ABSTRACT
A 36-year-old woman presented with a 3-year history of pruritic erythema and scaling on the trunk and extremities.Dermatological examination revealed ill-defined light pink macules with white lamellar scales on the chest,abdomen and buttocks.Histologically,there was a focal mononuclear cell infiltrate in the superficial dermis,with the epidermotropism of some cells and mild atypia of epidermotropic cells,as well as an interstitial mononuclear cell infiltrate and mild deposition of mucin between the collagen fibers in the middle dermis.CD3 and CD4 were expressed by scattered mononuclear cells infiltrating the upper and middle dermis.Based on these data,the patient was diagnosed with interstitial granuloma fungoides.
ABSTRACT
Objective To observe the expressions of two inhibitors of apoptosis proteins (LAPs), survivin and livin, as well as their related factors, Bci-xl and Caspase-3 in mycosis fungoides (MF), along with the effects of NB-UVB irradiation on them. Methods Totally, 30 patients with MF (5 at erythema stage, 16 at plaque stage and 9 at tumor stage) collected from 1995 to 2007 were included into this study. Of the patients, 11 received the treatment with NB-UVB irradiation. Tissue samples were resected from 30 untreated patients, 11 irradiated patients and 10 normal human controls. SABC immunohistochemistry (IHC) stain was used to evaluate the protein expression of survivin, livin, Bel-xi and caspase-3 in these samples. Also, the mRNA expression of these four factors and cell apoptosis were detected by hybridization in situ (ISH) and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-fluorescence nick end labeling (TUNEL stain) respectively in the samples from 11 patients before and after NB-UVB irradiation. Results In samples of erythema-stage MF, plaque-stage MF and tumor-stage MF, the positivity rate was 40.00%, 75.00%, 77.78% for survivin respectively, 60.00%, 68.75%, 88.89% for Bcl-xl respectively, 40%, 25%, 44.44% for livin respectively, and 60.00%, 68.75%, 88.89% for caspase-3 respectively. No expression of survivin or Bcl-xl was observed in normal controls, while the expression of livin and caspase-3 was similar between MF and control samples. After NB-UVB irradiation, an increase was noticed in the count of apoptosis cells (t=6.49, P<0.001) and mRNA expression of caspase-3 (P<0.10), while a decrease in the mRNA expression of survivin and Bcl-xl in MF tissues, and no changes occurred to the mRNA expression of livin (P>0.10). Conehsions Survivin, Bcl-xl and caspase-3 may be associated with the pathogenesis of MF by regulating the cell apoptosis of T lymphocytes. NB-UVB could suppress the mRNA expression of survivin and Bcl-xl, lower the levels of LAP, enhance the transcription of caspase-3, and accelerate the apoptosis of tumor cells, which may partly explain the mechanism of therapeutic effect of NB-UVB in MF.