Impact of NB-UVB phototherapy on Caveolin-1 expression in chronic plaque psoriasis.

BACKGROUND: Caveolin-1 (Cav-1) is a significant structural and regulatory constituent of cell membranes that has been implicated in cell kinetics and inflammation. OBJECTIVE: To assess Cav-1 expression in psoriasis before and after phototherapy. PATIENTS AND METHODS: Thirty psoriasis cases and 30 healthy controls were recruited. Cases were managed with narrow band-ultraviolet B (NB-UVB) phototherapy at frequency three times per week for 12 weeks. From every case, two biopsy specimens were gained from psoriatic lesions (pre and post phototherapy), in addition to one from apparently normal skin of psoriasis cases. Regarding the control group, one biopsy was taken from a matched site. All were studied for Cav-1 antibody immuno-expression. RESULTS: There was a significant decrease in Cav-1 expression in psoriatic lesions compared to both the apparently normal skin of psoriasis patients and standard control skin of healthy individuals. After NB-UVB phototherapy, significant upregulation of Cav-1 immunostaining score was observed in previously psoriatic skin when compared to that before treatment. In addition, there were significant negative correlations between Cav-1 immunostaining score and the clinical scores of psoriasis severity including; the erythema, scaling, and induration (ESI) score and the patient psoriasis area and severity index (PASI) score. CONCLUSION: Induction of Cav-1 expression may be a likely pathway for the effectiveness of NB-UVB in psoriasis. Cav-1 may be a useful marker for evaluation of psoriasis severity, disease progression, and therapeutic efficacy.

Spindle B-cell lymphoma: a rare variant of follicle center lymphoma.

Primary cutaneous follicle center lymphoma (PCFCL) is a common subtype of primary cutaneous B-cell lymphoma (PCBCL). The prognosis of this subtype is favorable and recurrence is observed in up to 50% of patients. The dissemination to lymph nodes or internal organs is rare. In this study, two cases of rare variant of PCFCL are reported. Both cases presented with multiple erythematous nodules, plaques and some annular configurations. Histopathological examination revealed dermal lymphocytic infiltrates consisting of admixed centrocytes and centroblasts. Interestingly, spindle-shaped cells with elongated nuclei, dispersed chromatin and scant cytoplasm were also detected. Immunohistochemical analysis revealed that all cells including the spindle cells were positive for CD20 and negative for CD3, CD43, CD10, CD34, CD68 and CD138. They were also negative for desmin and S-100. They consistently expressed nuclear bcl-6, but did not express bcl-2. The histopathological and immunohistochemical examination suggest a rare case of primary cutaneous spindle cell B-cell lymphoma (PCSBCL). Although few data is published about this rare subtype, PCSBCL is recently considered as a rare subtype of PCFCL. The prognosis and the nature of this peculiar subtype are not yet cleared. This indicates a great need for more investigations.

Dermoscopic features of acral pigmented lesions in Egyptian patients: a descriptive study.

BACKGROUND: Dermoscopy is a non-invasive technique allowing rapid and magnified in vivo observation of the skin. The anatomical structure of acral volar skin results in unique dermoscopic features in this location. OBJECTIVE: To describe and analyze the characteristic dermoscopic features of various kinds of acral pigmented lesions and emphasize the diagnostic value of the dermoscope in early melanoma at this anatomic site in a sample of Egyptians. PATIENTS AND METHODS: This study included 200 patients with 224 acral pigmented lesions. Dermoscopic examination was done to evaluate different dermoscopic patterns of these lesions. Clinically and dermoscopically suspicious lesions for malignancy were selected for more evaluation by histopathological examination by hematoxylin-eosin staining. RESULTS: The most frequent dermoscopic pattern was the parallel furrow pattern, (66.1%), followed by the lattice-like (8.9%), homogeneous (7.6%), fibrillar (6.3%), non-typical (5.4%), and then parallel ridge (2.2%). The least commonly reported patterns in our cases were the reticular and globular patterns (1.8% each). There was one case of acral lentiginous melanoma of the palm with a multicomponent dermoscopic pattern. CONCLUSION: The recognition of different dermoscopic patterns is essential for diagnosis of various types of acral pigmented lesions. In addition, dermoscopy is useful in discriminating between acral nevi and early acral melanoma and narrows down the number of biopsies needed.