Autism is a neurodevelopmental disorder. Individuals with autism can exhibit multiple neurological symptoms such as deficit in social communication, restricted interests, and repetitive behaviors. Recent study showed that murine model of autism displays an increased transepidermal water loss (TEWL) and dry skin. But whether epidermal functions are also altered in children with autism is unknown. In the present study, TEWL, stratum corneum hydration, and skin surface pH were compared between children with autism (N = 56) and normal controls (N = 48). Our results showed that children with autism exhibited lower stratum corneum hydration levels, higher TEWL, and elevated skin surface pH in comparison to normal controls (p < 0.0001 for all). These results demonstrate that children with autism exhibit epidermal dysfunction.

1.
Sauer
AK
,
Stanton
JE
,
Hans
S
,
Grabrucker
AM
.
Chapter 1 autism spectrum disorders: etiology and pathology
. In:
Grabrucker
AM
, editor.
Autism Spectrum Disorders (Internet)
Brisbane (AU)
Exon Publications
2021
2.
Faras
H
,
Al Ateeqi
N
,
Tidmarsh
L
.
Autism spectrum disorders
.
Ann Saudi Med
.
2010
;
30
(
4
):
295
300
.
3.
Barbaro
J
,
Sadka
N
,
Gilbert
M
,
Beattie
E
,
Li
X
,
Ridgway
L
.
Diagnostic accuracy of the social attention and communication surveillance-revised with preschool tool for early autism detection in very young children
.
JAMA Netw Open
.
2022
;
5
(
3
):
e2146415
.
4.
Veness
C
,
Prior
M
,
Bavin
E
,
Eadie
P
,
Cini
E
,
Reilly
S
.
Early indicators of autism spectrum disorders at 12 and 24 months of age: a prospective, longitudinal comparative study
.
Autism
.
2012
;
16
(
2
):
163
77
.
5.
Pierce
K
,
Conant
D
,
Hazin
R
,
Stoner
R
,
Desmond
J
.
Preference for geometric patterns early in life as a risk factor for autism
.
Arch Gen Psychiatry
.
2011
;
68
(
1
):
101
9
.
6.
Zeidan
J
,
Fombonne
E
,
Scorah
J
,
Ibrahim
A
,
Durkin
MS
,
Saxena
S
.
Global prevalence of autism: a systematic review update
.
Autism Res
.
2022
;
15
(
5
):
778
90
.
7.
May
T
,
Brignell
A
,
Williams
K
.
Autism spectrum disorder prevalence in children aged 12-13 Years from the longitudinal study of Australian children
.
Autism Res
.
2020
;
13
(
5
):
821
7
.
8.
Brugha
TS
,
Spiers
N
,
Bankart
J
,
Cooper
SA
,
McManus
S
,
Scott
FJ
.
Epidemiology of autism in adults across age groups and ability levels
.
Br J Psychiatry
.
2016
;
209
(
6
):
498
503
.
9.
Lai
DC
,
Tseng
YC
,
Hou
YM
,
Guo
HR
.
Gender and geographic differences in the prevalence of autism spectrum disorders in children: analysis of data from the national disability registry of Taiwan
.
Res Dev Disabil
.
2012
;
33
(
3
):
909
15
.
10.
Jariwala-Parikh
K
,
Barnard
M
,
Holmes
ER
,
West-Strum
D
,
Bentley
JP
,
Banahan
B
.
Autism prevalence in the Medicaid program and healthcare utilization and costs among adult enrollees diagnosed with autism
.
Adm Policy Ment Health
.
2019
;
46
(
6
):
768
76
.
11.
Hong
M
,
Lee
SM
,
Park
S
,
Yoon
SJ
,
Kim
YE
,
Oh
IH
.
Prevalence and economic burden of autism spectrum disorder in South Korea using national health insurance data from 2008 to 2015
.
J Autism Dev Disord
.
2020
;
50
(
1
):
333
9
.
12.
Smith DaWalt
L
,
Hickey
E
,
Hudock
R
,
Esler
A
,
Mailick
M
.
Impact of Working Together for adults with autism spectrum disorder: a multifamily group intervention
.
J Neurodev Disord
.
2021
;
13
(
1
):
44
.
13.
McDougal
E
,
Riby
DM
,
Hanley
M
.
Teacher insights into the barriers and facilitators of learning in autism
.
Res Autism Spectr Disord
.
2020
;
79
:
101674
.
14.
Surén
P
,
Stoltenberg
C
,
Bresnahan
M
,
Hirtz
D
,
Lie
KK
,
Lipkin
WI
.
Early growth patterns in children with autism
.
Epidemiology
.
2013
;
24
(
5
):
660
70
.
15.
Porter
N
,
Loveland
KA
,
Saroukhani
S
,
Posey
Y
,
Morimoto
K
,
Rahbar
MH
.
Severity of child autistic symptoms and parenting stress in mothers of children with autism spectrum disorder in Japan and USA: cross-cultural differences
.
Autism Res Treat
.
2022
;
2022
:
7089053
.
16.
Leigh
JP
,
Du
J
.
Brief Report: forecasting the economic burden of autism in 2015 and 2025 in the United States
.
J Autism Dev Disord
.
2015
;
45
(
12
):
4135
9
.
17.
Wang
Z
,
Man
MQ
,
Li
T
,
Elias
PM
,
Mauro
TM
.
Aging-associated alterations in epidermal function and their clinical significance
.
Aging
.
2020
;
12
(
6
):
5551
65
.
18.
Shah
MG
,
Maibach
HI
.
Estrogen and skin. An overview
.
Am J Clin Dermatol
.
2001
;
2
(
3
):
143
50
.
19.
Dichter
GS
.
Functional magnetic resonance imaging of autism spectrum disorders
.
Dialogues Clin Neurosci
.
2012
;
14
(
3
):
319
51
.
20.
Shin
KO
,
Crumrine
DA
,
Kim
S
,
Lee
Y
,
Kim
B
,
Abuabara
K
.
Phenotypic overlap between atopic dermatitis and autism
.
BMC Neurosci
.
2021
;
22
(
1
):
43
.
21.
Wiggins
LD
,
Rice
CE
,
Barger
B
,
Soke
GN
,
Lee
LC
,
Moody
E
.
DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children
.
Soc Psychiatry Psychiatr Epidemiol
.
2019
;
54
(
6
):
693
701
.
22.
Ye
L
,
Wang
Z
,
Li
Z
,
Lv
C
,
Man
MQ
.
Validation of GPSkin Barrier® for assessing epidermal permeability barrier function and stratum corneum hydration in humans
.
Skin Res Technol
.
2019
;
25
(
1
):
25
9
.
23.
Liu
Z
,
Song
S
,
Luo
W
,
Elias
PM
,
Man
MQ
.
Sun-induced changes of stratum corneum hydration vary with age and gender in a normal Chinese population
.
Skin Res Technol
.
2012
;
18
(
1
):
22
8
.
24.
Harvell
J
,
Hussona-Saeed
I
,
Maibach
HI
.
Changes in transepidermal water loss and cutaneous blood flow during the menstrual cycle
.
Contact Dermatitis
.
1992
;
27
(
5
):
294
301
.
25.
Green
M
,
Kashetsky
N
,
Feschuk
A
,
Maibach
HI
.
Transepidermal water loss (TEWL): environment and pollution-A systematic review
.
Skin Health Dis
.
2022
;
2
(
2
):
e104
.
26.
Luebberding
S
,
Krueger
N
,
Kerscher
M
.
Skin physiology in men and women: in vivo evaluation of 300 people including TEWL, SC hydration, sebum content and skin surface pH
.
Int J Cosmet Sci
.
2013
;
35
(
5
):
477
83
.
27.
Ye
L
,
Lai
Q
,
Wen
S
,
Wang
X
,
Yang
B
,
Man
MQ
.
Correlation of body mass index with epidermal biophysical properties varies with gender in Chinese
.
Skin Pharmacol Physiol
.
2022
;
35
(
4
):
215
23
.
28.
Ye
L
,
Lv
C
,
Man
G
,
Song
S
,
Elias
PM
,
Man
MQ
.
Abnormal epidermal barrier recovery in uninvolved skin supports the notion of an epidermal pathogenesis of psoriasis
.
J Invest Dermatol
.
2014
;
134
(
11
):
2843
6
.
29.
Montero-Vilchez
T
,
Segura-Fernández-Nogueras
MV
,
Pérez-Rodríguez
I
,
Soler-Gongora
M
,
Martinez-Lopez
A
,
Fernández-González
A
.
Skin barrier function in psoriasis and atopic dermatitis: transepidermal water loss and temperature as useful tools to assess disease severity
.
J Clin Med
.
2021
;
10
(
2
):
359
.
30.
Man
MQ
,
Hatano
Y
,
Lee
SH
,
Man
M
,
Chang
S
,
Feingold
KR
.
Characterization of a hapten-induced, murine model with multiple features of atopic dermatitis: structural, immunologic, and biochemical changes following single versus multiple oxazolone challenges
.
J Invest Dermatol
.
2008
;
128
(
1
):
79
86
.
31.
Hon
KL
,
Wong
KY
,
Leung
TF
,
Chow
CM
,
Ng
PC
.
Comparison of skin hydration evaluation sites and correlations among skin hydration, transepidermal water loss, SCORAD index, Nottingham Eczema Severity Score, and quality of life in patients with atopic dermatitis
.
Am J Clin Dermatol
.
2008
;
9
(
1
):
45
50
.
32.
Proksch
E
,
Brandner
JM
,
Jensen
JM
.
The skin: an indispensable barrier
.
Exp Dermatol
.
2008
;
17
(
12
):
1063
72
.
33.
Feingold
KR
.
Thematic review series: skin lipids. The role of epidermal lipids in cutaneous permeability barrier homeostasis
.
J Lipid Res
.
2007
;
48
(
12
):
2531
46
.
34.
Eberlein-König
B
,
Schäfer
T
,
Huss-Marp
J
,
Darsow
U
,
Möhrenschlager
M
,
Herbert
O
.
Skin surface pH, stratum corneum hydration, trans-epidermal water loss and skin roughness related to atopic eczema and skin dryness in a population of primary school children
.
Acta Derm Venereol
.
2000
;
80
(
3
):
188
91
.
35.
Danby
SG
,
Andrew
PV
,
Kay
LJ
,
Pinnock
A
,
Chittock
J
,
Brown
K
.
Enhancement of stratum corneum lipid structure improves skin barrier function and protects against irritation in adults with dry, eczema-prone skin
.
Br J Dermatol
.
2022
;
186
(
5
):
875
86
.
36.
Man MQ
M
,
Feingold
KR
,
Thornfeldt
CR
,
Elias
PM
.
Optimization of physiological lipid mixtures for barrier repair
.
J Invest Dermatol
.
1996
;
106
(
5
):
1096
101
.
37.
Mao-Qiang
M
,
Feingold
KR
,
Wang
F
,
Thornfeldt
CR
,
Elias
PM
.
A natural lipid mixture improves barrier function and hydration in human and murine skin
.
J Soc Cosmet Chem
.
1996
;
47
:
157
66
.
38.
Sindher
S
,
Alkotob
SS
,
Shojinaga
MN
,
Brough
HA
,
Bahnson
HT
,
Chan
S
.
Pilot study measuring transepidermal water loss (TEWL) in children suggests trilipid cream is more effective than a paraffin-based emollient
.
Allergy
.
2020
;
75
(
10
):
2662
4
.
39.
Taylor
MJ
,
Rosenqvist
MA
,
Larsson
H
,
Gillberg
C
,
D'Onofrio
BM
,
Lichtenstein
P
.
Etiology of autism spectrum disorders and autistic traits over time
.
JAMA Psychiatry
.
2020
;
77
(
9
):
936
43
.
40.
Shaw
CA
,
Sheth
S
,
Li
D
,
Tomljenovic
L
.
Etiology of autism spectrum disorders: genes, environment, or both
.
OA Autism
.
2014
;
2
(
2
):
11
.
41.
Hyman
SL
,
Levy
SE
,
Myers
SM
Council On Children With Disabilities, Section On Developmental And Behavioral Pediatrics
.
Identification, evaluation, and management of children with autism spectrum disorder
.
Pediatrics
.
2020
;
145
(
1
):
e20193447
.
42.
Wong
C
,
Odom
SL
,
Hume
KA
,
Cox
AW
,
Fettig
A
,
Kucharczyk
S
.
Evidence-based practices for children, youth, and young adults with autism spectrum disorder: a comprehensive review
.
J Autism Dev Disord
.
2015
;
45
(
7
):
1951
66
.
43.
Bennett
K
,
Reichow
B
,
Wolery
M
.
Effects of structured teaching on the behavior of young children with disabilities
.
Focus Autism Other Dev Disabl
.
2011
;
26
(
3
):
143
52
.
44.
Smith
T
,
Iadarola
S
.
Evidence base update for autism spectrum disorder
.
J Clin Child Adolesc Psychol
.
2015
;
44
(
6
):
897
922
.
45.
Arky
B
.
Autism and medication
.
Child Mind Institute
. obtained on 8 22 2022.
46.
Siniscalco
D
,
Schultz
S
,
Brigida
AL
,
Antonucci
N
.
Inflammation and neuro-immune dysregulations in autism spectrum disorders
.
Pharmaceuticals
.
2018
;
11
(
2
):
56
.
47.
Billeci
L
,
Tonacci
A
,
Tartarisco
G
,
Ruta
L
,
Pioggia
G
,
Gangemi
S
.
Association between atopic dermatitis and autism spectrum disorders: a systematic review
.
Am J Clin Dermatol
.
2015
;
16
(
5
):
371
88
.
48.
Tsai
TY
,
Chao
YC
,
Hsieh
CY
,
Huang
YC
.
Association between atopic dermatitis and autism spectrum disorder: a systematic review and meta-analysis
.
Acta Derm Venereol
.
2020
100
10
adv00146
.
49.
Zerbo
O
,
Leong
A
,
Barcellos
L
,
Bernal
P
,
Fireman
B
,
Croen
LA
.
Immune mediated conditions in autism spectrum disorders
.
Brain Behav Immun
.
2015
;
46
:
232
6
.
50.
Croen
LA
,
Qian
Y
,
Ashwood
P
,
Daniels
JL
,
Fallin
D
,
Schendel
D
.
Family history of immune conditions and autism spectrum and developmental disorders: findings from the study to explore early development
.
Autism Res
.
2019
;
12
(
1
):
123
35
.
51.
Bernardini
N
,
Skroza
N
,
Marraffa
F
,
Prevete
E
,
Mambrin
A
,
Proietti
I
.
A case of twins affected by psoriasis, psoriatic arthritis and autism: five years of efficacious and safe treatment with Secukinumab
.
Dermatol Ther
.
2022
;
35
(
7
):
e15533
.
You do not currently have access to this content.