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Imaging reveals distinct textures at three infant skin sites and reflects skin barrier status
Marty O Visscher1,2, Vivek Narendran1,2
1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Diaper dermatitis (DD) in infants shows distinct skin texture patterns. Streak texture, even in visually normal skin, may indicate early damage, aiding timely detection and treatment.
Area of Science:
- Dermatology
- Pediatrics
- Skin barrier research
Background:
- Infant diaper dermatitis (DD) is common, influenced by skin hydration, irritants, and pH.
- Understanding skin characteristics in relation to barrier integrity is crucial for DD management.
Purpose of the Study:
- To examine diaper dermatitis in infants over time.
- To characterize skin color and texture associations with skin barrier integrity, hydration, and pH.
Main Methods:
- A prospective study of 46 infants with DD.
- Evaluation of skin integrity over 15 days using visual assessment, transepidermal water loss, hydration, pH, and high-resolution skin surface imaging.
- Analysis using general linear models to assess effects by site and time.
Main Results:
- Six distinct skin texture patterns were identified, with significant differences across diapered and non-diapered sites.
- Streak and flat textures were more frequent in DD areas, while normal dermatoglyphics were more common in non-diapered sites.
- Lower barrier integrity (moisture accumulation rate) was associated with streak and flat textures compared to normal dermatoglyphics.
Conclusions:
- Streak texture in visually normal skin within the diaper area was frequent and may serve as an early indicator of skin damage.
- This finding suggests potential clinical utility for early detection and treatment of diaper dermatitis.
- Skin barrier properties were not significantly different between within-diaper and non-diaper areas.
Background:
Infant diaper dermatitis (DD) is a prevalent condition due to multiple, interactive factors including increased skin hydration, irritant exposure, and increased skin pH. We examined diaper dermatitis vs within diaper and non-diaper controls over time and characterized the association of skin color and texture relative to skin barrier integrity, hydration, and pH.
Materials And Methods:
The prospective study included 46 infants with DD at well-child visits. Skin integrity was evaluated over 15 days, including visual skin condition, rate of stratum corneum transepidermal water accumulation, hydration, pH, and skin color and texture from high-resolution digital skin surface images. Effects by site and time were evaluated with general linear models.
Results:
Six distinct texture patterns were observed. All three sites differed significantly for texture class frequency. Normal dermatoglyphics were more frequent for non-diaper vs both within diaper and rash sites. Dermatoglyphics with marked furrows or lines (class 3) were common within diaper vs rash but not for non-diaper vs within diaper. Streaks were highest for DD and lowest for non-diaper. Flat regions were more frequent DD. Barrier integrity, that is, moisture accumulation rate, was lower for normal dermatoglyphics than streaks or flat texture. DD severity decreased over 15 days. Barrier properties of within diaper and non-diaper areas were not well-differentiated.
Conclusion:
The incidence of streak texture in the within diaper high magnification images was high despite being visually normal. This finding suggests that it is an "early indicator" of skin damage and may be clinically useful for early detection and treatment.
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