Lesional skin vascular endothelial growth factor levels correlate with the clinical severity in patients with cement allergic contact dermatitis

ABSTRACT

Allergic contact dermatitis to cement is a common occupational skin disease. It is a delayed-type hypersensitity reaction with Th1 type cytokine response. Interferon-gamma [IFN-gamma] is recognized as the main effector cytokine in contact hypersensitivity [CHS]. Vascular endothelial growth factor [VEGF] might be involved in persisting erythema and edema in eczematous skin. Human VEGF is a multifactorial cytokine that not only promotes angiogenesis but also enhances vascular permeability and participates in chronic inflammation. Thirty two building workers with chronic allergic contact dermatitis due to occupational exposure to cement and twenty healthy controls were included. The severity of eczema was assessed using the Eczema Area and Severity index [EASI]. VEGF and IFN-gamma in serum and skin lesions were measured in patients and healthy controls. Patients with cement allergic contact dermatitis showed significantly elevated levels of serum and lesional skin levels of VEGF compared to healthy controls [p=0.005 and p=0.001 respectively]. They also had significantly higher serum and tissue IFN-gamma levels compared to controls [p=0.007 and p=0.001 respectively. A significant positive correlation was demonstrated between skin tissue levels of VEGF and EASI score in patients with cement allergic contact dermatitis [r=0.86, p=0.001]. VEGF and IFN-gamma might play a role in the pathogenesis of cement allergic contact dermatitis. Lesional skin VEGF levels could be an indicator of the severity of eczema