Value of GPSkin for the measurement of skin barrier impairment and for monitoring of rosacea treatment in daily practice

Abstract

Background: Stratum corneum hydration (SCH) and transepidermal water loss (TEWL) provide useful information about skin barrier function. This study aimed to determine the value of GPSkin Pro, a new handheld device determining both SCH and TEWL, to measure skin barrier impairment and to monitor barrier function in rosacea in daily practice.

Materials and methods: Two pilots were performed. Pilot 1: in 27 healthy participants, GPSkin SCH and TEWL were compared to Aquaflux® and Epsilon® values at the forearm before and after skin barrier perturbation via tapestripping. Moreover, GPSkin values were measured at both cheeks without intervention. Pilot 2: in 16 rosacea patients, GPSkin measurements were performed at the forearm, and at both cheeks before and during anti-inflammatory treatment. They were compared to clinical symptoms and to GPSkin values from pilot 1.

Results: Pilot 1: after merging data from before and after tapestripping, a strong correlation was observed between GPSkin TEWL and Aquaflux® (Rs = 0.9256), and GPSkin SCH and Epsilon® (Rs = 0.8798). Pilot 2: SCH was significantly lower at the cheeks of rosacea patients compared to controls, with a normalizing trend during successful treatment. TEWL was comparable among patients and controls and did not change during treatment at all locations.

Conclusion: The GPSkin determines TEWL and SCH accurately in healthy and impaired skin barrier state and can monitor skin barrier function in rosacea during treatment. The GPSkin device is much more practical compared to previous skin barrier tools when used in clinical practice. Its further validation in other inflammatory skin diseases is recommended.

Keywords: GPSkin; capacitance; skin barrier function; skin hydration; stratum corneum; transepidermal water loss.

Conflict of interest statement

JGML has received a research grant from Galderma. She carried out clinical trials for Abbvie, Novartis, Janssen, and LEO Pharma. She has received reimbursement for attending meetings from Abbvie. RJBD has received a research grant from Galderma. She carried out clinical trials for Cutanea Life Sciences, Galderma, Abbvie, Novartis, and Janssen. She has received reimbursement for attending meetings from Abbvie and Galderma. She has served as a consultant for Abbvie, Galderma, and Novartis. EMGJ has received research grants from AbbVie, Pfizer, Novartis, Janssen Pharmaceuticals, and Leo Pharma. All fees were paid directly to the institution. PEJE has no conflicts of interest to declare.

© 2020 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.

Figures

FIGURE 1

Overview of the study design, consisting of two sub‐pilots. Pilot 1, healthy volunteers. GPSkin, Epsilon, and Aquaflux measurements were performed at the right volar forearm before and directly after tapestripping. Moreover, GPSkin measurements were performed one at the left and right cheek without intervention. Pilot 2, rosacea patients. GPSkin values and clinical scores were determined at the left and right cheek before and min. 1 mo after start of new topical and/or oral anti‐inflammatory rosacea treatment. Additionally, GPSkin values were determined at both time points at the right volar forearm without intervention

FIGURE 2

Linear regression with R2‐values and 95% confidence intervals (dotted lines) for GPSkin vs conventional devices. Spearman correlation coefficient (Rs) is also displayed. GPSkin was tested against the Aquaflux to measure TEWL (A) and the Epsilon to measure hydration (B)

FIGURE 3

GPSkin results at the left cheek, right cheek, and volar forearm of rosacea patients at baseline and healthy controls. (A), TEWL, transepidermal water loss. (B), SCH, stratum corneum hydration. The boxes indicate the median value with 75th percentile and range. *0.01 ≥ P<.05, **0.001 ≥ P<.01, ***P < .001

FIGURE 4

Clinical scores of all rosacea patients (n = 16) at baseline and during treatment (= follow‐up). (A‐C), IGA scale, erythema scale, and telangiectasia scale. IGA, investigator's global assessment

FIGURE 5

GPSkin results at the left cheek, right cheek, and volar forearm of rosacea patients at baseline and during follow‐up. (A), TEWL, transepidermal water loss. (B), SCH, stratum corneum hydration. The boxes indicate the median value with 75th percentile and range

FIGURE 6

Weak inverse correlation found between stratum corneum hydration and transepidermal water loss in rosacea patients (baseline and follow‐up data combined), measured with the GPSkin