评价特应性皮炎中选定的皮肤屏障功能与疾病严重程度和瘙痒的关系

A. Polańska, A. Dańczak‑Pazdrowska, W. Silny, D. Jenerowicz, A. Osmola-Mańkowska, K. Olek-Hrab
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引用次数: 19

摘要

特应性皮炎(AD)是一种炎症性瘙痒性皮肤病,其特征是皮肤屏障功能受损,表现为经皮失水(TEWL)增加。目的:介绍AD患者皮肤屏障功能与病情严重程度及瘙痒程度的关系。材料与方法:55例AD患者入组,年龄8 ~ 60岁。在每位患者的同一受累皮肤区域(肘前窝)测定表皮屏障功能(TEWL测量和角膜测量)以及红斑测量。采用W-AZS评分系统进行临床评价。结果:用W-AZS指数表达的不同皮肤炎症程度患者组间TEWL均值差异有统计学意义,而皮肤水化和红斑测量值差异无统计学意义。W-AZS指数与TEWL、W-AZS I指数与TEWL有显著的统计学相关性。结论:皮肤屏障功能(TEWL,皮肤水化)和红斑程度是评价AD的重要指标。经皮失水测量与W-AZS和患者瘙痒强度有良好的相关性。仪器评估为我们提供了一个快速和客观的湿疹状态评估,这在循证医学时代似乎非常重要。
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Original paper Evaluation of selected skin barrier functions in atopicdermatitis in relation to the disease severity and pruritus
Introduction: Atopic dermatitis (AD) is an inflammatory pruritic dermatosis, which is characterized by an impaired skin barrier function manifested as an increased transepidermal water loss (TEWL). Aim: Presentation results of instrumental evaluation of the skin barrier function in AD patients in relation to the dis ease severity as well as pruritus. Material and methods: Fifty-five AD patients aged from 8 to 60 years were enrolled to the study. Epidermal barrier function (TEWL measurement and corneometry) as well as erythema measurement were determined in each patient within the same affected skin region, antecubital fossa. Clinical evaluation was performed using the W-AZS scor ing system. Results: There was a statistically significant difference in the mean TEWL values between groups of patients with different degrees of skin inflammation expressed by the W-AZS index, while no significant differences were observed in relation to the skin hydration and ertyhema measurement. There was a statistically significant correlation between the W-AZS index and TEWL as well as between the W-AZS I index and TEWL. Conclusions: Selected parameters of the skin barrier function (TEWL, skin hydration) and the level of erythema are useful in evaluation of AD. Transepidermal water loss measurement presents a good correlation with W-AZS and with intensity of patients itching. Instrumental assessment provides us with a fast and objective evaluation of the eczema status, what seems to be very important in the era of evidence-based medicine.
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