Quantification of skin erythema response to topical alcohol in alcohol-intolerant East Asians

Background/Purpose: Severe alcohol intolerance characterized by flushing, headache, nausea, and tachycardia even after very modest oral alcohol consumption, is common among East Asians (Chinese, Japanese, Koreans) and has been associated with the accumulation of acetaldehyde resulting from genetic polymorphism of aldehyde dehydrogenase (ALDH). These individuals also display erythema of the skin in response to exposure to topical alcohol. We have recently observed that dietary phytochemicals such as sulforaphane can accelerate the disposal of acetaldehyde from cells and animals by inducing ALDH. The goal of this study was to quantify the erythema response of skin to topical alcohol exposure. Methods: The erythema response of the forearm skin of healthy Japanese with unusual alcohol sensitivity evoked by a range of very low doses of alcohol (2, 4, 8, and 16 μmol/cm²) was determined by means of a chromometer, which measures a* values (red-green scale). Results: The magnitude of the a* response (∆a*) to alcohol was time- and dose-dependent, but differed considerably among individuals. It was much higher in those individuals who claimed to be alcohol intolerant, and ∆a* was unrelated to the initial a* values of the skin prior to alcohol challenge. Conclusion: The ∆a* index is suitable for the quantitative determination of topical alcohol-induced erythema response, and the evaluation of effectiveness of protective strategies against erythema response.