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Epidermal barrier changes in patients with psoriasis: The role of phototherapy
Author(s) -
MonteroVilchez Trinidad,
SolerGóngora Miguel,
MartínezLópez Antonio,
Ana FernándezGonzález,
BuendíaEisman Agustín,
MolinaLeyva Alejandro,
AriasSantiago Salvador
Publication year - 2021
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12650
Subject(s) - transepidermal water loss , psoriasis , medicine , erythema , dermatology , barrier function , stratum corneum , psoriasis area and severity index , pathology , mathematical optimization , mathematics
Background Some skin diseases may modify epidermal barrier function. Psoriasis is a chronic multi‐systemic inflammatory disease that affects the epidermal barrier. Phototherapy is an option for treating psoriasis, but little is known about how epidermal barrier function is modified by phototherapy in psoriatic patients. Objectives (a) To compare skin homeostasis between involved and uninvolved skin in psoriatic patients with healthy controls (b) To evaluate changes in the epidermal barrier function in psoriatic patients treated with phototherapy. Methods Sixty patients with plaque‐type psoriasis and sixty gender and age‐matched healthy controls were enrolled. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity, erythema and melanin index were measured using non‐invasive tools in the healthy control and involved and uninvolved psoriatic skin before and after phototherapy. Results Healthy controls had lower TEWL and erythema index and higher SCH than psoriatic patients, both at uninvolved psoriatic skin and psoriasis plaques. TEWL was higher at psoriasis plaques than at uninvolved skin (19.20 vs 11.57 g/h/m 2 ; P < .001). Following phototherapy, a decreasing trend was observed for TEWL, of 1.03 (SD 0.75) and 0.97 (SD 0.81) g/h/m 2 for uninvolved and involved skin respectively. SCH was significantly lower at psoriatic plaques than at uninvolved skin (7.32 vs 36.62Arbitrary Units [AU]; P < .001). SCH increased by 1.15AU (SD 0.26) on psoriatic plaques after the phototherapy session ( P < .001). Conclusion Psoriatic plaques showed epidermal barrier dysfunction compared to uninvolved skin and healthy controls. Phototherapy may improve epidermal barrier function in psoriatic patients. SCH increased after a phototherapy session on the psoriatic plaques.