Skin changes(e.g. seborrhoea) are a recognised feature of some patients with Parkinson’s disease (PD). The relationship between the skin changes in PD is not understood and has not been analysed in depth. Hypotheses include abnormal dopaminergic control, parasympathetic hyperactivity, hormonal control and pooling of sebum due to immobility. Quantitative or qualitative changes in sebum and their possible relationship to disease subtype, or disease severity have not been evaluated using modern methodology. We aim to measure the skin profile: sebum level, pH, hydration and lipid composition of facial skin in patients with PD to determine any relationship between skin findings and type or severity of neurologic disease and compare them to patients with atypical parkinsonism and controls.
Non-invasive methods: a handheld device (Courage+Khazaka electronic GmbH) and adhesive patches (Sebutape and DSquame discs) will be used to measure skin profile. Unified Parkinson’s disease Rating Scale (UPDRS) will be assessed on the day of skin analysis. Skin examination will be performed using standardised conditions (on medication, set skin preparation protocol, regulated room temperature and humidity, mid-morning sampling).
Our preliminary study of 55 PD patients and 57 age-and sex-matched controls with normal facial skin and without family history of neurodegeneration showed that PD patients (especially females) have higher skin surface sebum levels than control subjects, sebum levels are higher in those with moderate PD (higher UPDRS-III) than those with mild disease and those with tremor-predominant PD have lower sebum levels compared to patients with more severe postural instability gait disorder and mixed subtypes. There was no difference in skin hydration.
In the presence of normal skin hydration and pH levels these surface sebum changes may reflect a hitherto unrecognised neurocutaneous link in PD that merits further evaluation. Sebum production and analysis may offer a diagnostic marker and/or a biomarker for PD.
