{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:22:19Z","timestamp":1789363339307,"version":"build-2803163510"},"reference-count":73,"publisher":"Wiley","issue":"s4","license":[{"start":{"date-parts":[[2014,6,16]],"date-time":"2014-06-16T00:00:00Z","timestamp":1402876800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The skin is the largest organ of the body, providing a protective barrier against bacteria, chemicals and physical insults while maintaining homeostasis in the internal environment. Such a barrier function the skin ensures protection against excessive water loss. The skin's immune defence consists of several facets, including immediate, non\u2010specific mechanisms (innate immunity) and delayed, stimulus\u2010specific responses (adaptive immunity), which contribute to fending off a wide range of potentially invasive microorganisms. This article is an overview of all known data about \u2018fragile skin\u2019. Fragile skin is defined as skin with lower resistance to aggressions. Fragile skin can be classified into four categories up to its origin: physiological fragile skin (age, location), pathological fragile skin (acute and chronic), circumstantial fragile skin (due to environmental extrinsic factors or intrinsic factors such as stress) and iatrogenic fragile skin. This article includes the epidemiologic data, pathologic description of fragile skin with pathophysiological bases (mechanical and immunological role of skin barrier) and clinical description of fragile skin in atopic dermatitis, in acne, in rosacea, in psoriasis, in contact dermatitis and other dermatologic pathologies. This article includes also clinical cases and differential diagnosis of fragile skin (reactive skin) in face in adult population. In conclusion, fragile skin is very frequent worldwide and its prevalence varies between 25% and 52% in Caucasian, African and Asian population.<\/jats:p>","DOI":"10.1111\/jdv.12509","type":"journal-article","created":{"date-parts":[[2014,6,16]],"date-time":"2014-06-16T23:03:35Z","timestamp":1402959815000},"page":"1-18","source":"Crossref","is-referenced-by-count":43,"title":["Fragility of epidermis and its consequence in dermatology"],"prefix":"10.1111","volume":"28","author":[{"given":"J.F.","family":"Stalder","sequence":"first","affiliation":[{"name":"Department of Dermatology University Hospital of Nantes Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Tennstedt","sequence":"additional","affiliation":[{"name":"Department of Dermatology Saint\u2010Luc University Clinics Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Deleuran","sequence":"additional","affiliation":[{"name":"Department of Dermatology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Fabbrocini","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"de Lucas","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital La Paz Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Haftek","sequence":"additional","affiliation":[{"name":"University Lyon 1 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Taieb","sequence":"additional","affiliation":[{"name":"Pierre Fabre SA Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Coustou","sequence":"additional","affiliation":[{"name":"Private Dermatologist Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Mandeau","sequence":"additional","affiliation":[{"name":"Herbal Product Laboratory Institut de Recherche Pierre Fabre Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Fabre","sequence":"additional","affiliation":[{"name":"Herbal Product Laboratory Institut de Recherche Pierre Fabre Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Hernandez\u2010Pigeon","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Pharmacologie in vitro Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.F.","family":"Aries","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Pharmacologie in vitro Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.F.","family":"Galliano","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Pharmacologie in vitro Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Duplan","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Pharmacologie in vitro Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Castex\u2010Rizzi","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Pharmacologie in vitro Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bessou\u2010Touya","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Pharmacologie in vitro Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Mengeaud","sequence":"additional","affiliation":[{"name":"Pierre\u2010Fabre Dermo\u2010Cosm\u00e9tique European Center of Skin Research H\u00f4tel Dieu Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Rouvrais","sequence":"additional","affiliation":[{"name":"Pierre\u2010Fabre Dermo\u2010Cosm\u00e9tique European Center of Skin Research H\u00f4tel Dieu Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Pierre\u2010Fabre Dermo\u2010Cosm\u00e9tique European Center of Skin Research H\u00f4tel Dieu Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Bottino","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Lavaur France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Cottin","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Lavaur France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Saint Aroman","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermo\u2010Cosm\u00e9tique Lavaur France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,16]]},"reference":[{"key":"e_1_2_19_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2000.00082.x"},{"key":"e_1_2_19_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0022-202x.2001.01664.x"},{"key":"e_1_2_19_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1997.19792087.x"},{"key":"e_1_2_19_5_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M100201200"},{"key":"e_1_2_19_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2010.07.005"},{"key":"e_1_2_19_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2011.09.001"},{"key":"e_1_2_19_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abb.2010.12.019"},{"key":"e_1_2_19_9_1","doi-asserted-by":"publisher","DOI":"10.2217\/rme.13.33"},{"key":"e_1_2_19_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2010.23"},{"key":"e_1_2_19_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/biof.141"},{"key":"e_1_2_19_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O"},{"key":"e_1_2_19_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/humu.21300"},{"key":"e_1_2_19_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.matbio.2014.01.003"},{"key":"e_1_2_19_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.12.668"},{"key":"e_1_2_19_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/dds243"},{"key":"e_1_2_19_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.117020"},{"key":"e_1_2_19_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.12293"},{"key":"e_1_2_19_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12541775"},{"key":"e_1_2_19_20_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0700547104"},{"key":"e_1_2_19_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/jb\/mvh182"},{"key":"e_1_2_19_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.05.003"},{"key":"e_1_2_19_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12681"},{"key":"e_1_2_19_24_1","doi-asserted-by":"publisher","DOI":"10.1083\/jcb.141.5.1277"},{"key":"e_1_2_19_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12203"},{"key":"e_1_2_19_26_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S55223"},{"key":"e_1_2_19_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0039803"},{"key":"e_1_2_19_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07185.x"},{"key":"e_1_2_19_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(87)90016-X"},{"key":"e_1_2_19_30_1","doi-asserted-by":"publisher","DOI":"10.1024\/1422-4917\/a000208"},{"key":"e_1_2_19_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0076493"},{"key":"e_1_2_19_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7547.933"},{"key":"e_1_2_19_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1767"},{"key":"e_1_2_19_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2010.277"},{"key":"e_1_2_19_35_1","doi-asserted-by":"publisher","DOI":"10.1159\/000096915"},{"key":"e_1_2_19_36_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2002.05006.x"},{"key":"e_1_2_19_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08813.x"},{"key":"e_1_2_19_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01683.x"},{"key":"e_1_2_19_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12149"},{"key":"e_1_2_19_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12224"},{"key":"e_1_2_19_41_1","first-page":"626","article-title":"Clinical relevance of skin barrier changes associated with the use of oral isotretinoin: the importance of barrier repair therapy in patient management","volume":"12","author":"Rosso JQ","year":"2013","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_19_42_1","first-page":"18","article-title":"Acne vulgaris and the epidermal barrier: is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and\/or functional integrity of the epidermal barrier?","volume":"6","author":"Thiboutot D","year":"2013","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_19_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01262335"},{"key":"e_1_2_19_44_1","first-page":"49","article-title":"Atopic dermatitis and the stratum corneum: part 2: other structural and functional characteristics of the stratum corneum barrier in atopic skin","volume":"6","author":"Levin J","year":"2013","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_19_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12477026"},{"key":"e_1_2_19_46_1","first-page":"275","article-title":"Facilitating facial retinization through barrier improvement","volume":"78","author":"Draelos ZD","year":"2006","journal-title":"Cutis"},{"key":"e_1_2_19_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5849(02)01187-5"},{"key":"e_1_2_19_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-2165.2009.00455.x"},{"key":"e_1_2_19_49_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0846.2002.00330.x"},{"key":"e_1_2_19_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1992.tb14842.x"},{"key":"e_1_2_19_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(86)70236-3"},{"key":"e_1_2_19_52_1","unstructured":"TanghettiEA.Cleanser and moisturizer use with tazarotene 0.1% cream for acne vulgaris. Poster presented at Fall Clinical Dermatology.Las Vegas NV 2010."},{"key":"e_1_2_19_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0151\u20109638(10)70032\u20106"},{"key":"e_1_2_19_54_1","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.28.601"},{"key":"e_1_2_19_55_1","doi-asserted-by":"publisher","DOI":"10.3109\/15569521003774990"},{"key":"e_1_2_19_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.2009.00861.x"},{"key":"e_1_2_19_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2008.03037.x"},{"key":"e_1_2_19_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.09.017"},{"key":"e_1_2_19_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1996.tb02296.x"},{"key":"e_1_2_19_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.2010.01122.x"},{"key":"e_1_2_19_61_1","first-page":"4","article-title":"La piel sensible","volume":"13","author":"Escalas\u2010Taberner J","year":"2011","journal-title":"M\u00e1s dermatolog\u00eda"},{"key":"e_1_2_19_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.08280.x"},{"key":"e_1_2_19_63_1","first-page":"197","article-title":"A method of a praising the stinging capacity of topically applied substances","volume":"28","author":"Frosch PJ","year":"1977","journal-title":"J Soc Cosmet Chem"},{"key":"e_1_2_19_64_1","first-page":"266","volume-title":"Les Cosm\u00e9tiques","author":"Thiers H","year":"1986"},{"key":"e_1_2_19_65_1","volume-title":"Peaux r\u00e9actives: mythe ou r\u00e9alit\u00e9? R\u00e9alit\u00e9s Th\u00e9rapeutiques en Dermato\u2010V\u00e9n\u00e9r\u00e9ologie","author":"Misery L"},{"key":"e_1_2_19_66_1","first-page":"A24","article-title":"Sensitive skin: epidemiology and seasonal variations","volume":"125","author":"Misery L","year":"2005","journal-title":"J Invest Dermatol"},{"key":"e_1_2_19_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0151-9638(05)79303-0"},{"key":"e_1_2_19_68_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04343.x"},{"key":"e_1_2_19_69_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0536.2002.460205.x"},{"key":"e_1_2_19_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-2494.2004.00243.x"},{"key":"e_1_2_19_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-2130.2004.00082.x"},{"key":"e_1_2_19_72_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1467-2494.2002.00134.x"},{"key":"e_1_2_19_73_1","first-page":"37","article-title":"Allergies aux cosm\u00e9tiques","author":"Pons\u2010Guiraud A","year":"2003","journal-title":"Exp Sc Fr"},{"key":"e_1_2_19_74_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1250649"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12509","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12509","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.12509","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T03:52:22Z","timestamp":1694490742000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.12509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6]]},"references-count":73,"journal-issue":{"issue":"s4","published-print":{"date-parts":[[2014,6]]}},"alternative-id":["10.1111\/jdv.12509"],"URL":"https:\/\/doi.org\/10.1111\/jdv.12509","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6]]}}}