Sensitive skin: psychological effects and seasonal changes
Abstract
摘要
英文原文
Introduction：Sensitive skin is a frequent disorder, but its effects and its variability are unknown.
Objectives ：To investigate the effects of sensitive skin first on quality of life and the psyche, and secondly, on seasonal changes.
Methods：The French Opinion Poll Institute (IPSOS) conducted two opinion polls in March and July 2004. Samples included, respectively, 1006 and 1001 individuals, from a representative national sample of the French population aged 15 years or older. The polling subjects were interviewed by phone and selected by the quota method (gender, age, occupation of household head, type of geographical area and region). Questions about their perception of their sensitive skin and about potential aggravating factors were asked. Quality of life was assessed using the SF-12 questionnaire and depressive symptoms using the Hospital Anxiety and Depression (HAD) rating scale.
Results：The characteristics of the two samples were strictly similar. Persons with sensitive skin and very sensitive skin were more numerous in summer than in winter. In both surveys, the degree of sensitivity was significantly higher in the female population. Quality of life was worse in people with sensitive or very sensitive skin, above all in its psychological component–the more sensitive the skin, the more the quality of life deteriorated. There was no significant relationship between depressive symptoms and skin sensitivity in the ‘very sensitive’ or ‘sensitive’ groups.
Conclusion：Our study was the first to show seasonal changes in skin reactivity and to study the psychological impacts of sensitive skin.
对应中文
引言：敏感性皮肤是一种常见的疾病，但其影响和变异性尚不清楚。
目的 ：首先调查敏感性皮肤对生活质量和心理的影响，其次是对季节性变化的影响。
方法：法国民意调查研究所（IPSOS）于2004年3月和7月进行了两次民意调查。样本分别包括1006人和1001人，来自法国15岁以上人口的全国代表性样本。投票对象通过电话接受采访，并通过定额的方法（性别、年龄、户主的职业、地域类型和地区）进行选择。询问了他们自己对敏感皮肤的看法和潜在加重因素的相关问题。使用SF-12调查表评估生活质量，使用医院焦虑和抑郁（HAD）评分表评估抑郁症状。
结果：两个样本的特征完全相似。敏感皮肤和非常敏感的人在夏季比冬季更多。在两次调查中，女性人群的敏感程度明显较高。皮肤敏感或非常敏感的人生活质量更差，尤其是在心理方面：皮肤越敏感，生活质量越差。在 “非常敏感 “或 “敏感 “组中，抑郁症状和皮肤敏感性之间没有明显的关系。
结论：我们的研究首次显示了与皮肤反应相关的季节性变化和敏感皮肤的心理影响。
Introduction
引言
英文原文
Sensitive skin has been described by Kligman and Thiers. However, its existence was debated, and sometimes still is. A near consensus now exists on a clear clinical definition. Sensitive skin types are defined as the onset of prickling, burning or tingling sensation (possibly of pain or pruritus) due to various factors, which may be physical (ultraviolet radiation, heat, cold, wind), chemical (cosmetics, soap, water, pollution), psychological (stress) or hormonal (menstrual cycle). Erythema is frequently but not necessarily associated with sensitive skin. A few tests can aid in establishing the diagnosis and are useful exploratory methods: the stinging test, the thermal sensitivity test and the capsaicin test. Sensitive skin is also called reactive skin, hyper-reactive skin, intolerant skin or irritable skin.
对应中文
Kligman和Thiers对敏感皮肤进行了描述。然而，它的存在是有争议的，而有时仍然是。关于一个明确的临床定义，现在几乎达成了共识。敏感性皮肤类型被定义为由于各种因素引起的刺痛、烧灼感或刺痛（可能是疼痛或瘙痒）的发生，这些因素可能是物理的（紫外线辐射、热、冷、风）、化学的（化妆品、肥皂、水、污染）、心理的（压力）或激素的（月经周期）。经常出现红斑但不一定与敏感皮肤有关。一些试验有助于诊断，是有用的探索性方法：刺痛试验、热敏试验和辣椒素试验。敏感性皮肤也被称为反应性皮肤、高反应性皮肤、不耐受性皮肤或刺激性皮肤。
英文原文
The physiopathogenesis of sensitive skin is poorly understood. There is a decrease in the ‘tolerance threshold of skin.’ It is not an immune or allergic disorder. From a histological standpoint, vasodilation and an inflammatory infiltrate are infrequent findings. An impaired skin barrier function, with an increase in insensitive water loss, which could increase exposure to irritants, is observed.The presence of abnormal sensations and vasodilation demonstrates the involvement of the nervous system in the skin.Neurogenic inflammation seems to result from neuromediators such as substance P, CGRP and VIP, leading to vasodilatation and mast cell degranulation. Non-specific inflammation may also be associated with release of IL-1, IL-8, PgE2, PgF2 and TNFα.
对应中文
敏感皮肤的生理发病机制尚不清楚。皮肤的 “耐受阈值 “有所下降。敏感皮肤不是一种免疫或过敏性疾病。从组织学角度看，血管扩张和炎症浸润也不常见。观察到皮肤屏障功能受损，不敏感水分流失增加，这可能会增加暴露于刺激物。异常感觉和血管扩张的存在表明皮肤神经系统受累。神经源性炎症似乎是由P物质、CGRP和VIP等神经介质引起，进而导致血管扩张和肥大细胞脱颗粒。非特异性炎症也可能与IL-1、IL-8、PgE2、PgF2和TNFα的释放有关。
Discussion
讨论
英文原文
General quality of life is little impaired in subjects with sensitive skin, except in its psychological component, as measured by the MCS-12 score: the more sensitive the skin is, the more this psychological component of QoL is impaired. Does this involve a predisposition for a ‘psychological sensitivity’ or is this a consequence of having sensitive skin? The number of depression cases was not higher in subjects who presented with sensitive skin or very sensitive skin. It might be interesting to supplement this study by evaluating depression severity, as well as by screening for anxiety or acute stress reactivity. Similarly, the use of Quality-of-Life scales more specific to dermatology might be interesting.
对应中文
敏感皮肤受试者的一般生活质量几乎没有受到影响，但其心理成分除外，如MCS-12评分所测量的：皮肤越敏感，生活质量这部分心理成分受到的影响越大。这是否涉及一种 “心理敏感 “的倾向，或是拥有敏感皮肤的后果？在出现敏感皮肤或非常敏感皮肤的受试者中，抑郁症病例的数量并不高。通过评估抑郁症的严重程度以及筛查焦虑或急性应激反应来补充这项研究可能很有趣。同样，使用针对皮肤病学的生活质量量表也可能是有趣的。
英文原文
Our study is the first one to evaluate the effects of flushing triggered by emotions. There is a significant impact on the psychological component of quality of life. This impact is revealed by this study because persons with this condition present with marked depressive symptoms more frequently than other subjects. To our knowledge, no study has involved psychiatric comorbidity in patients with erythrophobia. Autonomic hyperactivity has simply been observed in case of psychological stress.
对应中文
我们是第一个评估由情绪引发潮红影响的研究。这对生活质量的心理部分有重大影响。这项研究揭示了这种影响，因为患有这种疾病的人比其他人更容易出现明显的抑郁症状。据我们所知，恐红症患者的精神共病还没有研究过。在心理压力的情况下，可以简单地观察到自主神经过度活动。
英文原文
Sensitive skin clearly appears more frequently in summer than in winter, especially in women. Our results show that a fair skin type (phototype) is more commonly associated with sensitive or very sensitive skin. The American study did not show any difference in prevalence among ethnic groups; however, it did show reactivity to different factors depending on ethnic groups. A German–Japanese study showed that Japanese women had subjective feeling of skin irritation after application of sodium lauryl sulphate, more frequently than German women, although there was no difference in impairment of the skin barrier. Among factors triggering sensitive skin, climatic factors appear to play a role: there is more sun, temperature changes, air pollution and air conditioning in July.
对应中文
敏感性皮肤显然在夏季比冬季更频繁地出现，特别是女性。我们的结果显示，白皙的皮肤类型（光型）与敏感或非常敏感的皮肤有关。美国的研究没有显示不同种族群体的发病率有任何差异；然而，它显示了不同种族群体对不同因素的反应性。一项德国和日本的研究显示，尽管在皮肤屏障的损害方面没有差异，日本女性在涂抹十二烷基硫酸钠后，比德国女性更容易产生皮肤刺激的主观感觉。在引发敏感皮肤的因素中，气候因素似乎起了作用：7月份更多的阳光、温度变化、空气污染和空调。
英文原文
Sensitivity to UVB (occurrence of an erythema) was higher in summer than in winter.This is a paradoxical finding as natural protection by melanin is stronger in summer. Other factors could thus explain this result. Higher skin reactivity in summer allows one then to better understand why UVB would induce more erythema in summer. Consequently, a variability in skin reactivity could exist according to seasonal and chronobiological factors, which would depend more on neurogenic inflammation than on release of the free radicals.
对应中文
夏季对紫外线的敏感性（出现红斑）比冬季高。这是一个矛盾的发现，因为夏季黑色素的自然保护作用更强。因此，其他因素可以解释这一结果。夏季较高的皮肤反应性使人们能够更好地理解为什么在夏季UVB会诱发更多的红斑。因此，根据季节和时间生物学因素，皮肤反应性可能存在差异，这将更多地取决于神经性炎症而不是自由基的释放。
REFERENCES
1.Misery L, Myon E, Martin N, Consoli S, Boussetta S, Nocera T, et al. Sensitive skin: psychological effects and seasonal changes. Journal of the European Academy of Dermatology and Venereology. 2007;21(5):620-8.