ABSTRACT
PURPOSE: To evaluate the changes in aqueous flare in psoriasis patients and to identify the factors that influence the level of aqueous flare. METHODS: We examined the 68 eyes of 34 psoriasis patients and the 68 eyes of 34 healthy subjects with a laser flare-cell meter. Complete dermatologic and ophthalmic examinations were performed on the psoriasis patients. RESULTS: Flare was significantly higher in psoriasis patients than in normal controls (P <.000l). The factors that increased flare significantly were age and Psoriasis Area and Severity Index. Flare was not significantly associated with sex, psoriasis type, duration of disease, and cyclosporin therapy. A flare increase was significantly correlated with serum total protein and immunoglobulin (Ig) A, but not with albumin, IgG, and IgM. CONCLUSIONS: Psoriasis patients, even without ocular symptoms, had slight damage to the blood-aqueous barrier. Multiple linear regression analysis showed that flare had the strongest correlation with the severity of psoriasis.
Subject(s)
Aqueous Humor/metabolism , Eye Proteins/metabolism , Psoriasis/metabolism , Adult , Blood-Aqueous Barrier , Capillary Permeability , Cyclosporine/therapeutic use , Diagnostic Techniques, Ophthalmological , Female , Humans , Light , Male , Middle Aged , Psoriasis/drug therapy , Risk Factors , Scattering, RadiationABSTRACT
We evaluated aqueous humor protein concentration in psoriasis using a laser flare-cell meter, which can quantify aqueous flare precisely and objectively. Psoriatic severity was evaluated on the basis of psoriasis area and severity index (PASI) score. Aqueous flare was measured in 40 eyes of 20 psoriasis patients (sixteen psoriasis vulgaris, three guttate psoriasis, and one psoriatic arthritis) and 28 eyes of 14 normal controls. Aqueous flare value was significantly higher in psoriatic patients than in normal controls (p < 0.01). There was no difference between psoriasis vulgaris and the other types of psoriasis. Aqueous flare value was higher in patients with psoriatic history longer than 10 years than in those with less than 10 years (p < 0.05), and also higher in patients with severe psoriasis (PASI score > 10) than in those with mild psoriasis (PASI score < 10) (p < 0.05). But no statistically significant differences in aqueous flare value were found among cyclosporin, etretinate, and psoralen ultra violet A therapies. These findings strongly suggest that patients suffering from psoriasis have slight damage of the blood-aqueous barrier even if they have no ocular symptoms, and that the degree of blood-aqueous barrier damage increases with time and severity of psoriasis.
Subject(s)
Aqueous Humor/chemistry , Eye Proteins/analysis , Psoriasis/metabolism , Adult , Blood-Aqueous Barrier , Female , Humans , Lasers , Male , Middle Aged , Photometry/instrumentation , Psoriasis/diagnosisABSTRACT
Four cases of neurilemmomatosis with multiple cutaneous neurilemmomas are described, including clinical, histologic, and electron microscopic features. Thirteen definite cases and sixteen probable cases of neurilemmomatosis with cutaneous tumors were collected from the Japanese literature. The skin lesions of multiple cutaneous neurilemmomas are nodules, infiltrated pigmented lesions, and plaque-like lesions consisting of papules. From the findings presented here, neurilemmomatosis is a clinical entity clearly distinguished from the neurofibromatosis of von Recklinghausen's disease.
Subject(s)
Neoplasms, Multiple Primary/pathology , Neurilemmoma/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Aged , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Infant, Newborn , Japan , Male , Middle Aged , Neoplasms, Multiple Primary/epidemiology , Neurilemmoma/epidemiology , Neurofibromatosis 1/diagnosis , Skin Neoplasms/epidemiology , Soft Tissue Neoplasms/pathologyABSTRACT
The explant culture of small skin specimens is a good model of in vivo epidermal growth. In this model epidermal cells are not dislodged and remain in vitro under the influences of the original mesenchyme, at least during early growth. Recently we attempted to grow epidermal cells from the skin lesions of some acantholytic dermatoses (Darier's disease [DD], Hailey-Hailey's disease [HHD], and pemphigus vulgaris [PV]) in explant culture, and we observed the behavior of outgrown epidermal cells for a relatively short time after explantation. The cell outgrowth from the skin of a patient with PV, which seemed to be apparently normal but showed positive Nikolsky's sign, formed a well organized flat sheet 48 to 96 hours after explantation, as seen in cultures of normal human adult skin. In contrast, the outgrown cells from the skin lesions of three patients with DD, as well as those from three patients with HHD, showed a characteristic disorganized outgrowth. They did not form the well-organized flat sheet, but showed a marked cell dissociation and conspicuously increased locomotive ability. These findings seems to clearly exhibit the processes of "acantholysis" in vitro and strongly suggest that the cells from these 2 latter dermatoses have a genetically determined insufficiency or defect in cell adhesion. From these results the authors conclude that the mechanism of cell dissociation in DD and HHD is fundamentally different from that in PV.
