Homo sapiens tends to see itself as the centre of the universe, so it is no surprise that “Skin Biology 101” teaches that development of the epidermis works in one direction – from the inside to the outside. One directional thinking also suggests the purpose of the barrier is to protect “our precious inside” from “the wicked outside” (though microbiologists could doubtless argue that biome defence against immunological attack is the philosophical reality!).

There are many external and internal factors that regulate and influence the differentiation and movement of keratinocytes from the basal lamina up through the epidermis to become the anucleate toughened corneocyte “bricks” embedded in lipid-rich matrix “mortar” we know as “the skin barrier”.  As with other biological barriers, its ultimate quality and effectiveness arises from a complex inter-relationship between internal physiology and external environment.

The INSIDE-OUT or OUTSIDE–IN? debate is not just a philosophical discussion, it has important research and practical implications. For example research suggests the skin biome has an important immune modulating effect early in life and the species of this biome from deeper in the SC may be more representative – more part of us than apart from us?

  • What happens when we disturb this system?
  • How reliant are we on the skin biome for barrier homeostasis?

There are many sides to this discussion, but at 16:30 on 18th September at Stratum Corneum VIII in Cardiff,  the “Inside-Out v Outside-In” question will be debated with the proposition:-

Studies of atopic dermatitis and other diseases involving both barrier disruption and immunological factors have taught us that Outside-In (barrier defects) is more important, than Inside Out, (pathogenesis arising from immunology).

In the debate we want to challenge preconceptions in an entertaining, informative and inclusive manner.  Experts will argue the case for and against and delegates will get their chance to question, argue their point and ultimately vote to decide which side has made the best case – Inside-Out or Outside-In?

The winning side will be awarded “The Squame of Reason” plaque!

What’s your view? Let us know here and, better still, come listen and take part in Cardiff.

For more on the programme and registration Click the CARDIFF 2014 STRATUM CORNEUM VIII link in the side panel


Outside In

Steve Barton – SCVIII Organising Committee