Skin water loss and accidental hypothermia in psoriasis, ichthyosis, and erythroderma.

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Abstract
The transepidermal water loss from the skin, due to the passive diffusion of water through the epidermis, was greatly increased in psoriasis and erythroderma and slightly but highly significantly increased in ichthyosis. Improvement of the skin condition showed a corresponding decrease in the water loss. In 47 normal subjects the mean transepidermal water loss from the abdomen was extremely small: 0. 35 (S. D. 0. 09) mg/sq. cm/hr. (skin temperature 32-36[degree]C., relative humidity 2-5%); the maximal loss from the whole body in a dry ambient humidity amounting to only 151 (S. D. 44.2) ml/day. No significant correlation was found with age. A slight but significant regional variation was observed, the loss from the calf and thigh being greater than from the abdomen. In patches of psoriasis the transepidermal water loss could be as much as 20 times that of normal, 5.37 (S. D. 2. 6) mg/sq. cm/hr. (relative humidity 10[long dash]70%). In ichthyosis the loss was about twice the normal, and sweating from the trunk and limbs was markedly reduced, though sweating from the constantly sweating emotional areas (palms, soles, axillae, dorsal distal phalanges and face) was normal in 8 of the 9 cases. In erythroderma the daily transepidermal water loss was about 14 times normal and could be as high as 2158 (S.D. 1019) ml/day. The loss of heat by vaporization of the increased transepidermal water loss could explain the hypothermia and increased basal metabolic rates which occur in some cases of erythroderma.