Evaluation und Standardisierung von Hauttestungen zur Diagnostik der irritativen Kontaktdermatitis
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Philipps-Universität Marburg
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Abstract
Irritant patch testing is often performed as a 24
or 48 hour (h) occlusive patch test with low concentrations of
sodium lauryl sulfate (SLS). The aim of this study was to
investigate potential ways to shorten this test procedure and
precise test results. 36 healthy volunteers underwent irritant
patch testing with different pretreatments (PT) of the test
fields. Occlusive test chambers were applied on the upper back
with SLS 0.5%, 1%, 2% and 5% in large Finn Chambers. The
patches were removed after 4 and 24 h, respectively, depending
on the used concentration. Test fields were pretreated as
follows: PT 1. field without any PT (control), PT 2. prick with
lancet, PT 3. prick with test stamp, PT 4. scratch with lancet,
PT 5. incision with standardized incision instrument (0.1-0.2
mm depth). Skin reactions were evaluated by transepidermal
water loss (TEWL), skin erythema (EI) and skin hydration (HY)
and as well by a visual score (VS) at 4, 24 and 72 h. Data show
an obvious distinction between PT 1 - 3 and PT 4 - 5 at all
measurement methods. The average TEWL values with PT 4 - 5 were
higher than these with PT 1 - 3, especially on the 4 h-course.
This distinction may derive from shape and size of the skin
impairment achieved by PT 4 - 5, leading to a mechanical
barrier disruption. However, SLS may infiltrate directly into
deeper skin layers supported by capillarity. Consequently, no
or little penetration through the epidermis and interaction
with its structures occurs, which is responsible for irritant
skin reactions. The SLS dose in the upper skin layers is
therefore lower at these PT. The less remaining dose of SLS
also explains this distinction, especially for the VS.
Additionally, there are presumed reactions in deeper layers of
the epidermis and dermis at PT 4 - 5. All these data suggest a
different reaction pattern from the classical irritant
response. Therefore, application without any PT seems to be
best suited for irritancy skin testing, especially for visual
assessment. PT prior to irritant patch testing have shown to be
unjustifiable. In the current study crescendo reactions were
seen at visual scoring and the skin erythema. For the TEWL no
delayed reactions have been discovered. Repeated measurements
therefore are only useful for VS, skin erythema and skin
hydration. A 4-hour test procedure for the SLS-skin irritation
test can be recommended to make the test more practicable for
the patient and the clinic. The following test procedure seems
to be appropriate: Application of a 4-hour epicutaneous
irritancy test with concentrations of SLS between 2 and 5 %
without any pretreatment of the test fields. An appropriate
clinical scoring consisting of TEWL and VS can be
recommended.
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Dates
Created: 2004Issued: 2004-04-01Updated: 2011-08-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
sodium dodecyl sulfateskin irritancy testsHautphysiologische Untersuchungsverfahrentransepidermal water lossTransepidermaler Wasserverlustirritant dermatitis
DFG-subjects
EpikutantestNatriumdodecylsulfatKontaktekzem , Kontaktdermatitis
DDC-Numbers
610
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Gebhard, Kerstin Luise (128939818): Evaluation und Standardisierung von Hauttestungen zur Diagnostik der irritativen Kontaktdermatitis. : Philipps-Universität Marburg 2004-04-01. DOI: https://doi.org/10.17192/z2004.0209.
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This item has been published with the following license: In Copyright