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

Abstract Skin biopsies are commonly used for the assessment of skin pathology in various skin diseases including atopic dermatitis (AD). However, due to 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 willing to give biopsies. Recently, researchers have began studying the skin with a minimal, non-invasive technique using skin tape strips (STS) to profile the epidermal transcriptome, proteins, and lipids in the skin. However, side by side comparisons of skin biopsy and STS have not been done to assess epidermal penetration. Therefore, 20 STS were collected from the volar surface of forearm from healthy non-atopic subjects and patients with AD, followed by the collection of skin biopsies from adjacent non- taped and taped area of skin. Using H&E staining and immunostaining, we demonstrated that 20 STS reach 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 non-invasive and reliable approach to evaluate the expression of skin terminal differentiation markers, which are defective in AD skin.