Serum levels of interleukin-6 and interleukin-10 correlate with total skin thickness score in patients with systemic sclerosis

Various growth factors and cytokines have been suggested to play a central role in initiating and developing fibrosis in systemic sclerosis (SSc). To determine which serum levels of soluble mediators are the most relevant to the degree of skin sclerosis in SSc, serum levels of various soluble mediators were examined by ELISA and correlated with skin thickening that was measured using modified Rodnan total skin thickness scoring (TSS) system. Serum levels of IL-4, IL-12, IL-13, tumor necrosis factor-alpha, connective tissue growth factor (CTGF), vascular endothelial growth factor, monocyte chemotactic protein-1, macrophage inflammatory protein-1beta, soluble IL-6 receptor, and soluble L-selectin were higher in SSc patients than normal controls. Levels of IL-6, IL-10, and CTGF in patients with diffuse cutaneous SSc were higher than patients with limited cutaneous SSc and controls. Serum levels of IL-6 and IL-10 positively correlated with TSS in patients with SSc (r=0.625, P<0.0001 and r=0.663, P<0.0001, respectively). In addition, IL-10 levels significantly correlated with pulmonary fibrosis. Thus, serum levels of IL-6 and IL-10 most strongly reflect the extent of skin thickening in SSc, suggesting that levels of IL-6 and IL-10 are useful serological indicators for skin fibrosis in SSc.     

Systemic sarcoidosis presenting with multiple tattoo granulomas and an extra-tattoo cutaneous granuloma

We describe a 29 year old Caucasian man who developed cutaneous sarcoidosis manifesting itself as a tumour at the left outer canthus clinically mimicking a basal cell carcinoma and nine tattoo granulomas. Subsequent investigation revealed that the patient was also suffering from systemic sarcoidosis.     

Mycobacterium chelonae infection with multiple cutaneous lesions after treatment with acupuncture

A 58-year-old-woman was first seen in November 1999 with a 4-week history of several tender, deep red or purple, suppurating subcutaneous nodules on the skin of the abdomen, suggestive of a panniculitis ( Fig. 1 ). She had no history of systemic immunosuppression. Three months prior to examination, the patient had treated with acupuncture for obesity. Two biopsy specimens of the nodules were taken and sent for culture and histologic examination. Histology showed a pattern of panniculitis with chronic inflammatory cells mixed with areas of polymorphonuclear abscesses and necrosis ( Fig. 2 ). Culture of the biopsy specimen grew acid fast bacilli within 4 days, later identified with biochemical and molecular tests as Mycobacterium chelonae (subspecies chelonae). Polymerase chain reaction-restriction enzyme pattern analysis (PRA) was used for molecular identification of mycobacteria. In vitro sensitivity tests showed sensitivity to clarithromycin, amikacin, tobramycin, doxycycline and erythromycin and resistance to ciprofloxacin, ofloxacin, trimethoprim-sulfamethoxazole, imipenem and cefoxitin. Oral clarithromycin (500 mg b.d.) was started and after 3 months of therapy the lesions had cleared completely.

Figure 1 Open in figure viewer PowerPoint Abdomen with disseminated subcutaneous erythematous nodules due to M. chelonae after treatment with acupuncture     

以皮肤结节为显著表现的先天性白血病一例并文献复习

报道1例出生时以皮肤结节为显著表现的先天性白血病并文献复习.患儿,女,出生时即全身弥漫性多发大小不等紫红色结节;外周血示白细胞284.24×109/L,原始细胞90％;皮肤病理示真皮及脂肪层弥漫性密集分布大量非典型细胞,表皮未受累,免疫组化染色CD68、CD43阳性;骨髓穿刺示白细胞数明显增高,以原始和幼稚单核细胞为主...     

Multicentric Castleman disease with cutaneous manifestations: report of 2 cases and comparison with systemic plasmacytosis

We report 2 patients with multicentric Castleman disease. Both presented with multiple, indurated, hyperpigmented plaques, generalized lymphadenopathy and polyclonal hypergammaglobulinemia. Biopsy specimens showed infiltration of mature plasma cells and lymphocytes in the dermis and lymph nodes. Skin specimens were negative for human herpesvirus 8, latent nuclear antigen 1 and Epstein-Barr virus by in situ hybridization. PCR disclosed clonal T-cell receptor gene rearrangement in the bone marrow cells of 1 patient. We discuss the possible relationship between multicentric Castleman disease and systemic plasmacytosis as well as plasma cell proliferation.     

Treatment of cutaneous plasmacytosis with mask‐bath PUVA: A therapeutic option

Cutaneous plasmacytosis (CP) is an uncommon chronic disease of unknown aetiology, reported mainly in middle‐aged patients of Asian descent. It is diagnosed by a constellation of physical, laboratory, radiological and histopathological findings. We report a patient with CP who demonstrated a favorable and promising response to mask‐bath PUVA.     

Increased interleukin-7 levels in the sera of psoriatic patients: lack of correlations with interleukin-6 levels and disease intensity

Interleukin (IL)-7 is a multifunctional cytokine which is involved in the regulation of keratinocyte-T lymphocyte interactions; the latter is an important factor in the pathogenesis of psoriasis. In vitro, IL-7 is able to induce release of cytokines, including IL-6; IL-6 expression is known to be enhanced in psoriatic patients. Serum levels of IL-7 and IL-6 were measured by ELISA in 40 psoriatic patients and compared with cytokine levels in 18 healthy individuals. Serum levels of IL-7 were also evaluated in 24 psoriatic patients during the remission of the disease after effective treatment. The IL-7 and IL-6 serum levels were significantly higher in psoriatic patients than in healthy subjects and the IL-7 serum levels did not significantly decrease after treatment. Serum levels of IL-7 did not correlate with PASI scores; however, a significant positive relationship was observed between IL-6 levels and PASI scores. There was no correlation between increased levels of IL-7 and IL-6 in the sera of psoriatic patients, suggesting the lack of a direct link between these two cytokines in the psoriatic process. In conclusion, increased IL-7 serum levels suggest that IL-7, like IL-6, may be involved in the pathogenesis of psoriasis, but in contrast with IL-6, serum IL-7 levels could not be used as a marker of disease activity in psoriatic patients.