Exposure of the skin to
sodium dodecyl sulfate (SDS) leads to disruption of barrier and skin irritation. We used repetitive short exposure to a low molarity SDS
solution as an in vivo model to mimic the development of
irritant contact dermatitis. In this model, we studied clinical (
erythema), functional (transepidermal water loss(TEWL)) and cell
biological changes. 24 healthy volunteers were patch tested with SDS (0.2%) for 4 h a day for 5 consecutive days. After removal of the patches, the exposed sites were treated 1 X daily either with a topical
corticosteroid (triamcinolon acetonide cream 0.05%), a
retinoid (
tretinoin cream 0.025%), or a
vitamin D3 derivative (
calcipotriol ointment 50 micrograms/g).
Irritant reactions were assessed by
erythema scoring and measurement of barrier function with TEWL up to 14 days after the first challenge. Skin biopsies were taken for cell
biological changes at day 4. Vehicle-treated sites served as controls. Repetitive exposure of human skin to SDS resulted in a gradual increase in
erythema scoring and TEWL associated with the upregulation of proliferative cells as measured by the expression of Ki-67-antigen and of
differentiation markers, visualized by increased expression of
involucrin and epidermal-
fatty-acid binding protein (E-FABP). Skin irritation as assessed by
erythema scoring and TEWL was not significantly suppressed by
triamcinolone cream. However, a significant reduction of the number of cycling keratinocytes and a decrease in
involucrin positive cell layers was observed in this group. Neither treatment with
calcipotriol ointment nor with
tretinoin cream induced improvement of skin irritation as judged by visual scoring and TEWL. In contrast to
steroid treatment, no significant effect of
calcipotriol ointment or
tretinoin cream treatment was observed with regard to the number of cycling cells and
differentiation markers. Further studies are needed to assess whether treatment with topical
corticosteroids is an effective modality in skin irritation and
irritant contact dermatitis.