Skin phosphocreatine

Background/purpose: The skin has the unique ability to survive ischemia associated with skin grafts, flaps and hair transplantation procedures. Spectroscopic data later confirmed by chromatography, immunohistochemistry and molecular biology techniques identified the presence of large quantities of phosphocreatine in human skin. Phosphocreatine molecules regenerate ATP cellular reserves during ischemia. This reaction is mediated by creatine phosphokinase enzymes that were also isolated and studied in normal and diseased skin. Methods: Literature search revealed important contributions by US, Swiss, German, French, Scandinavian and Japanese investigators in the development and understanding of this research field. Results: Serum creatine phosphokinase levels are elevated in burn victims and patients with toxic epidermal necrolysis. Phosphocreatine concentration and creatine phosphokinase activity are elevated in psoriatic skin and in non‐melanoma malignancies in comparison with normal skin. Furthermore, skin phosphocreatine and creatine phosphokinase enzymes are localized almost exclusively within the epidermis and in hair follicles. Finally, phosphocreatine and creatine phosphokinase enzymes help to protect skin from UV damage. Conclusions: Clearly, this research area is only starting to be appreciated by the scientific community. Topical and systemic phosphocreatine administration appears to reverse photodamage and improve wound healing. Spectroscopic monitoring of phosphocreatine and related phosphometabolites can be potentially used to monitor disease activity and respond to therapy in psoriasis, leg ulcers, skin malignancies and other skin conditions.