Baseline transepidermal water loss in patients with acute and healed irritant contact dermatitis

To examine the skin barrier function of patients with acute and healed irritant contact dermatitis (n=80) baseline transepidermal water loss (TEWL) was quantitatively measured using an evaporimeter. Healthy subjects served as controls (n=40). Test areas were the forearm and the thigh. A significant increase in TEWL was observed in the patients with acute and with healed irritant contact dermatitis (ICD) as compared to healthy volunteers (P less than or equal to 0.01). TEWL values in both test areas were comparable and markedly correlated (P less than or equal to 0.01) with each other in every group. Thus, it is possible that basal TEWL depends more on the intrinsic skin barrier function of the subjects rather than the 2 anatomical regions examined. TEWL at the forearm with acute ICD was significantly higher (P less than or equal to 0.01) than that of the group with healed ICD, but not for TEWL at the thigh suggesting that ICD may aggravate the barrier function of the adjacent uninvolved skin. It is assumed, that increased basal TEWL in patients with ICD may reflect a constitutional deviation of epidermal barrier function. This event seems to be comparable with the well-known symptom of atopic individuals. Using a detailed atopic scoring system in such a study may clarify the question of whether a proportion of patients with hand ICD may indeed be atopic individuals.