Archives of Dermatological Research

, Volume 307, Issue 1, pp 39–48 | Cite as

Development of a cumulative irritation model for incontinence-associated dermatitis

  • J. Larner
  • H. Matar
  • V. S. Goldman
  • R. P. Chilcott
Original Paper


Incontinence-associated dermatitis (IAD) is a painful yet preventable form of cumulative skin irritation prevalent amongst those with limited movement. Consequently, it has a significant impact on the quality of life for those affected as well as substantial cost implications. Prevention and intervention is typically through good skin hygiene regimes and regular use of barrier products. In this paper, we describe the development of an in vivo model of IAD in healthy volunteers by occluded application of alkaline synthetic urine to the volar aspect of volunteer’s forearms for 6 h per day over a five-day period to reproduce the moist and irritant conditions causative of IAD. Irritation was assessed and quantified on a daily basis by a series of non-invasive biophysical measurements and compared to a contralateral saline-treated (control) site. Dermal irritation was assessed by subjective (visual) and objective measurements (laser Doppler and polarisation spectroscopic imaging, infrared thermography, skin reflectance spectroscopy, transepidermal water loss and skin surface pH). The provocation of reproducible, cumulative skin irritation was successfully demonstrated and quantified. This five-day model of irritation is considered appropriate for the initial clinical assessment of topical products to prevent or treat IAD.


Dermatitis Urine Biophysical instrument TEWL Skin reflectance spectroscopy Laser Doppler imaging Thermal imaging Tissue viability imaging 



This study was funded by Bracco Diagnostics Inc. The authors would also like to thank Dr. John Skamarauskas for assistance with the analysis of TiVi images from the 5 day study, Professors Fabrizio Schifano and Ken Farrington for clinical support and Dr Richard Amlôt for statistical advice.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • J. Larner
    • 1
  • H. Matar
    • 1
  • V. S. Goldman
    • 2
    • 3
  • R. P. Chilcott
    • 1
  1. 1.Research Centre for Topical Drug Delivery and Toxicology, School of PharmacyUniversity of HertfordshireHatfieldUK
  2. 2.Bracco Diagnostics IncHealthcare Protective Products DivisionPrincetonUSA
  3. 3.Healthcare Protective Products GroupEmergent BioSolutionsPrincetonUSA

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