Skin reaction and regeneration after single sodium lauryl sulfate exposure stratified by filaggrin genotype and atopic dermatitis phenotype

BACKGROUND: Filaggrin is key for the integrity of the stratum corneum. Mutations in the filaggrin gene (FLGnull) play a prominent role in the atopic dermatitis (AD) pathogenesis. Persons with AD have an increased susceptibility to irritants. However, little is known about the effect of filaggrin genotype and AD phenotype concerning irritant response and skin regeneration.OBJECTIVES: To investigate the role of FLGnull and AD concerning skin reaction and recovery after Sodium Lauryl Sulfate (SLS) irritation.METHODS: Case-control study comprising 67 subjects, including healthy controls and patients with and without FLGnull and AD. Reactivity to different doses of SLS at 24, 48, 72 and 145 hours after SLS application was measured by transepidermal water loss (TEWL) and laser Doppler flowmetry (LDF). Reactivity was assessed univariately and by pattern analysis technique.RESULTS: All patient groups showed a higher degree of skin barrier disruption and inflammation than did controls in response to SLS. Assessing reactivity by ∆AUC both TEWL and LDF showed significant difference between healthy controls and those with the AD phenotype irrespective of filaggrin mutation. The poorest regeneration was among those with the AD phenotype. The two AD phenotype groups were separated by multivariate technique, due to earlier inflammatory reactivity among subjects with FLGnullplusAD compared to the AD phenotype alone.CONCLUSIONS: Both skin reaction and regeneration was significantly different between the patient population and the healthy controls. Additionally, response severity and regeneration depended more on phenotype (atopic dermatitis) than on filaggrin genotype, whereas the response was more rapid among FLGnullplusAD individuals. This article is protected by copyright. All rights reserved.