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Irritant contact dermatitis induced by a common household irritant: A noninvasive evaluation of ethnic variability in skin response

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Objective

This study was undertaken to investigate the ethnic susceptibility to irritant contact dermatitis induced by a common dishwashing liquid using noninvasive technologies.

Methods

A total of 30 participants (15 Caucasian, 15 African American) were patch tested to graded concentrations of a common household irritant and evaluated using clinical scoring, reflectance confocal microscopy, transepidermal water loss, and fluorescence excitation spectroscopy.

Results

At 24 hours, the concentration thresholds for clinically perceptible irritancy were significantly higher for African American compared with Caucasian participants. Reflectance confocal microscopy showed stratum corneum disruption, parakeratosis, and spongiosis; these features were more severe in Caucasian participants (P ≤ .002). Mean values for transepidermal water loss were significantly higher in the Caucasian group at comparable clinical scores (P ≤ .005). Fluorescence excitation spectroscopy showed a broad excitation band at 300 nm (emission 340 nm) and values in both groups returned to baseline by day 7.

Limitations

This pilot study was limited in scope and larger studies are needed to further evaluate ethnic differences in irritant contact dermatitis and to demonstrate the applicability of our findings for other irritants.

Conclusion

Clinical evaluation, reflectance confocal microscopy, and transepidermal water loss showed significant differences in the cutaneous irritant response between both groups suggesting a superior barrier function of African American skin. Fluorescence excitation spectroscopy on the other hand demonstrated no differences in the hyperproliferative response after irritant exposure and indicated similar kinetics for the two groups.

Section snippets

Participants

The research protocol was approved by our subcommittee on human studies at the institutional review board. Ten participants (5 Caucasian [skin phototype (SPT) II-III] and 5 African American [SPT V-VI]) plus 20 healthy volunteers (10 Caucasian [SPT II-III] and 10 African American [SPT V-VI]) between the ages 18 to 49 years were recruited to participate in this study. Those with a history of significant skin disease or atopy were excluded from the protocol. Written consent was obtained before

Clinical threshold

Fig 1 illustrates the mean clinical threshold in African American versus Caucasian individuals as determined in the preliminary study (n = 10). Average threshold concentrations were 10% in the Caucasian group and 25% in the African American group (P < .0001).

In vivo RCM

Characteristic RCM features of ICD, such as SC disruption, parakeratosis, individual corneocytes, spongiosis, and vesicle formation at the level of the granular and spinous compartment were observed in both groups at sites with similar

Discussion

There is currently no consensus about the relationship between the propensity to develop ICD and ethnicity. Although most published data have reported increased skin susceptibility to irritation in Caucasian skin over African American skin, several studies have presented convincing data demonstrating otherwise.9, 17, 18 The conflicting results are mainly thought to be a result of the difficulty in assessing erythema in deeply pigmented skin.21

Hicks et al41 and others43, 44 have recently used

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    Supported by a National Institutes of Health R01 grant (Dr González) and Johnson & Johnson Consumer and Personal Products Worldwide unrestricted gift (Dr Doukas).

    Conflicts of interest: None identified.

    Dr Astner and Dr Burnett contributed equally to this report.

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