Side-by-Side Comparison of Skin Biopsies and Skin Tape Stripping Highlights Abnormal Stratum Corneum in Atopic Dermatitis

Skin biopsies are commonly used for the assessment of skin pathology in various skin diseases, including atopic dermatitis (AD). However, because of the invasive nature of skin biopsies, many patients, particularly children, decline participation. This can lead to potential subject sampling bias as data could be skewed toward more severe, older patients who are willing to have biopsies. Recently, researchers have begun studying the skin with a minimal, noninvasive technique using skin tape stripping (STS) to profile the epidermal transcriptome, proteins, and lipids in the skin. However, side-by-side comparisons of skin biopsies with STS have not been done to assess epidermal penetration. Therefore, 20 STS were collected from the volar surface of forearms from healthy nonatopic subjects and patients with AD, following this skin biopsies were collected from adjacent nontaped and taped areas of the skin. Using hematoxylin and eosin staining and immunostaining, we demonstrated that 20 STS reached the upper granular layer of the epidermis. Additionally, we found that the expression of terminal differentiation markers in samples from STS procedure positively correlated with the expression level of these markers in matching skin biopsies. Therefore, STS is a noninvasive and reliable approach to evaluate the expression of skin terminal differentiation markers, which are defective in AD skin.