Amanda Feldt, William Lövfors, Elin Nyman, Peter R Worsley, Bijar Ghafouri, Sara Bergstrand
Skin damage from routine oronasal facemask use is common, but the early molecular changes and timing of inflammatory cytokine responses remain poorly characterized due to limitations in conventional detection methods. Early pressure ulcer formation involves a critical window where physiological changes occur before visible signs. This study addresses this gap, aiming to monitor the temporal inflammatory profile in skin sebumsurface after the standard use of oronasal facemasks. Sebum samples were collected from 11 patients at six6 timepoints up to 180 min post-mask removal. A panel of 71 inflammatory proteins was analysed using multivariate statistics, protein network analysis, and mathematical modelling. Two distinct cytokine response phases were identified: an early phase (0-20 min) and a delayed phase (40-180 min), with 17 cytokines driving this separation. Notably, the delayed phase showed sustained elevation despite the absence of visible erythema, indicating ongoing subclinical inflammation. Network analysis revealed activation of pathways related to angiogenesis, cell death regulation, and tissue remodelling - hallmarks of early wound healing and microvascular stress. These findings enhance understanding of early pressure ulcer pathophysiology, identify optimal biomarker sampling windows, and support the development of point-of-care biosensors for early detection and prevention of pressure-induced skin damage.