Characterization of atopic skin and the effect of a hyperforin-rich cream by laser scanning microscopy

Abstract. Atopic dermatitis (AD) is a multifactorial inflammatory skin disease that affects both children and adults in an increasing manner. The treatment of AD often reduces subjective skin parameters, such as itching, dryness, and tension, but the inflammation cannot be cured. Laser scanning microscopy was used to investigate the skin surface, epidermal, and dermal characteristics of dry and atopic skin before and after treatment with an ointment rich in hyperforin, which is known for its anti-inflammatory effects. The results were compared to subjective parameters and transepidermal water loss, stratum corneum moisture, and stratum corneum lipids. Using biophysical methods, in particular laser scanning microscopy, it was found that atopic skin has distinct features compared to healthy skin. Treatment with a hyperforin-rich ointment resulted in an improvement of the stratum corneum moisture, skin surface dryness, skin lipids, and the subjective skin parameters, indicating that the barrier is stabilized and improved by the ointment. But in contrast to the improved skin surface, the inflammation in the deeper epidermis/dermis often continues to exist. This could be clearly shown by the reflectance confocal microscopy (RCM) measurements. Therefore, RCM measurements could be used to investigate the progress in treatment of atopic dermatitis.

[1]  A. Marini,et al.  Ectoine-Containing Cream in the Treatment of Mild to Moderate Atopic Dermatitis: A Randomised, Comparator-Controlled, Intra-Individual Double-Blind, Multi-Center Trial , 2013, Skin Pharmacology and Physiology.

[2]  Wolfram Sterry,et al.  Confocal laser-scanning microscopy of capillaries in normal and psoriatic skin , 2012, Journal of biomedical optics.

[3]  J. Serup,et al.  Fluorescence confocal laser scanning microscopy for in vivo imaging of epidermal reactions to two experimental irritants , 2008, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[4]  R. Neubert,et al.  Improved procedure for the separation of major stratum corneum lipids by means of automated multiple development thin-layer chromatography. , 2002, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[5]  F. Rippke,et al.  Efficacy of a New Tonic Containing Urea, Lactate, Polidocanol, and Glycyrrhiza inflata Root Extract in the Treatment of a Dry, Itchy, and Subclinically Inflamed Scalp , 2013, Skin Pharmacology and Physiology.

[6]  J. Zbytovská,et al.  Effects of sphingomyelin/ceramide ratio on the permeability and microstructure of model stratum corneum lipid membranes. , 2014, Biochimica et biophysica acta.

[7]  J. J. Russell.  Topical tacrolimus: a new therapy for atopic dermatitis. , 2002, American family physician.

[8]  M. Mihm,et al.  Reflectance confocal microscopy may differentiate acute allergic and irritant contact dermatitis in vivo. , 2002, Journal of the American Academy of Dermatology.

[9]  H Vollert,et al.  Influence of dietary carotenoids on radical scavenging capacity of the skin and skin lipids. , 2013, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[10]  E. Berardesca,et al.  Preliminary evaluation of vitiligo using in vivo reflectance confocal microscopy , 2007, Journal of the European Academy of Dermatology and Venereology : JEADV.

[11]  W. Abramovits.  A clinician's paradigm in the treatment of atopic dermatitis. , 2005, Journal of the American Academy of Dermatology.

[12]  C. Borner,et al.  Inhibition of tumour cell growth by hyperforin, a novel anticancer drug from St. John's wort that acts by induction of apoptosis , 2002, Oncogene.

[13]  I I Lelis,et al.  [Atopic dermatitis]. , 1980, Vestnik dermatologii i venerologii.

[14]  M C Meinke,et al.  Enhancement of skin radical scavenging activity and stratum corneum lipids after the application of a hyperforin-rich cream. , 2014, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[15]  S. González,et al.  Non-invasive evaluation of the kinetics of allergic and irritant contact dermatitis. , 2005, The Journal of investigative dermatology.

[16]  C. Longo,et al.  In vivo confocal microscopy for diagnosis of melanoma and basal cell carcinoma using a two-step method: analysis of 710 consecutive clinically equivocal cases. , 2012, The Journal of investigative dermatology.

[17]  J. Simon,et al.  Antibacterial activity of hyperforin from St John's wort, against multiresistant Staphylococcus aureus and gram-positive bacteria , 1999, The Lancet.

[18]  Y. Linde,et al.  'Dry' skin in atopic dermatitis. II. A surface profilometry study. , 1989, Acta dermato-venereologica.

[19]  Sabine Schanzer,et al.  In vivo photoprotective and anti-inflammatory effect of hyperforin is associated with high antioxidant activity in vitro and ex vivo. , 2012, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[20]  R. Daniels,et al.  In vitro Skin Permeation and Penetration of Nonivamide from Novel Film-Forming Emulsions , 2013, Skin Pharmacology and Physiology.

[21]  T. Zuberbier,et al.  Children with Dry Skin and Atopic Predisposition: Daily Use of Emollients in a Participant-Blinded, Randomized, Prospective Trial , 2014, Skin Pharmacology and Physiology.

[22]  C. Akdis,et al.  Absence of T-regulatory cell expression and function in atopic dermatitis skin. , 2006, The Journal of allergy and clinical immunology.

[23]  Karsten König,et al.  In vivo detection of basal cell carcinoma: comparison of a reflectance confocal microscope and a multiphoton tomograph , 2013, Journal of biomedical optics.

[24]  N. Novak.  New insights into the mechanism and management of allergic diseases: atopic dermatitis , 2009, Allergy.

[25]  M. Ardigó,et al.  Interest of reflectance confocal microscopy for inflammatory oral mucosal diseases , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[26]  R. Fölster-Holst,et al.  Impaired sphingomyelinase activity and epidermal differentiation in atopic dermatitis. , 2004, The Journal of investigative dermatology.

[27]  J. Bouwstra,et al.  The important role of stratum corneum lipids for the cutaneous barrier function. , 2014, Biochimica et biophysica acta.

[28]  Rainer Hofmann-Wellenhof,et al.  In vivo reflectance confocal microscopy of erythematosquamous skin diseases , 2009, Experimental dermatology.

[29]  M Rajadhyaksha,et al.  Allergic contact dermatitis: correlation of in vivo confocal imaging to routine histology. , 1999, Journal of the American Academy of Dermatology.