Skin Barrier Dysfunction in Hand Eczema

Abstract

Hand eczema (HE) is a common chronic inflammatory skin disease of the hand, the occurrence and development of which are related to the dysfunction of the topical skin barrier. Causes of topical skin barrier dysfunction include dysregulation of gene/protein expression, permeability barrier abnormalities, flora imbalance in the microbial barrier, and abnormalities of antimicrobial peptides in the immune barrier. Because the incidence rate of HE is high and the disease is likely to recur, we wrote this review to identify pathogenic factors through skin barrier analysis of HE and to explore more favorable treatment methods. Previous studies have shown that the mutation of the filaggrin gene, a medical history of atopic dermatitis, and the hyperproliferation of Staphylococcus aureus in lesions are related to the prolongation of HE. Moreover, high pH value, increased transepidermal water loss, and damaged integrity of the stratum corneum are closely related to the activity and severity of chronic HE with or without atopic dermatitis. The S100 family of antimicrobial peptides, including S100A7A, S100A7, S100A8/A9, and S100A11, has also been shown to be highly expressed in vesicular and hyperkeratotic HE.