A nomogram to predict skin barrier dysfunction induced by mechanical irritation during skincare in hospitalized...

Mechanical irritation during skincare poses a risk of causing skin barrier dysfunction in older patients. Adequate skin assessment is thus required before skincare; however, no validated assessment method exists. This study developed a nomogram to predict skin barrier dysfunction induced by mechanical irritation during skincare in Japanese older patients using a subset of a randomized controlled trial dataset. The volar forearms of 149 older patients (≥65 years) underwent a mechanical irritation test. Skin barrier dysfunction was defined based on transepidermal water loss before and after the test. Candidate variables were obtained from medical records and skin assessments. We found that 26.2 % of older patients experienced skin barrier dysfunction. The nomogram, comprising chronic kidney disease, purpura, dry skin, activities of daily living, and body mass index, demonstrated satisfactory discrimination, calibration, and clinical utility. This tool serves as an innovative and validated method for skin assessment, offering the potential to prevent skin disorders and deliver tailored, high-quality skincare.