ABSTRACT
I. Introduction 2
II. Skin Susceptibility 109
A. Exogenous Factors 109
B. Endogenous Factor 109
III. Transepidermal Water Loss (TEWL) for Prediction of Skin Irritation 110 A. Technical Part 110
B. TEWL in Pathophysiological Conditions 110
C. Prediction of Skin Susceptibility 111
IV. Electrical Conductance and Capacitance for Prediction of Skin Irritation
A. Technical Part 110
B. Electrical Parameters in Pathophysiological Conditions 112
C. Prediction of Skin Susceptibility 111
V. Skin Color for Prediction of Skin Irritation 113
A. Technical Part 110
B. Skin Color in Pathophysiological Conditions 114
C. Prediction of Skin Susceptibility 111
VI. Skin pH for Prediction of Skin Irritation 114
VII. Skin Surface Lipids for Prediction of Skin Irritation 115
VIII. Ultrasound for Prediction of Skin Irritation 115
IX. Skin Blood Flow for Prediction of Skin Irritation 116
X. Conclusions 116
References 116
I. INTRODUCTION
Irritant contact dermatitis is a common disease in the population, and was reported to constitute 35% of all hand eczema cases in an industrial area.1 Prevention is advantageous since severe cases may turn into chronic and disabling disease.2 It is essential to diminish environmental hazards to the skin in the workplace as well as in private life. However, epidemiological studies indicate that individual-related factors are also important in the pathogenesis of irritant contact dermatitis,3 and a physiological difference in skin susceptibility to irritants even in healthy subjects has been illustrated in a number of experimental studies.4-8
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It has been debated whether a group of individuals with generally sensitive skin actually exists. Due to varying bioavailability and different mechanisms of irritancy, the skin response to one irritant does not necessarily predict the response to irritants in general.5,6 However, Frosch and Wissing were able to identify individuals with sensitive skin by assessment of susceptibility to seven different irritants and to UV-light.7 They concluded that hyperreactors exist and can be identified by irritancy testing.8 Tupker et al. tested 33 healthy volunteers with 11 different detergents and found the same ranking order in almost all
FIGURE 8.1 Skin susceptibility.
