Profile of Transepidermal Water Loss in Non-Atopic Dermatitis and Atopic Dermatitis in Indonesian Adults
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Background: Atopic dermatitis (AD) is a recurrent and chronic inflammatory skin disease affecting the quality of life and productivity of individuals. Several studies have reported the profile of transepidermal water loss (TEWL) in AD patients, however, there is either no data or very limited data on TEWL values in normal skin or in non-atopic individuals. Purpose: This study aims to update of the available evidence about TEWL values in healthy (non-AD) adults and AD patients, especially in Indonesia. Methods: This analytic study involved 37 non-AD subjects and 37 subjects with AD. TEWL measurements were assessed on the volar side of the left forearm. Result: The mean values in the non-AD group were 5.61 ± 3.85, while the mean values in the AD group were 18.07 ± 4.88. There is a significant difference in TEWL values between the groups with non-atopic dermatitis and atopic dermatitis (p<0.001). Conclusion: TEWL value is significantly higher in AD patients compared to non-AD individuals, indicating a compromised skin barrier function in AD. The consistent results across populations and geographic regions support the utility of TEWS as a reliable measure of AD severity, which can help clinicians customize treatment plans to meet the needs of each patient.
Echeverría C, Angles MV, Larralde M, Luna PC, Mazzuoccolo LD, Moreno P. Impact of atopic dermatitis on quality of life: a large web-based survey from Argentina. Rev Fac Cien Med Univ Nac Cordoba 2022;79(4):369-373.
Atakan N, Yalçın B, Özkaya E, Küçük SU, Öztürkcan S, Salman A, et al. Atopic dermatitis diagnosis and treatment consensus report. Turkderm 2022;56(Supple 2):86-121.
Nugroho WT, Ervianti E, Zulkarnain I, Hidayati AN, Damayanti D, Utomo B, et al. Characteristics of Atopic Dermatitis Patients who Underwent Skin Prick Test. Berkala Ilmu Kesehatan Kulit Kelamin 2022;34:10-14.
Umborowati MA, Jastika FR, Hendaria MP, Anggraeni S, Damayanti, Sari M, et al. Description of Hanifin-Rajka Criteria and Skin Hydration in Adult Patients with Mild-Moderate Atopic Dermatitis at Tertiary Hospital. . Berkala Ilmu Kesehatan Kulit Kelamin. 2024;36(1):20-25.
Thyssen J, Rinnov M, Vestergaard C. Disease Mechanisms in Atopic Dermatitis: A Review of Aetiological Factors. Acta Derm Venereol 2020;100:adv00162.
Huygen L, Thys PM, Wollenberg A, Gutermuth J, Krohn IK. Skin Barrier Function Assessment: Electrical Impedance Spectroscopy Is Less Influenced by Daily Routine Activities Than Transepidermal Water Loss. Ann Dermatol 2024;36:99-111.
Liu Y, Jiang P, Liu Y, Liu J, Li M, Tao M, et al. Evaluation of skin barrier function based on skin dermoscopic features in patients with rosacea. Chin Med J (Engl) 2023;136(15):1885-87.
Green M, Kashetsky N, Feschuk A, Maibach HI. Transepidermal water loss (TEWL): Environment and pollution—A systematic review. Skin Health Dis 2022;2:e104.
Prakoeswa CRS, Damayanti, Anggraeni S, Umborowati MA, Febriana SA, Oginawati K, et al. Profile of Transepidermal Water Loss (TEWL), Skin Hydration, and Skin Acidity (pH) in Indonesian Batik Workers. Dermatol Res Pract 2022;2022:7014004.
Akdeniz M, Gabriel S, Lichterfeld-Kottner A, Blume-Peytavi U, Kottner J. Transepidermal water loss in healthy adults: a systematic review and meta-analysis update. Br J Dermatol 2018;179:1049-55.
Kottner J, Lichterfeld A, Blume-Peytavi U. Transepidermal water loss in young and aged healthy humans: a systematic review and meta-analysis. Arch Dermatol Res 2013;305:315-23.
Dewi ISL, Agusni I, Indramaya DM. Comparison of Transepidermal Water Loss Values in Anesthetic and Nonanesthetic Macule lesions in Leprosy Patients. Berk. Ilmu kesehat. Kulit kelamin 2018;30:224-30.
Uehara O, Kusuhara T, Nakamura T. Transepidermal Water Loss Estimation Model for Evaluating Skin Barrier Function. Adv Biomed Eng 2023;12:1-8.
Klotz T, Ibrahim A, Maddern G, Caplash Y, Wagstaff M. Devices measuring transepidermal water loss: A systematic review of measurement properties. Skin Res Technol 2022;28:497-539.
Nikam V, Monteiro R, Dandakeri S, Bhat R. Transepidermal water loss in psoriasis: A case-control study. Indian Dermatol Online J 2019;10:267-71.
du Plessis J, Stefaniak A, Eloff F, John S, Agner T, Chou TC, et al. International guidelines for the in vivo assessment of skin properties in non‐clinical settings: Part 2. transepidermal water loss and skin hydration. Skin Res Technol 2013;19:265-278.
López-Hortas L, Pérez-Larrán P, González-Muñoz MJ, Falqué E, Domínguez H. Recent developments on the extraction and application of ursolic acid. A review. Food Res Int 2018;103:130-149.
Yudhistira M, Kusumawardani A, Widhiati S, Mulianto N. The relationship between increased body mass index with transepidermal water loss: a comparative study. J Gen - Proced Dermatology Venereol Indones 2022;6:25-30.
Mack MC, Chu MR, Tierney NK, Ruvolo E Jr, Stamatas GN, Kollias N, et al. Water‐Holding and Transport Properties of Skin Stratum Corneum of Infants and Toddlers Are Different from Those of Adults: Studies in Three Geographical Regions and Four Ethnic Groups. Pediatr Dermatol 2016;33:275-82.
Song EJ, Lee JA, Park JJ, Kim HJ, Kim NS, Byun KS, et al. A study on seasonal variation of skin parameters in Korean males. Int J Cosmet Sci 2015;37:92-7.
Correa MCM, Nebus J. Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy. Dermatol Res Pract 2012;2012:1-15.
Araviiskaia E, Pincelli C, Sparavigna A, Luger T. The Role of a Novel Generation of Emollients, ‘Emollients Plus’, in Atopic Dermatitis. Clin Cosmet Investig Dermatol 2022;15:2705-2719.
Del Rosso JQ, Cash K. Topical corticosteroid application and the structural and functional integrity of the epidermal barrier. J Clin Aesthet Dermatol 2013;6:20–27.
Prihadi IA, Ellistasari EY, Kusumawardani A. The Difference In Transepidermal Water Loss (TEWL) Values Between Sun-exposed and Non-sun-exposed Skin Among Male Medical Students. J Gen - Proced Dermatology Venereol Indones 2022;6:4.
Jurakic Toncic R, Kezic S, Jakasa I, Ljubojevic Hadzavdic S, Balic A, Petkovic M, et al. Filaggrin loss‐of‐function mutations and levels of filaggrin degradation products in adult patients with atopic dermatitis in Croatia. J Eur Acad Dermatology Venereol 2020;34:1789-1794.
Yoshida T, Beck LA, De Benedetto A. Skin barrier defects in atopic dermatitis: From old idea to new opportunity. Allergol Int 2022;71:3-13.
Ye Y, Zhao P, Dou L, Zhang Y, Ken K, Gu H, et al. Dynamic trends in skin barrier function from birth to age 6 months and infantile atopic dermatitis: A Chinese prospective cohort study. Clin Transl Allergy 2021;11:e12043.
Sasaki GH. The Significance of Trans-Epidermal Water Loss After Microneedling and Microneedling-Radiofrequency Procedures: Histological and IRB-Approved Safety Study. Aesthetic Surg J Open Forum 2019;1.
Mayrovitz HN. Transepidermal water loss and stratum corneum hydration in forearm versus hand palm. Skin Res Technol 2023;29:e13218.
Firooz A, Zartab H, Sadr B, Bagherpour LN, Masoudi A, Fanian F, et al. Daytime changes of skin biophysical characteristics: A study of hydration, transepidermal water loss, ph, sebum, elasticity, erythema, and color index on middle eastern skin. Indian J Dermatol 2016;61:700.
Kim S, Park JW, Yeon Y, Han JY, Kim E. Influence of exposure to summer environments on skin properties. J Eur Acad Dermatology Venereol 2019;33:2192-96.
Aisyah I, Zulkarnain I, Sawitri S. Profil Nilai pH dan Transepidermal Water Loss (TEWL) Pada Pasien Dermatitis Atopik Anak. . Berkala Ilmu Kesehatan Kulit Kelamin. 2019;31:138-43.
Zainal H, Jamil A, Md Nor N, Tang MM. Skin pH mapping and its relationship with transepidermal water loss, hydration and disease severity in adult patients with atopic dermatitis. Skin Res Technol 2020;26:91-8.
Montero-Vilchez T, Segura-Fernández-Nogueras MV, Pérez-Rodríguez I, Soler-Gongora M, Martinez-Lopez A, Fernández-González A, et al. Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity. J Clin Med 2021;10:359.
Williams SF, Wan H, Chittock J, Brown K, Wigley A, Cork MJ, et al. Characterization of skin barrier defects using infrared spectroscopy in patients with atopic dermatitis. Clin Exp Dermatol 2024;49:466-77.
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