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Standardized Tape Stripping: A Practical and Reproducible Protocol to Reduce Uniformly the Stratum Corneum

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Agache's Measuring the Skin

Abstract

The basic idea of strip patch testing (SPT) – a modification of conventional patch testing – is to increase the bioavailability of a test substance in the deeper epidermal cell layers by defined tape stripping the test area on the back prior to patch testing. In a prospective, investigator-blinded clinical study, we evaluated the variability and the inter-rater agreement of our proposed SPT protocol. The relative stratum corneum (SC) reduction after tape stripping was measured on 75 subjects for variability and in a subgroup of 18 subjects for inter-rater agreement, respectively, by performing in vivo confocal laser scanning microscopy. We found a good reproducibility with a SC reduction of 31 % with 95 % of the values lying between 22 % and 40 % and a good inter-rater agreement. As a result, our SPT protocol yields a clinically adequate standardization of SC reduction and may be recommended for performing the SPT in daily clinical routine.

A similar version of this contribution was published earlier in Dickel H, Goulioumis A, Gambichler T, Fluhr JW, Kamphowe J, Altmeyer P, Kuss O. Skin Pharmacol Physiol. 2010;23(5):259–65. S. Karger AG, Basel.

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Abbreviations

CI:

Confidence interval

CLSM:

Confocal laser scanning microscopy

PT:

Patch test

Q1:

25th Percentile

Q3:

75th Percentile

SC:

Stratum corneum

SD:

Standard deviation

SL:

Stratum lucidum

SPT:

Strip patch test

References

  • Basketter D, Darlenski R, Fluhr JW. Skin irritation and sensitization: mechanisms and new approaches for risk assessment. 2. Skin sensitization. Skin Pharmacol Physiol. 2008;21(4):191–202.

    Article  CAS  PubMed  Google Scholar 

  • Berrutti LE, Singer AJ, McClain SA. Histopathologic effects of cutaneous tape stripping in pigs. Acad Emerg Med. 2000;7(12):1349–53. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Bianchi ME, Manfredi AA. Immunology. Dangers in and out. Science. 2009;323(5922):1683–4. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Breternitz M, Flach M, Präßler J, Elsner P, Fluhr JW. Acute barrier disruption by adhesive tapes is influenced by pressure, time and anatomical location: integrity and cohesion assessed by sequential tape stripping; a randomized, controlled study. Br J Dermatol. 2007;156(2):231–40.

    Article  CAS  PubMed  Google Scholar 

  • Choi MJ, Zhai H, Löffler H, Dreher F, Maibach HI. Effect of tape stripping on percutaneous penetration and topical vaccination. Exog Dermatol. 2003;2(5):262–9.

    Article  CAS  Google Scholar 

  • Dickel H, Bruckner TM, Erdmann SM, Fluhr JW, Frosch PJ, Grabbe J, et al. The “strip” patch test: results of a multicentre study towards a standardization. Arch Dermatol Res. 2004;296(5):212–9.

    Article  PubMed  Google Scholar 

  • Dickel H, Geier J, Kuss O, Altmeyer P. Strip patch test vs. conventional patch test to detect type IV sensitization in patients with allergic contact dermatitis. J Eur Acad Dermatol Venereol. 2008;22(12):1516–7. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Dickel H, Kamphowe J, Geier J, Altmeyer P, Kuss O. Strip patch test vs. conventional patch test: investigation of dose-dependent test sensitivities in nickel- and chromium-sensitive subjects. J Eur Acad Dermatol Venereol. 2009a;23(9):1018–25.

    Article  CAS  PubMed  Google Scholar 

  • Dickel H, Scola N, Altmeyer P. The strip patch test – indication in occupational dermatology demonstrated with a case history. J Dtsch Dermatol Ges. 2009b;11(7):965–7.

    Google Scholar 

  • Fernandes MFM, de Mello JF, Pires MC, Vizeu MCM. Comparative study of patch test using traditional method vs. prior skin abrading. J Eur Acad Dermatol Venereol. 2007;21(10):1351–9.

    Article  CAS  PubMed  Google Scholar 

  • Fluhr JW, Darlenski R, Angelova-Fischer I, Tsankov N, Basketter D. Skin irritation and sensitization: mechanisms and new approaches for risk assessment. 1. Skin irritation. Skin Pharmacol Physiol. 2008;21(3):124–35. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Friedmann PS. The relationships between exposure dose and response in induction and elicitation of contact hypersensitivity in humans. Br J Dermatol. 2007;157(6):1093–102. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Frosch PJ, Weickel R, Schmitt T, Krastel H. Nebenwirkungen von ophthalmologischen Externa. Z Hautkr. 1988;63(2):126–36.

    CAS  PubMed  Google Scholar 

  • Grabbe S, Schwarz T. Immunoregulatory mechanisms involved in elicitation of allergic contact hypersensitivity. Immunol Today. 1998;19(1):37–44. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Haukoos JS, Lewis RJ. Advanced statistics: bootstrapping confidence intervals for statistics with “difficult” distributions. Acad Emerg Med. 2005;12(4):360–5. PubMed.

    Article  PubMed  Google Scholar 

  • Holbrook KA, Odland GF. Regional differences in the thickness (cell layers) of the human stratum corneum: an ultrastructural analysis. J Invest Dermatol. 1974;62(4):415–22. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Holzmann S, Tripp CH, Schmuth M, Janke K, Koch F, Saeland S, et al. A model system using tape stripping for characterization of Langerhans cell-precursors in vivo. J Invest Dermatol. 2004;122(5):1165–74.

    Article  CAS  PubMed  Google Scholar 

  • Jacobi U, Meykadeh N, Sterry W, Lademann J. Effect of the vehicle on the amount of stratum corneum removed by tape stripping. J Dtsch Dermatol Ges. 2003;1(11):884–9.

    Article  PubMed  Google Scholar 

  • Jacobi U, Weigmann HJ, Ulrich J, Sterry W, Lademann J. Estimation of the relative stratum corneum amount removed by tape stripping. Skin Res Technol. 2005;11(2):91–6. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Kezic S, Nielsen JB. Absorption of chemicals through compromised skin. Int Arch Occup Environ Health. 2009;82(6):677–88.

    Article  CAS  PubMed  Google Scholar 

  • Lachapelle JM, Maibach HI. Patch testing and prick testing – a practical guide (official publication of the ICDRG). 2nd ed. Berlin: Springer; 2009. 195 p.

    Google Scholar 

  • Lademann J, Jacobi U, Surber C, Weigmann H-J, Fluhr JW. The tape stripping procedure – evaluation of some critical parameters. Eur J Pharm Biopharm. 2009;72(2):317–23. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Lindemann U, Wilken K, Weigmann HJ, Schaefer H, Sterry W, Lademann J. Quantification of the horny layer using tape stripping and microscopic techniques. J Biomed Opt. 2003;8(4):601–7. PubMed.

    Article  PubMed  Google Scholar 

  • Löffler H, Dreher F, Maibach HI. Stratum corneum adhesive tape stripping: influence of anatomical site, application pressure, duration and removal. Br J Dermatol. 2004;151(4):746–52.

    Article  PubMed  Google Scholar 

  • Lucid® Inc. ImageJ applications for vivascopy: stratum corneum thickness analysis. Manual. Rochester, NY: 2005.

    Google Scholar 

  • Martin SF, Jakob T. From innate to adaptive immune responses in contact hypersensitivity. Curr Opin Allergy Clin Immunol. 2008;8(4):289–93. PubMed.

    Article  CAS  PubMed  Google Scholar 

  • Müller W. Das Berufsekzem. Berlin: Acron Verlag; 1980. 235 p.

    Google Scholar 

  • Nickoloff BJ, Naidu Y. Perturbation of epidermal barrier function correlates with initiation of cytokine cascade in human skin. J Am Acad Dermatol. 1994;30(4):535–46.

    Article  CAS  PubMed  Google Scholar 

  • Oldhoff JM, Bihari IC, Knol EF, Bruijnzeel-Koomen CAFM, de Bruin-Weller MS. Atopy patch test in patients with atopic eczema/dermatitis syndrome: comparison of petrolatum and aqueous solution as a vehicle. Allergy. 2004;59(4):451–6.

    Article  CAS  PubMed  Google Scholar 

  • Onoue A, Kabashima K, Kobayashi M, Mori T, Tokura Y. Induction of eosinophil- and Th2-attracting epidermal chemokines and cutaneous late-phase reaction in tape-stripped skin. Exp Dermatol. 2009;18(12):1036–43.

    Article  CAS  PubMed  Google Scholar 

  • Pirot F, Kalia YN, Stinchcomb AL, Keating G, Bunge A, Guy RH. Characterization of the permeability barrier of human skin in vivo. Proc Natl Acad Sci U S A. 1997;94(4):1562–7. PubMed.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Proksch E, Brandner JM, Jensen JM. The skin: an indispensable barrier. Exp Dermatol. 2008;17(12):1063–72. PubMed.

    Article  PubMed  Google Scholar 

  • Rawlings AV. Ethnic skin types: are there differences in skin structure and function? Int J Cosmet Sci. 2006;28:79–93.

    Article  CAS  PubMed  Google Scholar 

  • Sandby-Møller J, Poulsen T, Wulf HC. Epidermal thickness at different body sites: relationship to age, gender, pigmentation, blood content, skin type and smoking habits. Acta Dermatol Venereol (Stockh). 2003;83(6):410–3.

    Article  Google Scholar 

  • Scheuplein RJ, Blank IH. Permeability of the skin. Physiol Rev. 1971;51(4):702–47. PubMed.

    CAS  PubMed  Google Scholar 

  • Spier HW, Natzel R. Chromatallergie und Zementekzem. Gewerbedermatologischer und analytischer Beitrag. Hautarzt. 1953;4(2):63–5.

    CAS  PubMed  Google Scholar 

  • Spier HW, Sixt I. Untersuchungen über die Abhängigkeit des Ausfalles der Ekzem-Läppchenproben von der Hornschichtdicke. Quantitativer Abriß-Epikutantest Hautarzt. 1955;6(4):152–9.

    CAS  Google Scholar 

  • Weigmann HJ, Ulrich J, Schanzer S, Jacobi U, Schaefer H, Sterry W, et al. Comparison of transepidermal water loss and spectroscopic absorbance to quantify changes of the stratum corneum after tape stripping. Skin Pharmacol Physiol. 2005;18(4):180–5.

    Article  PubMed  Google Scholar 

  • Wolf J. Die innere Struktur der Zellen des Stratum desquamans der menschlichen Epidermis. Z Mikrosk Anat Forsch. 1939;46:170–202.

    Google Scholar 

  • Zhang LW, Monteiro-Riviere NA. Assessment of quantum dot penetration into intact, tape-stripped, abraded and flexed rat skin. Skin Pharmacol Physiol. 2008;21(3):166–80. PubMed.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Dermatology and Allergology, Ruhr University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany

    Heinrich Dickel, Thilo Gambichler, Jeanette Kamphowe & Peter Altmeyer

  2. Department of Dermatology, Charité – Universitätsmedizin Berlin, Berlin, Germany

    Joachim W. Fluhr

  3. Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Street Auf’m Hennekamp 65, Düsseldorf, 40225, Germany

    Oliver Kuss

  4. Department of Anesthesiology, Intensive Care and Pain Therapy, The Knappschaftskrankenhaus Dortmund, Am Knappschaftskrankenhaus 1, Dortmund, 44309, Germany

    Alexandros Goulioumis

Authors
  1. Heinrich Dickel
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  2. Alexandros Goulioumis
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  3. Thilo Gambichler
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  4. Joachim W. Fluhr
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  5. Jeanette Kamphowe
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  6. Peter Altmeyer
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  7. Oliver Kuss
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Corresponding author

Correspondence to Heinrich Dickel .

Editor information

Editors and Affiliations

  1. Department of Dermatology, University Hospital of Besançon, Besançon, France

    Philippe Humbert

  2. Center for Study and Research on the Integuments, Department of Dermatology, University Hospital of Besançon, Besançon, France

    Ferial Fanian

  3. Department of Dermatology, School of Medicine, University of California, San Francisco, California, USA

    Howard I. Maibach

  4. Department of Dermatology, University Hospital of Besançon, Besançon, France

    Pierre Agache

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Dickel, H. et al. (2017). Standardized Tape Stripping: A Practical and Reproducible Protocol to Reduce Uniformly the Stratum Corneum. In: Humbert, P., Fanian, F., Maibach, H., Agache, P. (eds) Agache's Measuring the Skin. Springer, Cham. https://doi.org/10.1007/978-3-319-32383-1_28

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  • DOI: https://doi.org/10.1007/978-3-319-32383-1_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32381-7

  • Online ISBN: 978-3-319-32383-1

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