A twenty-four-hour occlusive exposure to 1% sodium lauryl sulfate induces a unique histopathologic inflammatory response in the xerotic skin of atopic dermatitis patients

Abstract

Twenty-four occlusive exposures of 1% aqueous sodium lauryl sulfate (SLS) produced unique functional and histological responses in patients with atopic dermatitis. Disruption of the stratum corneum barrier, measured by transepidermal water loss, was much greater and longer lasting than in normal controls. In contrast to controls the histologic pattern induced reproduced the typical features of the disease with spongiosis, exocytosis of mononuclear cells and a perivenular infiltrate containing eosinophils. The perivascular infiltrate consisted of CD1a+, CD4+ and HLA-DR+ cells, which was much greater and more persistent in atopics. Eosinopholic major basic protein was abundant in atopics but absent in controls. SLS provocation of atopic dermatitis is a striking experimental example of Koebnerization, in which disruption of the stratum corneum barrier as well as cytokine activation of keratinocytes reproduces the clinical diseases.