![]() Abnormal muscle contraction related to decreased adenosine triphosphate (ATP) synthesis as well as lower skin pH and adiponectin deficiency may also be related to this phenomenon (11). ![]() Recently, a systematic study of the putative causes of sensitive skin showed a decrease in the density of intra-epidermal nerve fibres as a consequence of the alteration of these nerve endings (10). Sensitive skin is probably related to neuronal mechanisms (8), and it has been shown that there are arguments for neuropathic pain/itch as a factor of sensitive skin (9). Approximately 50% of individuals (60% women and 40% men) report having reactive skin (3), although this patient-reported prevalence varies across European countries (4), the USA (5), Japan (6), Brazil and Russia (7). Although this syndrome is commonly discussed by patients and the media, there is a lack of a clear definition and diagnostic guidance from dermatologists. Sensitive or reactive skin (1, 2) is a common condition that affects many people. ![]() ![]() ![]() 1Department of Dermatology, University Hospital of Brest, 2Laboratory of Neurosciences of Brest, University of Western Brittany, Brest, France, 3Department of Dermatology, Center for Chronic Pruritus, University Hospital of Münster, Münster, Germany, 4Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland, 5Department of Dermatology and Venereology, University Hospital of Lund, Lund, Sweden, 6Department of Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, The Netherlands, 7Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, 8Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan, 9Department of Dermatology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany, 10San Gallicano Dermatological Institute, Rome, Italy, and 11Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany ![]()
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