QUANTITATION OF MAST CELLS AND COLLAGEN FIBERS IN SKIN TAGS

Background:

Skin tags are common benign skin tumors usually occurring on the neck and major flexors of elder people.

Aims:

The aim of this study is to perform quantitation of mast cells and collagen fibers in skin tags and normal skin in diabetics and nondiabetics, to find a possible correlation between mast cells and collagen fibers in the pathogenesis of skin tags.

Methods:

Thirty participants with skin tags were divided into two groups (15 diabetic and 15 nondiabetic). Three biopsies were obtained from one anatomical site: A large skin tag, a small skin tag, and adjacent normal skin. Mast cells stained with Bismarck brown were counted manually in ten different fields of each section with magnification ×1000 and the average count was correlated with the percentage of mean collagen area in five fields done by the image analyzer.

Results:

A statistically significant correlation between mast cell count and percentage of collagen mean area was detected in both studied groups (except in large skin tags of the nondiabetic group).

Conclusion:

The positive correlation between mast cell count and percentage of collagen mean area suggests the critical role of mast cells in the etiogenesis of skin tags through its interaction with fibroblasts.     

DNA SYNTHESIS IN CULTURED EPIDERMAL CELLS FROM PSORIATIC AND NORMAL SKIN

While it is generally accepted that psoriatic epidermis in vivo shows an increase in the number of DNA-synthesizing cells and mitoses, the published data from in vitro studies disagree as to whether or not psoriatic epidermal cells in vitro are more proliferative than normal epidermal cells. In this study, DNA synthesis was measured autoradiographically using cultured epidermal cells from both the involved and uninvolved skin of 8 psoriatic patients as well as from 8 normal individuals. Our results showed no statistically significant differences in DNA synthesis among the three groups.     

THE OXYGEN CONSUMPTION OE THE GEEMINAL EPITHELIUM IN NORMAL AND PSORIATIC SKIN

The Cartesian diver microgasometer was used to study the oxygen consumption in microdissected samples of the basal parts of epidermis. Specimens were taken from guttate lesions and uninvolved skin of psoriatic patients and also from subjects without psoriasis. Incubations were performed in TC 199 phosphate medium supplemented with either 5·6 mM glucose, 20 mM pyruvate or oxalacetate and/or 10 mM sodium succinate. Without supplements to the medium the oxygen consumption averaged 16 mmol./hr. and kg. dry weight and no differences were found between the normal epidermis and the 2 types of psoriatic epidermis. Addition of glucose or pyruvate did not change the rate of respiration. In normal epidermis and in the unaffected epidermis from patients with psoriasis the oxygen uptake increased by a factor of 1·5 after addition of succinate. A much more intense stimulation was obtained by succinate in the guttate psoriatic lesion₂ the oxygen consumption in these experiments increased by a factor of 6·8. Oxalacetate did not influence the respiration in the absence of succinate, but a strong inhibitory effect was evident in all epidermal groups studied after addition of succinate. The results indicate that in the psoriatic lesion the cells have a considerable capacity for metabolic energy production.     

PHARMACOLOGIC MODULATION BY CETIRIZINE OF SOME ADHESION MOLECULES EXPRESSION IN PSORIATIC SKIN LESIONS

Background. Adhesion molecules play a major role in the pathogenesis of inflammatory skin diseases by regulating lymphocyte trafficking and homing in an inflamed area. Methods. The expression of the lymphocyte function-associated antigen-1 (LFA-1) and of its ligand, the intercellular adhesion molecule-1 (ICAM-I) has been studied in psoriatic skin lesions of 10 patients with guttate, nummular, and palmoplantar psoriasis. In addition, the peculiar immunophenotype of infiltrating cells (CD3, CD4, CD8, CD25) and their correlation with HLA-DR expression before and after treatment with oral cetirizine, a highly selective, third generation H_1-receptor antagonist has been examined using the labeled avidin biotin (LAB) system. Results. Cetirizine treatment modulated in vivo the expression of adhesion molecules LFA-I/ICAM-1 as shown in all cases by decreased levels of their expression on keratinocytes and on dermal endothelial cells (P < 0.001). The expression of HLA-DR on keratinocytes and endothelial cells was also inhibited after treatment. The numbers of infiltrating CD3–, CD4–, CD8–positive cells were reduced, whereas there was no significant modification of CD25–positive cells within the epidermis and the dermis. Conclusion. This open clinical trial suggests that cetirizine could be effective in treating psoriasis: (1) for its symptomatic control on itching; (2) for its immunopharmacologic modulation of leukocyte integrins and on the immunophenotype pattern of infiltrating and resident cells, and (3) for contributing to the clearing of the lesions clinically.     

THE VITAMIN B12 LEVEL IN PSORIATIC SKIN AND SERUM

SUMMARY.— Skin and serum B:; levels were measured using Lactobacillus leishmanii in 16 non-psoriatic control subjects and in 10 psoriatic patients before and after treatment. There was a significant positive correlation between the B₁₂ levels of the skin and serum of the control group. The B₁₂ level was lower in psoriatic than non-psoriatic skin and active lesions had lower levels than healed lesions. The findings suggest that the increased metabolic activity in psoriatic skin is associated with lowered B₁₂ levels which may precede visible pathological change.     

FINGERNAIL GROWTH IN NORMAL AND PSORIATIC SUBJECTS

SUMMARY.— A study has been made of nail growth in normal healthy subjects and in patients with psoriasis. Nails with pitting grew significantly faster than clinically normal nails of psoriatic patients, which in turn grew faster than those of normal controls. Of the nails measured, those of the middle finger grew more quickly than the others, the thumb and little finger growing most slowly; right hand nails grew faster than those of the left hand.     

ULTRASOUND IMAGING OF PSORIATIC SKIN: A NONINVASIVE TECHNIQUE TO EVALUATE TREATMENT OF PSORIASIS

Background. The aim of our study was to image psoriasis plaques by ultrasound to assess the changes in psoriasis and to measure and quantify them objectively. Materials and Methods. Thirty-one psoriasis plaques were studied in 19 patients. Measurements of skin thickness were obtained with a high resolution B-mode echographic system. Results. Some changes were seen in psoriatic skin. A new structural element was observed: a wide subepidermal nonechogenic band. The other changes were a decrease in dermal echoes that were less intense and less dense, and an increase in the epidermal and dermal skin thicknesses. The skin thickness was increased in all psoriasis plaques as compared to apparently normal skin (P < 0.001). The average increase was 67% for whole skin and 200% for epidermis. Conclusions. Ultrasound imaging of psoriatic skin allowed the identification of different skin changes induced by psoriasis, and particularly, the differentiation between epidermal and dermal alterations. We presume that epidermal thickness reflects epidermal proliferation and desquamation, and the increase in the dermal and whole skin thickness reflects infiltration. We feel that ultrasound imaging of psoriatic skin is a quantitative method that is as easy and noninvasive as the psoriasis area and severity index (PASI). It could be used for following up patients with psoriasis and could achieve widespread use, especially in research protocols.     

GENETICS OF PSORIASIS AND PSORIATIC ARTHRITIS

It is well established that psoriasis and psoriatic arthritis (PsA) have a strong genetic component. Recent advances in genetics have confirmed previous associations and new loci have been discovered. However, these loci do not fully account for the high heritability of psoriasis and PsA and therefore many genetic as well as environmental factors remain to be identified. This paper reviews the current status of genetic studies in psoriasis and PsA.     

EFFICACY AND TOLERABILITY OF CEFDITOREN PIVOXIL IN UNCOMPLICATED SKIN AND SKIN STRUCTURE INFECTIONS IN INDIAN PATIENTS

Background:

Uncomplicated skin and skin structure infections (uSSSI) are commonly encountered community-acquired infections and are typically confined to the superficial layers of the skin. Hence, they seldom lead to the destruction of skin structures.

Aims:

To evaluate the efficacy and tolerability of cefditoren pivoxil in uSSSI in Indian patients.

Methods:

One hundred and seventy-eight patients diagnosed with uncomplicated SSSI were enrolled in this randomized, comparative, multicentric study. Patients received either cefditoren pivoxil or cefdinir for ten days. Efficacy was assessed both clinically and microbiologically. Safety evaluation consisted of reporting of type, frequency, severity, and causal relationship of adverse events.

Results:

One hundred and fifty-one patients completed the study. Clinical and bacteriological efficacy of cefditoren pivoxil was comparable to that of cefdinir in the treatment of uSSSI. One hundred and five patients were eligible for per protocol (PP) analysis of bacteriological outcome and clinical efficacy. Clinical cure or improvement was achieved in 98.00% patients treated with cefditoren pivoxil and 98.18% patients treated with cefdinir. In the modified Intent to Treat (mITT) patient population, clinical cure or improvement was recorded in 97.33% patients treated with cefditoren pivoxil and 96.20% patients treated with cefdinir. Microbiological eradication (or presumed eradication) was recorded in 88.00% patients treated with cefditoren pivoxil and 94.55% patients treated with cefdinir. The above differences in the outcome rates between the two drugs were not statistically significant. Six adverse events (AEs) (two in cefditoren group and four in cefdinir group) were reported in this study.

Conclusion:

Cefditoren pivoxil 200 mg b.i.d. was effective and well tolerated in the treatment of uSSSI.     

AGE-RELATED CHANGES IN DRUG CONCENTRATION IN SKIN AND LUNGS OF MICE

How drug concentration in skin and lung due to vascular action changed with aging was examined quantitatively by a bioassay using bacteria. The concentration of the drug (anticancerous agent, Bleomycin) did not decrease in the skin of older mice as compared with that in younger mice, but showed a decrease in the lungs. An experiment using Kallikrein, a peripheral vasodilator, revealed that the kinin-kallikrein system exists in mice. The peripheral circulation increasing action of Kallikrein decreased in the skin and increased in the lungs of older mice as compared with young mice.