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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.

BACKGROUND: Expression profiling of skin biopsies has established molecular features of the skin in atopic dermatitis (AD). Invasiveness of biopsies has prevented their use in defining individual level AD pathobiological mechanisms (endotypes) in large research studies. OBJECTIVE: To determine if minimally invasive skin tape strip transcriptome analysis identifies gene expression dysregulation in AD and molecular disease endotypes. METHODS: We sampled non-lesional and lesional skin tape strips and biopsies from adult Caucasian subjects AD patients (18 males, 12 females; age (Mean±SE) 36.3±2.2 yrs) and healthy controls (9 males, 16 females; age (Mean±SE) 34.8±2.2 yrs). Ampliseq whole transcriptome sequencing was performed on extracted RNA. Differential expression, clustering/pathway analyses, immunostaining of skin biopsies, and clinical trait correlations were performed. RESULTS: Skin tape expression profiles were distinct from skin biopsy profiles and better sampled epidermal differentiation complex genes. Skin tape expression of 29 immune and epidermis-related genes (FDR