伊藤痣上继发色素减退斑1例

报告1例伊藤痣上继发色素减退斑。患者女,43岁。7个月前原左颈肩区先天性蓝色斑片中开始出现色素改变：自后体表正中线向左,呈瓷白色、天蓝色及黄蓝色逐渐改变。天蓝色皮损组织病理检查示：表皮基底层黑素细胞消失．真皮浅层及中层少量梭形黑素细胞及较多形态各异的载色素细胞。表皮轻度海绵形成、角化不全、角质形成细胞局灶性坏死及基底层空泡变性。表、真皮交界处淋巴细胞浸润。诊断为继发于伊藤痣上的晕痣（halonevus）和晕皮炎（halo dermatitis）。     

Textile chemical finish dermatitis

Chemicals used on fabrics to improve 10 different performance characteristics have resulted in irritant or allergic contact dermatitis. The most significant problem is due to formaldehyde and N-methylol compounds to produce durable press fabrics. Little is known about incidence of finish dermatitis or mode and amount of transfer of chemicals from fabric to skin.     

Textile dermatitis: an update

Cases of textile-related dermatitis reported in the medical literature after the mid-1980s are reviewed. Part I focuses on cases in which textile resins, fiber additives, or fibers were the causal agent. Studies which provide insight into understanding fabric-induced prickle and itch are included.     

IgE-positive epidermal Langerhans cells in allergic contact dermatitis lesions provoked in patients with atopic dermatitis

Summary To see whether or not IgE-bearing epidermal Langerhans cells are specific to skin lesions of atopic dermatitis (AD), we performed immunohistochemical and immunoelectron microscopic examinations of dinitrochlorobenzene (DNCB) contact dermatitis lesions provoked in uninvolved skin of eight patients with AD. In all of the eight examined, IgE-positive epidermal Langerhans cells were observed in the DNCB dermatitis lesions. Typical staining of anti-IgE was absent in the epidermis of normal-appearing skin of five patients with AD. Thus, it is likely that IgE positive epidermal Langerhans cells non-specifically occur in different eczematous diseases provoked in patients with AD.     

Textile dye allergic contact dermatitis prevalence

This article summarizes textile dye prevalence studies and makes recommendations for advancing knowledge about textile-dye sensitization. Prevalence data is provided by study and by dye. Dermatology teams are encouraged to conduct textile-dye prevalence studies in countries other than Italy, include dyes for which the least prevalence data has been collected, to standardize method of application and reading, and to verify purity and identity of dyes used for patch testing. Testing with pure dyes and other chemicals in dye formulations should provide insights in choosing dye systems that will decrease sensitization.     

The role of cutaneous dendritic cells in the immunopathogenesis of atopic dermatitis

We review the immunology of atopic dermatitis (AD) and focus attention on the role of cutaneous dendritic cells. AD is a complex immune-mediated skin disorder characterized by the recruitment of both CD4+ and CD8+ T cells into the skin. T-helper (Th) 2-type cytokines are dominant in acute AD skin, while both Th1- and Th2-type cytokines are present in chronic AD. Cutaneous dendritic cells, which are present in increased numbers within AD skin, are believed to play a key part in the activation of T cells in the skin. They may also help to determine the pattern of cytokines produced by activated effector T cells.     

Leukoderma in patients with atopic dermatitis

Atopic dermatitis (AD) is occasionally associated with vitiligo, however, the incidence and conditions of vitiligo or leukoderma, and the characteristics of concurrent AD, remain unclear. We conducted a prospective observational study to investigate the leukoderma‐related clinical manifestations and bioparameters of AD. Because vitiligo in AD lesions is occasionally associated with inflammation, we used leukoderma in this study. Enrolled were all AD patients who had been followed up in our AD outpatient clinic and visited within the previous 4 months. During this period, we carefully inspected whether the patients had leukoderma. Eight of 52 patients had leukoderma (15.4%) and were designated as the leukoderma group, and the remaining 44 patients comprised the non‐leukoderma group. While the ages were statistically not different between the two groups, female preponderance was significantly observed in the leukoderma group. The leukoderma patients tended to have higher values of SCORAD, CCL17/thymus and activation regulated chemokine and lactate dehydrogenase than the non‐leukoderma patients. The leukoderma group was also characterized by a lower frequency of allergic rhinitis and a higher frequency of prurigo lesions. Thus, despite the possession of high AD severity, the leukoderma patients may possibly retain a relatively T‐helper 1‐skewing state in relation to the development of leukoderma and less association with rhinitis.     

Immunocytochemical detection of the carbohydrate antigen, Sialyl Lewisx, in normal human skin and during irritant contact dermatitis

Abstract Sialys Lewis^x (SLex) is a ligand for the E-selectin and the interaction of E-selectin on the endothelium and SLe^x on T cells may be important for T-cell migration into the skin. We investigated the expression of SLe^x on Langerhans cells (LC) in normal skin and on LC repopulating epidermis deprived of LC due to a preceding irritant contact dermatitis. SLe^x was visualized by fluorescence and light microscopic immunocytochemistry using the monoclonal antibody. CSLEX-1. The results showed that about 40% of LC in normal epidermis express SLe^x. In the repopulation phase, most of the epidermal cells were CDla⁺/SLe^x+. We suggest that SLe^x is present on epidermal LC that have recently immigrated from the dermis.     

Phenotype of Langerhans cells in human afferent skin lymph derived from allergic contact dermatitis

Abstract By means of microsurgical lymph cannulation human skin lymph derived from the late phase of an elicitation reaction to diphenylcyclopropenone was sampled. Cells were isolated by centrifugation and then treated with mouse anti-CDl a mnonoclonal antibodies and sheep antimouse antibody-coated Dynabeads. Ultrastructural and immunocytochemical analyses revlaled anti-CDl a/Dynabead-rosetted CDl a- and protein S-100-positive cells which did not express monocyte surface markers, but surface antigens such as HLA-DR, ICAM-I and, in part, LFA-3. In comparison to freshly prepared human epidermal Langerhns cells (LC), a large fraction of these cells contained no or markedly fewer Birbeck granules and exhibited extensive ruffling of the surface. These data suggest that the phenotype of LC in skin lymph derived from the elicitation phase of allergic contact dermatitis is similar to LC cultured in vitro. In the functional concept or LC or our time, these cells correspond to the dendritic cells designated as “veiled”.     

Phenotyping of epidermal dendritic cells allows the differentiation between extrinsic and intrinsic forms of atopic dermatitis

Atopic dermatitis (AD) is a clinically characteristic, chronic inflammatory skin disease of unknown origin. IgE-mediated uptake and antigen focusing of environmental allergens by dendritic cells (DCs) is assumed to be a central immunopathogenetic event. A so-called intrinsic type of AD (IAD) has been delineated from the more common extrinsic AD (EAD) by normal serum IgE levels, negative RAST tests and negative immediate-type skin reactions towards environmental allergens. The recently characterized human autoantigen Hom S 1 has been proposed to play a part in the pathogenesis of IAD. OBJECTIVES: To compare clinical and laboratory data between patients with IAD and EAD, and to investigate potential differences in the inflammatory micromilieu of the epidermal compartment in IAD and EAD lesions. METHODS: Epidermal DC phenotyping, a recently validated technique based on the three-colour flow cytometric analysis of Langerhans cells and the so-called inflammatory dendritic epidermal cells from epidermal single-cell suspensions, was performed on samples from 69 patients with AD (seven with IAD and 62 with EAD) and 94 controls. RESULTS: Patients with EAD tended to have an earlier onset of disease but similar disease duration and family history of atopic diseases. Quantitative analysis of CD36 expression on DCs as a marker of inflammation, as well as the percentage of inflammatory dendritic epidermal cells in the CD1a+ epidermal DC pool, indicated a comparable disease activity in IAD and EAD. EAD was characterized by a significantly higher FcepsilonRI expression on the CD1a+ epidermal DCs than IAD. Using the FcepsilonRI/FcgammaRII expression ratio as a disease marker for AD, values for IAD fell below the diagnostic cut-off level of 1.5 for this ratio. CONCLUSIONS: While IAD is clinically similar to EAD, the inflammatory microenvironment in this condition seems different from classical EAD and can be distinguished by phenotyping of epidermal DCs.     

Role of keratinocytes in allergic contact dermatitis

Although once thought to play a purely structural role, there is increasing evidence that keratinocytes are actively involved in epidermal immune responses, including allergic contact dermatitis (ACD). In vitro studies demonstrate that both urushiol and nickel sulphate induce cytokine production in cultured keratinocytes including molecules responsible for endothelial cell activation and lymphocyte chemotaxis and adhesion. In vivo, these same molecules are expressed in experimentally induced patch test reactions to a variety of allergens. Furthermore, such expression precedes the onset of the inflammatory phase of ACD. Taken together, these studies suggest a role complementary to that of Langerhans cells for keratinocytes in the initiation and propagation of ACD.     

Textile dermatitis from Disperse Blue 85 in a knee brace

In some cases, the diagnosis of contact dermatitis caused by textiles may be difficult because of its considerable clinical polymorphism (1, 2).