Acta dermato-venereologica. Supplementum最新文献

We have demonstrated both in vivo and in vitro that Cyclosporin (CsA) treatment during psoriasis induced a regression of typical keratinocyte alterations and normalization of the basement membrane (BM). It is also known that the structure of BM implies cohesion between the networks formed by laminin and type IV collagen and that these components positively influence the cytomorphosis processes of keratinocytes. According to these results, we have evaluated, by immunohistochemical study, the behaviour of laminin and type IV collagen on psoriatic skin prior to the therapy and at the end of pharmacological treatment with CsA. This study was carried out on biopsies of involved skin taken from 12 patients with severe psoriasis and with PASI between 50 and 70. Our results can be summed up as follows: Untreated psoriasis: absence of laminin within BM; modest staining in basal keratinocytes; intense staining in suprabasal keratinocytes; discontinuous staining of Type IV collagen in the BM. After treatment: evident and continuous staining of laminin and Type IV collagen within the BM. The obtained results confirm the positive effect of immunomodulation determined by CsA in the regulation of the functional activity of cells implicated in BM component production. In conclusion, the authors discuss the pathogenesis of the disease.

The aim of this study was to show degree and pattern of hand eczema in affected hairdresser trainees (n = 52), compared with a general population of affected hairdressers (n = 69). The mean ages were 18 years (range: 16-25) for the trainees and 27 years (range: 17-63) for the hairdressers. For the latter group, the mean number of months spent in profession was 96 (range: 2-552) and the number of working hours per week was 36 (range: 4-50). Twenty-seven per cent of all trainees (67/246) were reported to have had initial of eczematous lesions on the hands and/or forearms during their apprenticeship. The extent of skin affection, as assessed by scores for localization and distribution of eczema, was significantly lower in trainees, compared with the general population of hairdressers. Patch test revealed sensitization to nickel to be prominent in both groups; 34% among affected hairdressers and 26% among affected and non-affected trainees. Of the hairdressers, 3% had allergy to hair dye (2.5-toluenediamine), while 8% were sensitized to glyceryl monothioglycolate. None of the trainees were sensitized to those two chemicals.

Clinical reports of hereditary palmoplantar keratoderma are generally based on a limited number of patients. In 1967 the prevalence in the northernmost county of Sweden (Norrbotten) was shown to be 0.55%. In 1982 it was possible to trace half of the original propositi from that study. Among these families, a severe clinical form with a presumed recessive inheritance could be distinguished. The clinical pictures in relatives of the original propositi were described, and other diseases were listed together with those in patients from previously performed studies. The frequency of dermatophytosis was 36.2%, which was equal to a prevalence of 37.6%. T. mentagrophytes occurred significantly more often and immunological factors, such as increased presence of blood group A, specific dermatophyte IgG antibodies, precipitating antibodies and an immunological in vitro reaction to keratin, supported differences in the distribution of dermatophytes. However, the amount of keratin was considered the most important factor for the affinity of dermatophytes to the palms and soles. A vesicular eruption along the hyperkeratotic border and a mononuclear cell infiltrate were often reported. Such reactions were interpreted as immunological reactions to dermatophytosis. Scaling and fissuring were considered clinical signs of dermatophyte infections and not a part of the originally reported clinical picture. Results of the histopathological study corresponded to previously reported descriptions of the Unna-Thost variety. However, it has recently been reported that the histopathological picture of this variety was based on histopathological features of epidermolytic palmoplantar keratoderma. The existence on the Continent of the Unna-Thost variety was therefore questioned. Histopathological features of epidermolytic palmoplantar keratoderma were not found in the County of Norrbotten and the designation "Diffuse HPPK type Norrbotten" has therefore been proposed. The histopathological picture of the presumed recessive variety did not differ from that of the dominant variety but ultrastructural characteristics differentiated it from Mal de Meleda and the dominant variety. It was therefore concluded that a new variety with a presumed recessive inheritance was found.

Calcitriol has recently been shown to be effective against psoriasis. However, its mode of action is not exactly known. The present study focused on the influence of calcitriol on growth, differentiation, chemokine mRNA and ICAM-1 mRNA expression of keratinocytes (KC) and on the binding of T-cells to keratinocytes. In vitro studies showed that calcitriol has a strong anti-proliferative effect and induces terminal differentiation. gamma-IP-10 and ICAM-1 mRNA were induced by gamma-IFN, an induction not influenced by calcitriol. Moreover, the functional expression of ICAM-1 on the KC cell surface as measured by a cell adhesion assay, was not influenced either. IL-8 and huGRO mRNAs were constitutively produced in KC, as was demonstrated after incubation with cycloheximide. Up-regulation of both IL-8 and huGRO mRNA by IL-1 alpha was also not affected by calcitriol. It is concluded that calcitriol has a strong antiproliferative activity and does not interfere with KC responsiveness to gamma-IFN and IL-alpha induced chemokine expression or with the adhesion of T-cells to keratinocytes.

Both clinical and experimental evidence is accumulating on the role of the nervous system in the pathogenesis of psoriasis. Sporadic reports as well as extensive studies indicate that emotional stress can act as an exacerbating event in psoriasis. Moreover, that neurogenic mechanisms are operating in psoriasis is suggested by clinical, pharmacologic and experimental data. We have focused our investigations on the role of vasoactive intestinal peptide (VIP) and substance P (SP) in psoriatic lesions using a variety of experimental approaches: 1) receptor autoradiography; 2) immunohistochemistry; 3) radio-immunoassay; 4) human keratinocytes cultures. Our results indicate that an imbalance of VIP and SP exists in psoriatic lesions, and that these neuropeptides exert different and specific effects on human keratinocytes. At present, however, the finding of psoriasis being exacerbated by psychological factors cannot be satisfactorily explained merely by alterations of neuropeptides in the skin.

Twenty-five psoriatic patients were studied histologically before and after PUVA therapy in order to delineate the relationship between dermal mast cells, psoriasis healing process and collagen changes. A number of mast cells were found in the psoriatic changes. A number of mast cells were found in the psoriatic lesion both before PUVA and also after PUVA therapy in 22 of the 25 patients. Fibrosis of the papillary dermis and upper reticular dermis was found in 3 cases. Increased collagen deposition and increased numbers of fibroblasts were accompanied by verticalization of ectatic and elongated blood vessels, with an overall pattern of relatively recent scarring. Mast cells were no longer detectable in the fibrosis area. We cannot exclude the possibility that PUVA therapy exerts a further stimulus on mast cell histamine and heparin degranulation in this type of psoriasis, thus leading to dermal fibrosis and blood vessel neogenesis.

Calcipotriol, a non-calcemic vitamin D3 analogue, inhibits the proliferation and is necessary for final differentiation of keratinocytes. The aim of the present study was to determine the efficacy and tolerability of calcipotriol ointment in patients treated for 6 weeks. Twenty patients with chronic plaque-type psoriasis were treated twice daily with calcipotriol ointment 50 ng/g. After 6 weeks' treatment there was a marked and statistically significant decrease in the PASI score values for 17 patients, no improvement was seen in 1 patient and local adverse events occurred in 2. Hypercalcemia or other laboratory abnormalities did not develop in any patient.