Dimethyl sulfoxide could be a useful probe to evaluate unusual skin angioneurotic reaction and epidermal permeability

A new discussion of the cutaneous vascular reactivity in sensitive skin: A sub-group of SS?

BACKGROUND

Sensitive skin (SS) seems not to be a one-dimensional condition and many scholars concentrate on skin barrier disruption or sensorineural change, but few focus on its increased vascular reactivity. This study explored the possibility of using the different selection methods and measurement methods to verify a high vascular reactivity in SS without an impaired cutaneous barrier function.

METHODS

Sixty "self-perceived sensitive skin" volunteers were enlisted and each one completed three kinds of screening tests: assess cutaneous sensory using questionnaire survey and Lactic Acid Sting Test (LAST); assess barrier function using Sodium lauryl sulphate (SLS) skin irritation test and assess cutaneous vascular reactivity using 98% DMSO test and non-invasive measurement. Volunteers were divided into different groups based on response to SLS. The DMSO clinical score and the biophysical parameters obtained by non-invasive measurement were subsequently analysed.

RESULTS

(1) The positive correlations could be seen between sum LAST score and sum DMSO score regardless of the observation time; (2) The biological parameters (CBF、a*values and L* values) are all keeping with DMSO score; (3) If the participants were divided into SLS reactors and non-reactors, a composition ratio of DMSO score was significant difference in these two groups and in SLS non-reactors, there were still seven participants showed high reaction to DMSO.

CONCLUSIONS

There is a sub-group of SS for characteristics of a high vascular reactivity without an impaired cutaneous barrier function. The DMSO test and novel non-invasive measurements which are conducive to assess cutaneous vascular reactivity, combined with SLS skin irritation test could help us to screen this kind of SS.

Epicutaneous sensitization to house dust mite allergen requires interferon regulatory factor 4-dependent dermal dendritic cells

BACKGROUND

Exposure to allergens, such as house dust mite (HDM), through the skin often precedes allergic inflammation in the lung. It was proposed that T_H2 sensitization through the skin occurs when skin barrier function is disrupted by, for example, genetic predisposition, mechanical damage, or the enzymatic activity of allergens.

OBJECTIVE

We sought to study how HDM applied to unmanipulated skin leads to T_H2 sensitization and to study which antigen-presenting cells mediate this process.

METHODS

HDM was applied epicutaneously by painting HDM on unmanipulated ear skin or under an occlusive tape. HDM challenge was through the nose. Mouse strains lacking different dendritic cell (DC) populations were used, and 1-DER T cells carrying a transgenic T-cell receptor reactive to Der p 1 allergen were used as a readout for antigen presentation. The T_H2-inducing capacity of sorted skin-derived DC subsets was determined by means of adoptive transfer to naive mice.

RESULTS

Epicutaneous HDM application led to T_H2 sensitization and eosinophilic airway inflammation upon intranasal HDM challenge. Skin sensitization did not require prior skin damage or enzymatic activity within HDM extract, yet was facilitated by applying the allergen under an occlusive tape. Primary proliferation of 1-DER T cells occurred only in the regional skin-draining lymph nodes. Epicutaneous sensitization was found to be driven by 2 variants of interferon regulatory factor 4-dependent dermal type 2 conventional DC subsets and not by epidermal Langerhans cells.

CONCLUSION

These findings identify skin type 2 conventional DCs as crucial players in T_H2 sensitization to common inhaled allergens that enter the body through the skin and can provoke features of allergic asthma.

Reflectance confocal microscopy for the evaluation of sensitive skin

BACKGROUND

Nowadays, the diagnosis for sensitive skin relies on subjective assessment or on the combination of subjective and objective evaluation. No quantitative evaluation is available. It could be expected that confocal microscopy imaging could be of interest to better define the condition.

METHODS

Total 166 healthy female subjects were recruited in this study. Firstly, all subjects completed the sensitive questionnaire. Then, the cutaneous structures were measured by the reflectance confocal microscopy (RCM) on the face and fossa cubitalia. The lactic acid sting test was conducted finally. According to the results of self-perception sensitive skin questionnaire and lactic acid stinging test to evaluate facial skin sensitivity the both positive subjects were regarded as sensitive skin group and both negative group as healthy control group.

RESULT

The results of RCM indicating that the proportion of 'disarranged honeycomb pattern' and 'spongiform edema' in the sensitive group and healthy control group were statistically different (P < 0.05), respectively; The following report 'damaged dermal papilla rings' was not a distinctive pattern, with no significant statistical difference (P > 0.05). The epidermal thickness was 38.88 ± 6.81 μm, healthy control group was 40.31 ± 9.37 μm in, respectively, sensitive skin group and healthy control group, there was no significant statistical difference between the two groups (P > 0.05). The honeycomb structure depth of sensitive group was 20.57 ± 4.86 μm. It was for 23.27 ± 6.38 μm, healthy control group the difference being statistically different between the two groups (P < 0.05).

CONCLUSION

Based on the RCM results, 'epidermal honeycomb structure' and 'spongiform edema' may be used as new skin signs of RCM evaluation of sensitive skin effectively. Indeed, sensitive skin honeycomb structure depth was thinner compared with healthy control group. Such a specific pattern has good clinical and monitoring value for the further exploration. RCM could provide new data and patterns for the evaluation of sensitive skin.

The evaluation of neural and vascular hyper-reactivity for sensitive skin

BACKGROUND

The impaired barrier function has been studied comprehensively but few about the heighted neural and vascular reaction for the pathogenesis of sensitive skin.

METHODS

Lactic acid stinging test (LAST) was used to identify sensitive subjects in selection phase. In the subsequent test phase, the baseline value of the blood flow (BF) and the current perception threshold (CPT) was measured by non-invasive instruments firstly. Then, the 0.001% capsaicin was applied to the nasolabial fold for 5 min. After the capsaicin test (CAT), the BF (immediately after the CAT) and CPT (1 h later after the CAT) were measured again. Blood sample were collected for genetic analysis of four TRPV1 gene single nucleotide polymorphisms between the positive-group and the negative-group.

RESULT

The positive-group had lower baseline value of CPT at 5 and 250 Hz compared with the negative-group, but no difference in baseline value of BF. After the CAT, significant variation in CPT at 5 and 250 Hz values and the BF were found in positive-group but not in negative-group. The genotype frequencies of AG/GG in RS224534 and AC/CC in RS4790523 in positive-group were higher than that of negative-group.

CONCLUSION

The sensitive subjects were prone to be stimulated by capsaicin to trigger neural and vascular hyper-reactivity. The genetic variation of TRPV1 and the unpleasant sensation demonstrate that TRPV1 play an important role in the pathogenesis of sensitive skin. Our study supports that sensory irritation inhibitors and anti-inflammatory compounds should be considered to be added in cosmetics to reduce the heighted neural and vascular reaction of sensitive skin.