The effect of aqueous cream BP on the skin barrier in volunteers with a previous history of atopic dermatitis
The effect of aqueous cream BP on the skin barrier in volunteers with a previous history of atopic dermatitis
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DOI：
10.1111/j.1365-2133.2011.10395.x
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发表时间：
2011-08-01
影响因子：
10.3
通讯作者：
Cork, M. J.
中科院分区：
文献类型：
--
作者：
Danby, S. G.;Al-Enezi, T.;Cork, M. J.
研究背景特应性皮炎(AD)常用BP润肤霜治疗，但其不良反应发生率较高。目的探讨BP水霜对有皮肤屏障缺陷的志愿者角质层完整性和皮肤屏障功能的影响。方法13名有AD病史(连续6个月)的志愿者在一侧前臂掌侧涂抹BP水霜，每日2次，共4周。另一只前臂没有接受治疗作为对照。在治疗前后通过测量经皮失水(TEWL)和剥离胶带来确定通透性、屏障功能和SC的完整性。作为对照，13名患有阿尔茨海默病的志愿者被招募，在没有治疗的情况下，评估未受影响部位的SC完整性和皮肤屏障功能。结果局部应用BP水乳膏导致基线TEWL显著升高，SC完整性降低。对当前AD患者不进行治疗后，在未受影响的部位进行的测量表明，使用BP水乳膏对皮肤屏障产生负面影响，使皮肤屏障接近与疾病爆发相关的受损状态。结论BP水乳膏作为一种离任润肤剂，对既往有AD病史的志愿者皮肤屏障造成严重损害。BP水乳膏不应用作AD患者的离体型润肤剂。
Background The emollient aqueous cream BP is frequently used for the treatment of atopic dermatitis (AD), yet it is associated with a high rate of adverse cutaneous reactions. It contains the harsh anionic surfactant sodium lauryl sulphate, a known negative environmental factor associated with the exacerbation of AD.Objectives To investigate the effect of aqueous cream BP on stratum corneum (SC) integrity and skin barrier function in volunteers with a predisposition to a defective skin barrier.Methods Thirteen volunteers with a previous history of AD (no symptoms for 6 months) applied aqueous cream BP twice daily to the volar side of one forearm for 4 weeks. The other forearm was left untreated as a control. Permeability barrier function and SC integrity were determined before and after treatment by measuring transepidermal water loss (TEWL) in conjunction with tape-stripping. For comparison, 13 volunteers with current AD were recruited for assessment, without treatment, of SC integrity and skin barrier function at unaffected sites.Results Topical application of aqueous cream BP resulted in significant elevation of baseline TEWL and a concomitant decrease in SC integrity. Measurements made after no treatment in volunteers with current AD, at unaffected sites, suggest that application of aqueous cream BP negatively affects the skin barrier towards the damaged state associated with onset of flares of the disease.Conclusions Aqueous cream BP used as a leave-on emollient caused severe damage to the skin barrier in volunteers with a previous history of AD. Aqueous cream BP should not be used as a leave-on emollient in patients with AD.