There are many different types of skin disease, and they look deceptively alike. But when it comes to treating painful itches, one medicine does not fit all. Although inflammation is a common symptom, the underlying reasons for various rashes point to a need for unique and specific treatments. We know this because new research focuses on the differences by using small strips of adhesive tape applied to patients’ itchy skin rashes. These innovative medical tape strips are helping scientists to see the differences more precisely.
The reason is simple: medical tape strips adhere to diseased skin cells—just as when band-aids are removed, they pull up skin cells. A tape strip pressed into patches of red, inflamed skin pulls out cells full of information. With those cellular clues, the infection is more accurately targeted and treatment appropriately tailored.
Ordinary tape found in most households and offices picks up cellular amounts of dust, crumbs, metal, and more. Similarly, medical adhesive tape strips pull out cells from inflamed skin.
In the past, biopsy was the only way to identify which of various skin disorders a patient might have. Biopsies collected the biomarkers needed to identify molecular tissue. Skin biopsy, also known as needle-biopsy, removes tissue from itchy skin patches to assess the scope and cause of infection. Biopsy entails a painkiller injection, then breaking the skin to extract the sample.
In contrast, adhesive tape strips collect the same information but feel like simply peeling off a band-aid.
Feeling right at home
We’ve been performing in-home skin-sample collection for researchers and long-term studies. For tape strips, we use D-Squame Standard Sampling Discs. The discs are small circles of adhesive tape, less than one inch in diameter. They do not cause discomfort for our patient members who are participating in research. Where research studies can involve a large number of patients, biopsying would be a wildly costly endeavor. Tape-stripping takes about 5 minutes for participants and is a viable alternative.
Interestingly, tape-stripping results are being confirmed by evidence of various skin conditions that show up in biopsies. This means taping data is becoming as accurate as results from a biopsy. This underscores how powerfully suitable tape-stripping is for our in-home collection process.
The common skin disorder atopic dermatitis – also known as eczema – often occurs in children younger than 5 years old. So, it makes sense that new research is focusing on innovations for pediatric patients. The ease of tape-strip testing is significant because of the impracticality of biopsies for children. The term “needle-biopsy” tells us everything we need to know about how aversive it is to perform on babies.
They look alike
It can be challenging to distinguish between atopic dermatitis and psoriasis, and taking the wrong medicine can prolong skin disease. You wouldn’t treat a foot blister with cough drops.
This is where tape-strip testing comes in handy. In recent studies, tape strips have captured genetic information that separates atopic dermatitis and psoriasis.
Tape-strip data shows why psoriasis is an autoimmune disease. The data show that atopic dermatitis has autoimmune sources too, but it can also arise from non-immune factors.
The biggest difference for patients is that the atopic dermatitis itch is so intense people sometimes bleed from scratching it, and find sleep impossible. Psoriasis causes milder itching – still painful, but not as life-altering. The underlying reason is evident in the tape-strip data. The data shows how the immune system is using different weapons to fight the two different conditions. If they were the same disease, our immune systems would be using only one mode of attack.
Psoriasis makes skin cells too quickly, causing them to pile up into dry, thick patches. It’s an unwanted speed-up, as if the skin-cell generator had accidentally hit its car’s gas pedal instead of the brake. Although less painful than atopic dermatitis, psoriasis piles up in days rather than weeks.
Psoriasis builds up cells into bumpy red patches covered with silvery-white scales, but it is not contagious. You cannot get it from swimming in the same pool with someone, or from shaking hands.
Treatment that matches the condition
There are multiple types of skin disease. From rosacea to hives, impetigo to athlete’s foot, many of them cause similar, itchy symptoms. Tape-strip research is revealing the specific triggers of each disease by unveiling the molecular distinctions. Ribonucleic acid, or RNA, exists in all living cells. RNA is a messenger carrying instructions from DNA to direct the actions of proteins. Skin conditions vary because they have different RNA. So, although they may look alike, they arise from dissimilar RNA instructions.
Skin taping can also provide a general snapshot of the patient’s epidermal profile. In terms of experimental targets, skin taping has been used extensively to reveal insights into the stratum corneum, or outer layer of skin. Isolates of the stratum corneum that can be obtained through taping are AMPs, NMF, lipids, aquaporins, as well as other general surface level proteins and cellular components. A variety of methods can be used to either visualize or extract these materials from the tape strip. Methods that have been tested include colorimetrical staining the tape itself, or the scraping of collected materials into that of an extraction buffer. The correct skin taping and analysis of collected material should provide a look into the epidermal microbiome.
Through these methods, tape strips help scientists to sort out and quantify the diverse reasons for contagion, appearance, severity, location on the body, genetic input, pain level, environmental triggers, recurrence, vulnerable ages, and other factors, in ways never before possible.
In the past, both atopic dermatitis and psoriasis were treated with anti-inflammatories that suppress inflammation in a general sense. That provided some relief, for some patients, some of the time. But not to everyone. We now know atopic dermatitis and psoriasis require different treatments.
No pain, big gain
The underlying source of inflammation for atopic dermatitis differs from psoriasis. This is why tape-stripping is so important – it can guide researchers toward separating and identifying each condition’s unique source. This makes possible the creation of unique treatments.
Spilled milk looks just like spilled white paint, but that’s where the similarity ends. Due to their invisible molecular differences, they don’t clean up quite the same way.
As a cutting-edge method of gathering data, tape strips thrive on the medical science frontier – primarily by replacing cutting.
- Berekmeri A, Tiganescu, et al. Non-invasive approaches for the diagnosis of autoimmune/autoinflammatory skin diseases: A focus on Psoriasis and lupus erythematosus. Frontiers in Immunology. August 21, 2019. https://www.frontiersin.org/articles/10.3389/fimmu.2019.01931/full
- Smith G. Tape strip tests can painlessly tell eczema from psoriasis. Allergic Living. July 26, 2020. https://www.allergicliving.com/2020/07/26/tape-strip-tests-can-painlessly-tell-eczema-from-psoriasis/
- Guttman-Yassky E, Diaz A; Use of tape strips to detect immune and barrier abnormalities in the skin of children with early-onset atopic dermatitis. Journal of the American Medical Association, Dermatology. 2019;155(12):1358-1370. https://jamanetwork.com/journals/jamadermatology/fullarticle/2752710
- Chovatiya R, Silverberg JI. Pathophysiology of Atopic Dermatitis and psoriasis: Implications for management in children. October 4, 2019, 108. U.S. National Library of Medicine, National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826460/
- What is atopic dermatitis? American Academy of Dermatology Association. AAD.org, Accessed April 2021. https://www.aad.org/public
- How researchers using adhesive skin tapes found a single gene biomarker to distinguish atopic dermatitis from psoriasis. Mount Sinai Today. August 5, 2020. https://health.mountsinai.org/blog/how-researchers-using-adhesive-skin-tape-strips-found-a-single-gene-biomarker-to-distinguish-atopic-dermatitis-from-psoriasis/
- Eczema vs. psoriasis: similarities, differences and treatments. Penn Medicine, Perelman School of Medicine at the University of Pennsylvania, August 5, 2019. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/august/psoriasis