Atenolol-induced psoriasiform photodermatitis evolving into sezary syndrome - a case report

Development of sezary syndrome from photodermatitis induced by atenolol in a 74-year old lady is described.     

Psoriasis vulgaris - an inflammatory skin disease and/or benign epidermal hyperplasia

Psoriasis vulgaris (PV) is a systemic inflammatory disease in which immune and genetic factors are involved in the pathogenesis. Some treatment approaches in PV patients have been similar to therapy of some tumors. This fact has led to a new scientific approach to PV not only as an inflammatory disease, but also as a benign epidermal hyperplasia or a benign tumor. In this article, we hypothesize that there has been a parallel between some benign tumors and neoplasms and PV. The aim of this article is to present the approach to PV as an inflammatory disease as well as benign epidermal hyperplasia or tumor, and to introduce a new meaning.     

Expression of sarco/endo-plasmic reticulum Ca2+-ATPase type 2 isoforms (SERCA2) in normal human skin and mucosa,and Darier's disease skin

BACKGROUND: The recent report that mutations in ATP2A2, which encodes the Ca2+ transporting sarco/endo-plasmic reticulum pump type 2 isoforms (SERCA2), cause Darier's disease (DD) suggests that SERCA2 plays an important role in epidermal cell adhesion and differentiation. However, no data exist regarding SERCA2 expression in normal human skin, mucosa and DD. OBJECTIVES: We have therefore investigated SERCA2 expression in normal human skin (40 samples), oral and vaginal mucosa (13 samples) and DD lesional skin (six samples). MATERIALS AND METHODS: These investigations were performed with a mouse monoclonal antibody specific for human SERCA2, using a standard ABC immunoperoxidase technique. RESULTS: SERCA2 was expressed in all specimens. SERCA2 expression was pronounced in the subnuclear aspect of basal epidermal keratinocytes, with variable suprabasal expression. SERCA2 expression was also observed in the infundibulum and outer root sheath of hair follicles; germinative and mature cells of sebaceous glands; secretory coil and duct of eccrine glands; apocrine gland cells, and arrector pili muscle. Fibroblasts and blood vessels (endothelium and muscle) expressed SERCA2, whereas nerves did not. SERCA2 expression was observed throughout oral and vaginal mucosa. In DD skin, strong SERCA2 positivity was detected in the basal, suprabasal and acantholytic lesional cells. Perilesional DD skin was comparable to normal skin. CONCLUSIONS: These findings support the hypothesis that SERCA2 is an important player in cutaneous biology, and provide baseline data that will facilitate the design and interpretation of functional studies of cutaneous SERCA2.     

Expression pattern of VEGFR-1, -2, -3 and D2-40 protein in the skin of patients with systemic sclerosis

The earliest clinical symptoms of systemic sclerosis (SSc) relate to disturbances in the peripheral vascular system. However, detailed examination of the microcirculation including the lymphatics in the skin of patients with SSc has not been reported. The aim of our study was to examine the expression patterns of vascular endothelial growth factor receptor (VEGFR)-1, VEGFR-2, VEGFR-3 and the lymphatic endothelial cell marker D2-40 in the skin of SSc patients. Skin biopsy specimens from nine patients with SSc were analysed by immunohistochemistry using antibodies against VEGFR-1, VEGFR-2, VEGFR-3 and D2-40 protein. The lumen area of lymphatic vessels was measured. The data were statistically analysed using the Mann-Whitney U test, Wilcoxon signed-ranks or Spearman's rank correlation coefficient method. The intensity of VEGFR-2 and VEGFR-3 staining in the skin of patients with SSc was significantly higher than that in healthy controls. The lumen area of lymphatic vessels in the skin of patients with SSc was significantly larger than that in healthy controls. This study details the expression of VEGFR and D2-40 in the skin of patients with SSc, and highlights a possible role of microcirculatory dysfunction in the pathogenesis of systemic sclerosis.     

Epidemiology of occupational skin disease in Singapore 1989-1998

This is an epidemiologic study of occupational skin disease in Singapore. All patients diagnosed with occupational dermatoses in the National Skin Centre, Singapore, over the 10-year period 1989-1998 were studied retrospectively. Irritant contact dermatitis was found to be more common than allergic contact dermatitis. The major sources of occupational dermatitis in Singapore were the metal/engineering, building/construction, electrical/electronics and transport industries. The main irritants were detergents/wet work, solvent and oil/grease. The main allergens were chromate, rubber chemicals and nickel. We concluded that the main sources of occupational skin disease and main allergens in Singapore had remained the same compared to a similar study of occupational skin diseases in 1984-85. Weak irritants are still the predominant causes of occupational irritant contact dermatitis, though the main irritants have changed compared to the previous study, where cutting fluids, cement and solvent were the most common irritants.     

Severe combined immunodeficiency mouse-human skin chimeras: a unique animal model for the study of psoriasis and cutaneous inflammation

Elucidation of the molecular and cellular mechanisms responsible for the pathogenesis of psoriasis had been significantly handicapped due to lack of an ideal animal model. To overcome this hurdle several investigators have developed a number of animal models for psoriasis. Recent establishment of the SCID-human skin chimeras with transplanted psoriasis plaques has opened new vistas to study the molecular complexities involved in psoriasis. This model also offers a unique opportunity to investigate various key biological events such as cell proliferation, angiogenesis, homing in of T cells in target tissues, neurogenic inflammation and cytokine/chemokine cascades involved in an inflammatory reaction. The SCID mouse model will be of immense help to target the cellular and molecular events associated with these pathogenic processes and develop novel drugs for psoriasis and other inflammatory diseases. In this article we have reviewed the prospects and the limitations of the SCID mouse model of psoriasis.     

Patterns in naevoid skin disease: development,disease and modelling

Please cite this paper as: Patterns in naevoid skin disease: development, disease and modelling. Experimental Dermatology 2010; 19: 240–245. Abstract: The aetiology of pattern‐formation in human naevoid skin disease remains unknown. However, it is likely that the majority of previously proposed mechanisms – those that simply rely on passive clonal trafficking in embryogenesis – are incomplete. A more comprehensive explanation for pattern‐formation in naevi invokes the principle of self‐organization. We define two types of patterning: anatomical and functional. Anatomical patterning is where the abnormal clone is limited to regions of pathologic skin, while functional patterning is where the abnormal clone and pathologic skin are spatially uncorrelated. From a theoretical perspective self‐organized naevoid patterns may be either secondary to local interactions between normal and aberrant genotypes or due to the interaction between aberrant genotypes and the presence of normal embryonic patterning cues. The latter possibility suggests the critical observation and analysis of patterns in naevoid skin disease may lead to unique insights into key aspects of early human embryogenesis.     

人源性单纯疱疹病毒Ⅱ型抗gD蛋白噬菌体单链抗体库的构建

目的:利用HSV-2病毒IgG、IgM抗体阳性的生殖器疱疹患者外周血淋巴细胞,构建人源单链抗体库。方法:取患者外周血淋巴细胞提取总RNA,逆转录成cDNA,以其为模板,分别扩增抗体重链及轻链可变区基因,将重链、轻链可变区基因拼接成单链抗体(scFv)基因,酶切后连接到噬菌粒载体pFAB5c中,将重组噬菌粒载体电转化大肠杆菌XL-1Blue,构建噬菌体抗体库并测定其库容量。结果:成功构建人源性单纯疱疹病毒抗gD蛋白噬菌体抗体库,库容达1.86×106。结论:利用RT-PCR和噬菌体表面展示技术成功构建了HSV-2抗gD蛋白人源性单链抗体库,为其进一步的研究打下了基础。     

IgG4-related skin disease, a mimic of angiolymphoid hyperplasia with eosinophilia

Mikulicz's disease is considered one of the IgG4-related diseases that are characterized by elevated serum IgG4 concentrations and the immunohistochemical finding of IgG4-positive plasma cells. The IgG4-related diseases often exhibit a wide variety of eosinophil infiltration. A 66-year-old male with Mikulicz's disease developed multiple, nonpruritic, red papules on the left opisthotic region 2 years after diagnosis. A biopsy of the skin lesions revealed follicle-like formation in the dermis and subcutaneous tissue containing nodular lymphocytic infiltration with numerous eosinophils and plasma cells, predominately around venules, mimicking angiolymphoid hyperplasia with eosinophilia (ALHE). Immunohistochemically, most IgG-expressing plasma cells were positive for IgG4 (IgG4/IgG ratio = 72%). Our patient appeared to have a condition associated with the IgG4-related diseases. Caution should be exercised in diagnosing skin lesions of the IgG4-related diseases, which are confusingly similar in appearance and histology to ALHE.     

Scleromyxoedema (lichen myxoedematosus) associated with a paraprotein, IgG1 of type kappa

A case of scleromyxoedema (lichen myxoedematosus) associated with an IgG₁, type kappa paraproteinaemia is reported. Culture of bone marrow material demonstrated that this tissue synthesized monoclonal IgG (subclass γ I) with a light chain of type kappa. The culture of a biopsy specimen of the diseased skin demonstrated low-speed IgG synthesis. It is concluded that the bone marrow and pathological skin synthesize a paraprotein with the same characteristics as that in the serum. Microchemical analysis of pathological skin demonstrated an increase in the content of neutral glycoproteins, hyaluronic acid and chondroitin sulphates as well as the presence of heparin and keratan sulphates. It could not be demonstrated that the serum of this patient contained antibody against connective tissue ground substance or other skin constituents.     

Granulomatous slack skin disease: a review,in comparison with mycosis fungoides

Granulomatous slack skin (GSS) is a rare cutaneous disorder characterized by the evolution of circumscribed erythematous loose skin masses, especially in the body folds, and histologically by a loss of elastic fibers and granulomatous T‐cell infiltrates. This disease is often associated with preceding or successive lymphoproliferative malignancies, especially Mycosis Fungoides (MF) and Hodgkin’s Disease (HD). Whether Granulomatous Slack Skin Disease is a benign disorder, an unusual host reaction or a precursor of malignant lymphoma or an indolent Cutaneous T‐cell Lymphoma (CTCL) in itself, is still a controversy. This article reviews its literature on the etiology, clinical findings, and treatment of Granulomatous Slack Skin Disease. It also concentrates on its association with Hodgkin’s disease and its comparison with Mycosis Fungoides and Sezary Syndrome.