In Nancy's case, which describes the skin barrier change most likely due to occlusion by absorptive underwear?

In Nancy's case, which describes the skin barrier change most likely due to occlusion by absorptive underwear?

• A. Elevated TEWL (trans-epidermal water loss) and skin pH
• B. Elevated TEWL and reduced skin pH
• C. Elevated perspiration and reduced skin pH
• D. Reduced perspiration and TEWL

Answer: (A)

Occlusion from absorptive underwear creates a consistently moist, warm environment that macerates the skin and weakens the barrier. When the barrier is compromised, water loss through the epidermis increases, so trans-epidermal water loss rises. At the same time, urine exposure is alkaline; the prolonged contact under an occlusive layer raises skin pH, moving it away from its normal acidic level. Together, elevated TEWL and higher skin pH reflect the barrier changes most likely with occlusion. The other patterns aren’t as consistent: occlusion doesn’t primarily reduce TEWL, and the expected pH shift is toward alkalinity rather than more acidic, making the combination of increased TEWL and increased pH the best fit.

Occlusion from absorptive underwear creates a consistently moist, warm environment that macerates the skin and weakens the barrier. When the barrier is compromised, water loss through the epidermis increases, so trans-epidermal water loss rises. At the same time, urine exposure is alkaline; the prolonged contact under an occlusive layer raises skin pH, moving it away from its normal acidic level. Together, elevated TEWL and higher skin pH reflect the barrier changes most likely with occlusion. The other patterns aren’t as consistent: occlusion doesn’t primarily reduce TEWL, and the expected pH shift is toward alkalinity rather than more acidic, making the combination of increased TEWL and increased pH the best fit.