Tape Strips in Dermatology Research

A. J. Hughes; S. S. Tawfik; K. P. Baruah; E. A. O'Toole; R. F. L. O'Shaughnessy

Disclosures

The British Journal of Dermatology. 2021;185(1):26-35. 

In This Article

Which Dermatoses can be Studied From Tape Strips?

As TS sample the SC,[3,19] most studies focus on upper epidermal pathologies such as atopic eczema (AE) (Table S1; see Supporting Information). However, upper epidermal pathology is not a prerequisite, as exemplified by the use of TS to detect skin cancers.[20–22] The dermatoses studied using TS are listed in Table 1.

TS are well suited for childhood AE studies, providing a simple and noninvasive method to obtain samples from young children.[2,3] Adult biopsies cannot be substituted, as childhood AE is a distinct disease endotype.[23] TS could eventually be used to noninvasively diagnose or predict the onset of AE, but research is currently identifying and categorizing biomarkers.[24] Seibold et al. used RNA-seq from TS to identify patients with AE with increased T helper (Th)2 gene expression in their nonlesional skin who could be targeted with precision biological therapy.[25] Another potential use of TS is to assess emollient adherence, as artificial ceramides from emollients can be quantified and differentiated from naturally occurring ceramides using TS.[26]

The hyperkeratotic SC in psoriasis is also accessible to TS sampling.[18] However, there are fewer studies regarding the use of TS sampling in psoriasis than in AE (Table S1). This may be because TS have been used to induce and study the Koebner phenomenon.[27] However, up to 20 TS have been used in nonlesional psoriasis studies without report of koebnerization.[5] One study specifically reported that four TS did not induce the Koebner phenomenon in any patient.[8] He et al. identified that nitric oxide synthase (NOS)2/inducible NOS (iNOS) expression was elevated in TS from lesional psoriasis and could differentiate psoriasis from AE with 100% accuracy.[5] Berekméri et al. found TS interleukin (IL)-36 expression could differentiate psoriasis from AE with a sensitivity of 94% and specificity of 100%.[24]

TS have been used to sample cutaneous microbes.[28,29] Lange-Asschenfeldt et al. showed that bacteria were found on all 15 sequential TS and that 85% of bacteria resided in the first six TS.[28] Unlike biopsies, differential tape stripping allows the identification of microorganisms within specific SC layers.[28] Skin swabbing detects only surface bacteria.[30] Ogai et al. found that, while microbiome bacterial composition was equivalent between TS and skin swabs using next-generation sequencing or anaerobic culture, there was greater bacterial diversity in TS samples using aerobic culture.[29] Chng et al. compared the use of TS to swabs and cup scrubs in patients with AE and found a higher intrapatient concordance of microorganisms detected using TS.[31]

TS have been used to detect exposures to environmental chemicals that embed into the SC and can be removed with sequential TS, such as silver particles in patients with AE who used silver garments.[32]

Although skin cancer extends beyond the epidermis, TS can detect epidermal transcriptomic changes from melanoma.[20,33] The company DermTech Inc. (La Jolla, CA, USA) offers a noninvasive assay to differentiate pigmented lesions from melanoma.[33] This uses quantitative real-time polymerase chain reaction (qPCR) from four TS to assess expression of two genes, LINC and PRAME, as biomarkers for melanoma.[33] Sensitivity is 91–95%, specificity is 69–91%, and 99·94% of negative samples avoided a surgical biopsy at 12 months.[33] This company has also made progress in differentiating basal cell and squamous cell carcinomas from benign lesions.[22] This is the first example where TS have been incorporated into clinical practice and we anticipate that this will grow in the future.

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