中华皮肤科杂志 ›› 2018, Vol. 51 ›› Issue (3): 199-203.doi: 10.3760/cma.j.issn.0412-4030.2018.03.009

• 论著 • 上一篇    下一篇

健康成人皮肤对十二烷基硫酸钠刺激反应的反射式共聚焦显微镜特征分析

江文才1,谈益妹2,江长清3,徐雅菲1,秦鸥1   

  1. 1. 上海市皮肤病医院
    2. 上海市皮肤病性病医院
    3. 上海市皮肤病医院皮肤与化妆品研究室
  • 收稿日期:2017-03-31 修回日期:2017-07-08 出版日期:2018-03-15 发布日期:2018-03-06
  • 通讯作者: 秦鸥 E-mail:qo123819@126.com
  • 基金资助:
    上海市卫生与计划生育委员会科研课题计划项目

Reflectance confocal microscopy features of irritant cutaneous reactions to sodium lauryl sulphate in healthy adults

  • Received:2017-03-31 Revised:2017-07-08 Online:2018-03-15 Published:2018-03-06
  • Supported by:
    Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning

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摘要： 目的 观察十二烷基硫酸钠（SLS）刺激后18 ~ 60岁健康人皮肤反射式共聚焦扫描显微镜（RCM）特征的差异，分析年龄和性别对皮肤反应的影响，同时初步探讨RCM在客观评价皮肤反应中的价值。方法 采用封闭式斑贴试验，分别将0.1%和0.5% SLS贴敷于120例健康受试者背部48 h，并于去除后不同时间点进行临床评估和RCM检测。结果 0.1%和0.5% SLS组皮肤刺激反应的RCM特征主要有角化不全、角质层结构不清、棘层海绵水肿、表皮炎症细胞浸润和真皮乳突毛细血管扩张等。去除0.1%和0.5%SLS 刺激后24 h，RCM特征发生率达到高峰，其中真皮毛细血管扩张的发生率分别高达66.7%和95.0%。0.5% SLS去除后24 h，男性海绵水肿的发生率为68.9%（42/61），显著低于女性［84.7%（50/59），χ2 = 4.24，P < 0.05］； 0.1%SLS去除后24 h，18 ~ 40岁年龄组人群棘层海绵水肿的发生率为53.3%（32/60），显著高于41 ~ 60岁［35.0%（21/60），χ2 = 4.09，P < 0.05］；其余RCM参数，在0.1%和0.5% SLS刺激去除后，不同性别或不同年龄组之间差异均无统计学意义（P > 0.05）。临床评估显示去除0.1%和0.5% SLS后24 h，男女皮肤刺激反应发生率差异均无统计学意义（均P > 0.05），18 ~ 40岁和41 ~ 60岁两个年龄组之间差异也无统计学意义（均P > 0.05）。Spearman相关性分析显示，临床评估结果与RCM特征之间具有良好的相关性，其中，去除0.1% SLS后24 h，海绵水肿和真皮毛细血管扩张与临床评估结果的相关系数均高达0.77（P < 0.001）。但去除SLS 0.5 h后，0.1%和0.5% SLS组表现出2项以上RCM特征的受试者比例分别为17.5%（21/120）和51.7%（62/120），比同一时刻临床评估的阳性率［2.5%（3/120）和12.5%（15/120）］更接近去除SLS 24 h后的临床评估结果34.2%（41/120）和85.0%（102/120）。结论 性别和年龄对0.1%和0.5% SLS诱导的皮肤刺激反应无明显影响；相对临床评估，RCM在刺激反应早期能更加客观准确地评估皮肤反应。

关键词: 皮炎, 刺激性, 十二烷硫酸钠, 年龄因素, 性别因素, 显微镜检查, 共焦

Abstract: Jiang Wencai, Tan Yimei, Jiang Changqing, Xu Yafei, Qin Ou Department of Skin and Cosmetic Research, Shanghai Dermatology Hospital, Shanghai 200443, China Corresponding author: Qin Ou, Email: qo123819@126.com 【Abstract】 Objective To investigate reflectance confocal microscopy （RCM） features of irritant cutaneous reactions to sodium lauryl sulphate （SLS） in healthy persons aged from 18 to 60 years, to analyze effects of age and gender on cutaneous reactions, and to estimate the value of RCM in objective evaluation of cutaneous reactions. Methods An occlusive patch test was performed on the back of 120 healthy testees with 0.1% and 0.5% SLS solution （0.1% and 0.5% SLS groups） and distilled water （negative control group） for 48 hours. At different time points after the patch removal, clinical evaluation and RCM were performed. Results RCM imaging in the 0.1% and 0.5% SLS groups showed parakeratosis, indistinct structure of the stratum corneum, spongiosis and infiltration of inflammatory cells in the epidermis, and telangiectasia in the papillary dermis. The incidence of RCM features reached the peak until 24 hours after the removal of 0.1% and 0.5% SLS patches, and the incidence of telangiectasia in the dermis was up to 66.7% and 95.0% in the 0.1% and 0.5% SLS groups respectively. At 24 hours after the removal of 0.5% SLS patch, the incidence of spongiosis was significantly lower in the males than in the females （68.9%［42/61］ vs. 84.7%［50/59］, χ2 = 4.24, P < 0.05）. However, the incidence of spongiosis was significantly higher in testees aged 18 - 40 years than in those aged 41 - 60 years at 24 hours after the removal of 0.1% SLS patch （53.3%［32/60］ vs. 35.0%［21/60］, χ2 = 4.09, P < 0.05）. For the other RCM features, there were no significant differences in their incidence between different genders or age groups after the removal of 0.1% and 0.5% SLS patches （all P > 0.05）. Clinical evaluation showed that after the removal of 0.1% and 0.5% SLS patches, no significant difference in the incidence of irritant cutaneous reactions was observed between the males and the females or between the testees aged 18 - 40 years and those aged 41 - 60 years （all P > 0.05）. There were good correlations between the clinical evaluation results and RCM features. At 24 hours after the removal of 0.1% SLS patch, the correlation coefficient between spongiosis and clinical evaluation results was up to 0.77, so was that between telangiectasia in the dermis and clinical evaluation results （both P < 0.001）. However, at 0.5 hour after the removal of SLS patches, clinical evaluation showed that the positive reaction rates were 2.5% （3/120） and 12.5% （15/120） in the 0.1% and 0.5% SLS groups respectively. In the meantime, there were 17.5% （21/120） and 51.7% （62/120） of testees manifesting more than 2 RCM features in the 0.1% and 0.5% SLS groups respectively, which were more similar to the clinical evaluation results at 24 hours after the removal of SLS patches （34.2% ［41/120］ and 85.0% ［102/120］ in the 0.1% and 0.5% SLS groups respectively） compared with the clinical evaluation results at 0.5 hour after the removal of SLS patches. Conclusions Neither gender nor age affects irritant cutaneous reactions to 0.1% and 0.5% SLS. Compared with clinical evaluation, RCM can evaluate cutaneous reactions more objectively and accurately in the early stage of irritant reactions.

Key words: Dermatitis, irritant, Sodium dodecyl sulfate, Age factors, Sex factors, Microscopy, confocal