ABSTRACT
BACKGROUND: Cell death is divided into two types, cell necrosis and apoptosis. In contrast to cell necrosis, an apoptotic cell is ingested by phagocytes and apoptosis is not accompanied by local inflammatory cells. Recently, apoptosis is considered to be involved in the pathogenesis of autoimmune diseases. OBJECTIVE: We investigated the presence of apoptotic cells in discoid lupus erythematosus, lichen planus, and psoriasis which are cutaneous autoimmune diseases, and also in erythema multiforme, which is not an autoimmune disease and of which characteristic in histopathologic features is necrotic keratinocytes. METHODS: A total of forty-six skin biopsy specimens were chosen. The specimen is made up of ten of each discoid lupus erythematosus, lichen planus, psoriasis, erythema multiforme and six of normal skin. We performed TUNEL stain on each specimen to observe apoptotic cells in the epidermis and dermis. The mean numbers of apoptotic cells were compared using the Kruskal-Wallis test and post hoc according to Conover. RESULTS: In discoid lupus erythematosus, apoptotic cells were observed as the most common disease in the epidermis and also in the dermis. In lichen planus, apoptosis was rarely observed in the epidermis, but was observed as the second common disease in the dermis. In psoriasis, apoptosis was rarely observed in both the epidermis and dermis. In erythema multiforme, apoptosis was observed in both the epidermis and dermis, and especially observed as the second common disease in the epidermis among four diseases. CONCLUSION: Apoptosis may contribute to pathogenesis of discoid lupus erythematosus and also in part to lichen planus and erythema multiforme. However, in psoriasis, apoptosis was rarely observed and resistance to apoptosis may be involved in the pathogenesis of psoriasis.
Subject(s)
Apoptosis , Autoimmune Diseases , Biopsy , Cell Death , Dermis , Epidermis , Erythema Multiforme , In Situ Nick-End Labeling , Lichen Planus , Lupus Erythematosus, Discoid , Necrosis , Phagocytes , Psoriasis , SkinABSTRACT
Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus, which manifests as hyperpigmented dark brown macular hyperpigmentations chiefly involving the face and upper extremities. The histopathologic changes consist of vacuolar degeneration of the basal layer, presence of dermal melanophages, and lichenoid lymphocytic infiltrations. LPP with exclusive localization in intertriginous areas is named as LPP-inversus, and is infrequently reported in previous dermatologic literature. A 16-year-old girl presented with several brownish to dark grayish patches on both axilla for 7 months. The lesions were asymptomatic and did not have preceding erythema. The patient had not come into contact with any chemicals and denied existence of previous allergy episodes, and her medical history was non-contributory. A skin biopsy from a brownish patch revealed vacuolar alteration of the basal layer, and band-like lymphocytic infiltration with pigment incontinence. We report a typical case of LPP-inversus with relevant literature.
Subject(s)
Adolescent , Humans , Axilla , Biopsy , Erythema , Hypersensitivity , Lichen Planus , Lichens , Skin , Upper ExtremityABSTRACT
CD4+/CD56+ hematodermic neoplasm is a rare and aggressive lesion that affects many organs, and skin involvement is highly characteristic. It is also termed blastic natural killer cell lymphoma in the World Health Organization classification. Several origins of tumor cells have been proposed, but recent studies have shown a relationship with plasmacytoid dendritic cells. A 2-year-old boy presented with multiple bruise-like violaceous subcutaneous nodules and plaques on the trunk, upper and lower extremities. Histological examination showed small-to-medium-sized blastoid cellular infiltration in the dermis and subcutaneous tissue. Tumor cells were positive for CD4, CD56 and TdT, and negative for CD8, CD20 and MPO. It primarily affects elderly patients, but, in this case, occurred in an infant. Due to its rarity, we present a case of CD4+/CD56+ hematodermic neoplasm affecting a pediatric patient.
Subject(s)
Aged , Humans , Infant , Dendritic Cells , Dermis , Killer Cells, Natural , Lower Extremity , Lymphoma , Child, Preschool , Skin , Subcutaneous Tissue , World Health OrganizationABSTRACT
Over the past years, hydrocolloid dressings have been introduced routinely in the treatment of various types of wounds. They provide a moist environment promoting autolytic debridement, and stimulate angiogenesis. However, long-term application often leads to inflammation of the skin in the immediate area of the ulcer, causing irritant dermatitis in many cases, but sometimes also leads to contact sensitization. A 32 year-old woman burnt herself by an iron, and presented to our clinic and was treated with Duoderm extrathin(R). Nine days later, she again presented with an erythematous oozing patch with edema, and allergic contact dermatitis was suspected. A patch test (TRUE test) was performed and a positive reaction to colophonium was obtained. Duoderm extrathin(R) contains hydrogenated rosin (colophonium) as the tackifying agent, so we could diagnose this case as allergic contact dermatitis due to the hydrogenated rosin in Duoderm extrathin(R). We report another case of allergic contact dermatitis due to Duoderm extrathin(R) in a 32 year-old woman.