IRRITANCY PATCH TEST COMPARISON 65 Table VI Comparison of Mean Total Cumulative Scores of Each Patch Type by Test Material Test material Total cumulative irritationa Hill Top Chamber occlusive Finn Chamber occlusive Band-Aid semiocclusive Webril semiocclusive Webril occlusive Cream 0.92 ± 2.08 1.13 ± 1.75 0.67 ± 2.01 0.38 ± 0.82b 0.88 ± 3.08 Lotion 8.00 ± 8.75 8.33 ± 7.22 2.46 ± 6.10b,c 0.88 ± 2.13b,c 2.92 ± 5.52b,c,d 2% Bath cream 21.79 ± 5.21 12.75 ± 8.01c 10.67 ± 7.27c 0.71 ± 1.30b,c,e 21.08 ± 8.21b,d,e 1% SLS 35.50 ± 1.06 33.38 ± 2.20c 31.38 ± 2.90b,c 21.92 ± 8.13b,c,e 35.04 ± 1.00b,c,d,e Blank 3.63 ± 2.81 2.67 ± 5.14c 2.67 ± 3.64 0.33 ± 1.09b,c,e 0.96 ± 1.37c,d,e a Numbers represent the mean ± standard deviation total cumulative irritation score (n = 24 subjects). b Signifi cant difference versus Finn Chamber occlusive (p 0.05). c Signifi cant difference versus Hill Top Chamber occlusive (p 0.05). d Significant difference versus Webril semiocclusive (p 0.05). e Significant difference versus Band-Aid semiocclusive (p 0.05). Table VII Comparison of Mean Total Cumulative Scores of Each Test Material by Patch Type Patch type Total cumulative irritationa Cream Lotion 2% bath cream 1% SLS Blank Hill Top Chamber occlusive 0.92 ± 2.08 8.00 ± 8.75b 21.79 ± 5.21b,c 35.50 ± 1.06b,c,d 3.63 ± 2.81b,c,d,e Finn Chamber occlusive 1.13 ± 1.75 8.33 ± 7.22b 12.75 ± 8.01b,c 33.38 ± 2.20b,c,d 2.67 ± 5.14c,d,e Band-Aid semiocclusive 0.67 ± 2.01 2.46 ± 6.10b 10.67 ± 7.27b,c 31.38 ± 2.90b,c,d 2.67 ± 3.64b,d,e Webril semiocclusive 0.38 ± 0.82 0.88 ± 2.13 0.71 ± 1.30 21.92 ± 8.13b,c,d 0.33 ± 1.09e Webril occlusive 0.88 ± 3.08 2.92 ± 5.52b 21.08 ± 8.21b,c 35.04 ± 1.00b,c,d 0.96 ± 1.37d,e a Numbers represent the mean ± standard deviation total cumulative irritation score (n = 24 subjects). b Significant difference versus cream (p 0.05). c Significant difference versus lotion (p 0.05). d Significant difference versus 2% bath cream (p 0.05). e Significant difference versus 1% SLS (p 0.05). In contrast with other test materials, cream was a mild material that had the lowest cu- mulative irritation test scores in our studies. This was probably because cream has a lower level of surfactant compared with the other materials. It had been reported that the initial interaction of surfactant with the intercellular lipids of the stratum corneum leads to penetration of the surfactant into the viable epidermal cell layer underneath. The surfac- tant can then cause cell damage or even cell lysis with the development of a clinically obvious irritant reaction (6). In addition, we found different results between Webril occlusive patch and Webril semi- occlusive patch. Although the same test materials having the same concentrations were applied for the same duration in both patches, the semiocclusive patch showed lower cumulative irritation test scores than the occlusive patch for all test materials. The only difference between the two patches was the adhesive tape one was latex-free hypoaller- genic paper tape, whereas the other was latex-free silklike hypoallergenic tape. The latex- free silklike hypoallergenic tape has worse air permeability. When silklike hypoallergenic

JOURNAL OF COSMETIC SCIENCE 66 tape sticks on the skin, it forms an airtight skin area, which causes sweat as a source of irritant (7). Moreover, occlusion of the skin may cause an increased transepidermal water loss (TEWL) and the increase in TEWL may be interpreted as damage to the skin barrier (8). We also compared the respective impacts on the patch test between the chamber and tape in this study. Among the fi ve patch types, Finn Chamber occlusive showed the highest cumulative irritation scores for cream and lotion. This was because the alumina used was more irritating than rubber and cotton, even though the tape of the Finn Chamber oc- clusive was a microporous paper tape. Considering that cream and lotion were mild and probably acted as a slight irritant to the skin, the type of chamber induced bigger effects on cumulative irritation than type of tape for low irritating material. Hill Top Chamber occlusive revealed the highest cumulative irritation scores, Webril occlusive showed the second highest, and Finn Chamber occlusive showed the third highest for the positive control SLS. This is mainly because the three types of patches have different types of tapes. The tape of Hill Top Chamber occlusive and Webril occlusive was latex-free silk- like hypoallergenic tape, the tape of Finn Chamber occlusive was nonwoven microporous hypoallergenic tape, and the air permeability of latex-free silklike hypoallergenic tape was worse than that of paper tape. This result reveals that the infl uence of the permeabil- ity of tape to cumulative irritation may be greater than the type of chamber for highly irritating material, which encourages us to design further studies to test the idea. ACKNOWLEDGMENTS The patches and test materials were provided by the Johnson & Johnson Company. REFERENCES (1) M. W. Trimble, N. K aul, J. E. Wild, and J. P. Bowman, The differences in human cumulative irritation responses to positive and negative irritant controls from three geographical locations, J. Cosmet. Sci., 58, 519–525 (2007). (2) S. Z. Sajun Merchan t, A. D. Vaidya, A. Salvi, R. S. Joshi, and R. B. Mohile, A new occlusive patch test system comparable to IQ and Finn chambers, Indian J. Dermatol. Venereol. Leprol., 80, 291–295 (2014). (3) J. Brasch, C. Szlis ka, and J. Grabbe, More positive patch test reactions with larger test chambers? Con- tact Dermatitis, 37, 118–120 (1997). (4) D. M. Bagley, E. K. Boisits, T. L. Spriggs, and S. Schwartz, Effect of patch type on the cumulative ir- ritation potential of 4 test materials, Am. J. Contact Dermatitis, 12, 25–27 (2001). (5) S. B. Richard and P . B. James, A reappraisal of the 21-day cumulative irritation test in man, Cutan. Ocul. Toxicol., 1, 109–115 (2008). (6) P. Dykes, Surfactan ts and the skin, Int. J. Cosmet. Sci. 20, 53–61 (1998). (7) C. H. Hu, Sweat-rel ated dermatoses: old concept and new scenario, Dermatologica, 182, 73–76 (1991). (8) T. Agner and J. Ser up, Time course of occlusive effects on skin evaluated by measurement of transepi- dermal water loss (TEWL) including patch tests with sodium lauryl sulphate and water, Contact Derma- titis, 28, 6–9 (1993).