Stratum Corneum Samples Effective for Immune Response Analysis in Pediatric Atopic Dermatitis

Doppler ultrasound
Doppler ultrasound
Some aspects of pathophysiologic mechanisms may differ in children with atopic dermatitis with light skin types vs those with dark skin types.

The collection of stratum corneum (SC) samples with the use of a minimally invasive strip method is suitable for determination of a large array of immunomodulatory mediators and skin barrier biomarkers in children with atopic dermatitis (AD), according to the results of an explorative study conducted at the University of Amsterdam, The Netherlands. Findings from the analysis were published in the British Journal of Dermatology.

The investigators sought to examine skin barrier and immune response biomarkers in SC tape strips from children with AD with a variety of skin types. They collected tape strips from lesional and nonlesional forearm skin of 53 children with AD and 50 pediatric controls. A total of 28 immunomodulatory mediators were analyzed in these individuals, along with natural moisturizing factors (NMFs) and corneocyte morphology with the use of atomic force microscopy.

The presence of interleukin 1β, interleukin 18, CXCL8, CCL22, CCL17, and CCL2 was significantly higher in lesional AD skin vs nonlesional AD skin (P <.05), whereas interleukin 1α exhibited the opposite trend. Further, the presence of CXCL8, CCL2, and CCL17 demonstrated a significant association with objective Scoring Atopic Dermatitis (oSCORAD) score.

NMF levels exhibited a gradual decline from healthy skin to nonlesional and lesional AD skin. This gradual decreasing pattern was demonstrated in skin type II but not in skin type VI. In fact, higher NMF levels were observed in both nonlesional and lesional AD skin in those with skin type VI compared with those with skin type II. Moreover, corneocyte morphology was significantly different in lesional AD skin vs both nonlesional AD skin and healthy skin.

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The investigators concluded that on the basis of the differences reported in NMF levels between children with AD with skin type II and those with AD with skin type VI, some aspects of pathophysiologic mechanisms may differ in children with AD with light skin types vs those with dark skin types. Major limitations of the study include the small sample size and the fact that subgroup analyses in all skin types were not possible.


Hulshof L, Hack DP, Hasnoe QCJ, et al. Stratum corneum analysis provide a minimal invasive tool to study immune response and skin barrier in atopic dermatitis children [published online July 10, 2018]. Br J Dermatol. doi: 10.1111/bjd.16994