197 Altered epidermal function in uninvolved skin supports a pathogenic role of epidermal dysfunction in hand eczema

Abstract

Although compromised epidermal permeability barrier can contribute to the development of contact dermatitis, whether subjects with hand eczema display abnormalities in epidermal permeability barrier function in their uninvolved skin remains unknown. We assess here epidermal permeability barrier function in subjects with or without hand eczema. All volunteers were recruited from clothing manufacturers in Guangdong, China. Epidermal functions, including transepidermal water loss (TEWL) rates, stratum corneum (SC) hydration and skin surface pH were measured on the flexural surface of the left forearm in all volunteers. These epidermal functions were compared among cohorts of subjects with active hand eczema, a prior history of hand eczema and without any history of hand eczema. A total of 650 questionnaires were collected from 462 females and 188 males. Thirty five subjects (5.4%) currently had hand eczema, while 28 subjects (4.3%) reported a prior history of hand eczema that was inactive currently. Neither a prior personal nor a family history of allergies was associated with the prevalence of hand eczema. But certain occupations and frequent contact with disinfectants were independently associated with the prevalence of hand eczema. Males displayed higher TEWL rates and SC hydration levels than did females. Both skin surface pH and TEWL rates differed significantly among normal controls and subjects with active hand eczema, or a prior history of hand eczema (p<0.05).In conclusion, the uninvolved skin site of subjects with hand eczema exhibits abnormalities in epidermal permeability barrier, supporting a pathogenic role of epidermal dysfunction in hand eczema. Whether subjects with hand eczema in other occupations also display altered epidermal function on uninvolved skin remains to be explored.