Cigarette Smoke-Induced Interleukin-1 Alpha May Be Involved in the Pathogenesis of Adult Acne

BACKGROUND: Lipid peroxide (LPO) in comedones, which are produced as a result of sebum oxidation, might potentially induce interleukin-1alpha (IL-1alpha) and exacerbate comedogenesis and inflammatory changes in comedones. OBJECTIVE: To investigate the relationship of proinflammatory cytokines and LPO levels in the extracts of comedones with the acne of clinical difference between smokers and non-smokers, and with the severity and distribution of the acne lesions. METHODS: Twenty-two non-smoking and 21 smoking adult acne patients were evaluated by comedone extraction and measurement of proinflammatory cytokines and LPO levels. Acne severity and distribution of the lesions were also analyzed. RESULTS: Relative to the non-smoking group, smokers had significantly higher levels of IL-1alpha and LPO in comedones. Their levels showed a positive correlation. However, there were no statistically significant difference between the severity or distribution of the disease and the levels of LPO and IL-1alpha in comedones. CONCLUSION: Smoking may be involved in the pathogenesis of adult acne by increasing the oxidative stress that results in subsequent accumulation of LPO in comedones.

Differential Expression of TGF-beta Isoforms in Human Kerationocytes by Narrow Band UVB

BACKGROUND: Transforming growth factor-beta (TGF-beta), a multifunctional growth factor, has three isoforms: TGF-beta1, TGF-beta2, and TGF-beta3. Different isoforms of TGF-beta are associated with different proliferation and differentiation states of the epidermis. Narrow band ultraviolet B (NBUVB) emits a concentrated UVB source of 311 nm. NBUVB 1,000 mJ/cm2 induces apoptosis in approximately 50% of keratinocytes. OBJECTIVE: The purpose of this study was to evaluate whether irradiation with NBUVB would alter the expression and production of TGF-beta1, 2, and 3. METHODS: We measured TGF-beta1, 2, and 3 mRNA and TGF-beta1 and 2 protein levels at 800, 1,000, and 1,200 mJ/cm2 for 24 hours and 48 hours. RESULTS: TGF-beta1 mRNA levels were increased at both 24 hr and 48 hr, TGF-beta2 mRNA levels were decreased at both 24 hr and 48 hr, and TGF-beta3 mRNA levels were increased at 24 hr and similar to control at 48 hr. TGF-beta1 protein levels were increased at 48 hr but decreased at 24 hr. TGF-beta2 protein levels were decreased at both 24 hr and 48 hr. CONCLUSION: The results suggest a possible role for TGF-beta1 after NBUVB irradiation and opposing roles for TGF-beta1 and TGF-beta2 isoforms in NBUVB irradiation.

A Study on Altered Expression of Serine Palmitoyltransferase and Ceramidase in Psoriatic Skin Lesion

Ceramides are the main lipid component maintaining the lamellae structure of stratum corneum, as well as lipid second messengers for the regulation of cellular proliferation and/or apoptosis. In our previous study, psoriatic skin lesions showed marked decreased levels of ceramides and signaling molecules, specially protein kinase C-alpha (PKC-alpha) and c-jun N-terminal kinase (JNK) in proportion to the psoriasis area and severity index (PASI) scores, which suggested that the depletion of ceramide is responsible for epidermal hyperproliferation of psoriasis via downregulation of proapoptotic signal cascade such as PKC-alpha and JNK. In this study, we investigated the protein expression of serine palmitoyltransferase (SPT) and ceramidase, two major ceramide metabolizing enzymes, in both psoriatic epidermis and non-lesional epidermis. The expression of SPT, the ceramide generating enzyme in the de novo synthesis in psoriatic epidermis, was significantly less than that of the non-lesional epidermis, which was inversely correlated with PASI score. However, the expression of ceramidase, the degradative enzyme of ceramides, showed no significant difference between the lesional epidermis and the non-lesional epidermis of psoriatic patients. This might suggest that decreased expression of SPT protein is one of the important causative factors for decreased ceramide levels in psoriasis.

The Effect of TNF-alpha and INF-gamma on the Telomerase Activity of Cultured Human Keratinocyte

Psoriasis is a chronic inflammatory skin disease characterized by hyperproliferation and abnormal differentiation of the lesional epidermis. In pathogenesis, inflammatory cytokines such as TNF-alpha and IFN-gamma from infiltrated T-cells seem to act a central role. Although many chronic inflammatory conditions can lead to cancer development, there is no evidence of increased incidence of cancer in psoriatic skin lesion. Telomerase is an enzyme-reverse transcriptase that protects chromosomes from degradation by stabilizing telomere length. Recent studies suggest that telomerase activity may be responsible for some part of nonmalignant proliferatory skin disease. In addition, there is evidence that telomerase activity is related with proliferation and differentiation of keratinocyte. In this experiment, we tried to evaluate the effect of TNF-alpha and IFN-gamma to the telomerase activity and its differential effect thought the passage. The results showed increased telomerase activity according to stimulation and this extent was different from the various passage. These results suggest that the key cytokines of psoriasis, namely, TNF-alpha and IFN-gamma increase telomerase activity at proliferative cells, which could contribute to hyperproliferation and abnormal differentiation of lesional keratinocyte. Moreover, this increased telomerase activity could partially explain the cancer incidence of psoriasis that is not increased compared to the normal population.

A Case of Microscopic Polyangiitis with Acral Necrosis as Skin Manifestation / 대한피부과학회지

Microscopic polyangiitis (MPA) is a systemic vasculitis that is histologically characterized by small vessel involvement. Although MPA is primarily associated with necrotizing and crescentric glomerulonephritis and pulmonary capillaritis, MPA often has cutaneous features. We report a case of microscopic polyangiitis with acral necrosis as the skin manifestation. A 56-year-old man presented with acral dry gangrene on tip of finger and toe and reticulated erythema on leg. He had suffered from proteinuria, hemoptysis, and arthralgia. Histopathologically, small vessel vasculitis without granuloma was seen. A high serum level of pANCA was detected by ELISA. This is a relatively rare disease, which has a poor prognosis in the absence of aggressive therapy, and is infrequently reported in dermatologic journals in Korea.

A Case of Adult-Onset Still's Disease Presented with Urticaria / 대한피부과학회지

Adult-onset Still's diseas e(AOSD) is a rare, systemic inflammatory disease of unknown etiology, characterized by spiking fever, skin rash, arthralgia or arthritis, lymphadenopathy, hepatosplenomegaly, sore throat and serositis. The typical skin rash in AOSD is an evanescent, erythematous maculopapular lesion, often associated with spiking fever. However, other atypical skin lesions such as urticaria are rarely seen. Here, we report a case of a 24-year-old female patient in whom an urticaria-like rash was an uncommon clinical feature of AOSD.

A Case of Microvenular Hemangioma Clinically Mimicking Kaposi's Sarcoma / 대한피부과학회지

Microvenular hemangioma is an uncommon aquired vascular tumor, occurring in young to middle-aged adults of both genders. It usually presents as a small, solitary, purple-to-red papule, nodule or plaque on the extremities or trunk. Histologically, the tumor is composed of small branching venules with collapsed lumina and conspicuous pericytes infiltrating the full thickeness of the reticular dermis. Herein, we report a case of microvenular hemangioma, clinically mimicking Kaposi's sarcoma, on the toe of the right foot in a 44-year old male.