in the Iso group. These results suggest that hypo-osmotic shock–induced inflammatory reactions promote hypersensitivity to pruritus in skin with disrupted barrier function.


Author(s):  

Background: The pH of the skin surface is elevated in the elderly therefore it may cause impaired barrier function manifest as various cutaneous abnormalities, including xerosis, pruritus, dermatitis, and skin infections. Consequently, skin care products for the elderly should contain moisturizing ingredients which are formulated to normalize the skin surface pH. Application of pH 4 emulsion is potentially beneficial to improve barrier function in the elderly and promoting skin health. We aimed to determine the difference of effectiveness of pH 4 emulsion compared to identical non pH 4 emulsion on decreasing TEWL in the elderly. A systematic review and meta-analysis was performed of randomized clinical trials assessing the effects of pH 4 emulsion on skin barrier function in the elderly. Methods: Medline Pubmed, Scopus, ProQuest, Cochrane library, ClinicalTrials.gov, the reference list, conference proceedings, researchers in the field of eligible studies were searched. Four studies (n=98 subjects) were included in qualitative analysis of which two studies (n=45 subjects) were included in the meta-analysis. The mean age of the participants was 71.1 years old. Interventions use the application of pH 4 water in oil emulsion (n=2) and pH 4 oil in water emulsion (n=2). Duration of intervention (24 hours-7 weeks) and outcomes of interest varied among included studies. Results: Pooling of data using random-effects model found lower TEWL score in the pH 4 emulsion than in non pH 4 emulsion, with no significant difference (overall effect mean difference -0.068, 95% confidence interval -0.485 – 0.348, p = 0.11, I2=60.1, two RCTs). In addition to that, the qualitative analysis found that the application of pH 4 emulsion increased stratum corneum hydration, decreased skin surface roughness and scaliness, decreased DASI, and improved ICLL length and lamellar organization. Conclusion: The meta-analysis result of the mean differences of TEWL scores lowering effect between pH 4 emulsion and non pH 4 emulsion is statistically inconclusive. This is despite the observation that the pH 4 emulsion appears to be more effective comparatively. The qualitative analysis found that the application of pH 4 emulsion had improved skin barrier function in the elderly. Larger scale, well-designed RCTs assessing the effects of pH 4 emulsion on skin barrier function in the elderly, are still needed.


2020 ◽  
Author(s):  
xiaolei Ma ◽  
Lulu Lu ◽  
Zheng Zhao ◽  
Mingru Cai ◽  
Na Gao ◽  
...  

Abstract Background: Senile pruritus is common, yet its etiology remains unknown. We examined the lipidomics profiles of skin surface lipids (SSL) in the elderly to better understand potential causes for senile pruritus. Methods:Transepidermal water loss (TEWL) was used to assess skin barrier function. Ameliorated Kawashima itch scale were used to measure the pruritus score. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) and multivariate data analysis were used to investigate SSL alternations. Results:The results showed that the senile pruritus have higher TEWL values than controls (13.13±4.28 versus 6.71±2.45, p< 0.01). LC-MS/MS showed significant differences in lipidomics and identified 81 species of SSL that differ between two groups. Compared to controls, the levels of ceramides, diacylcerols, fatty acids, phosphatidylcholines, phosphatidylethar, phytosphingsines, sphingosines, diacylceryl-3-O-carboxyhydroxymethylcholine, diacylglyceryl trimethylhomoserine, unsaturated free fatty acids increased, whereas triacylglycerol decreased. CER-EOS, CER-NDS and CER-NS were positively correlated with TEWL values (p<0.05). Sphingomyelin, Cer-NP, Cer-AS, Cer-NDS, Cer-NS were positively correlated with pruritus severity scores, while Cer-BS, Cer-EODS, Cer-EOS, Cer-AP were negatively correlated. Conclusion:Our study indicated that the senile pruritus have impaired skin barrier function and altered SSL composition. Select SSL species identified in this study may be potential target for future studies on the pathogenesis of idiopathic senile pruritus


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