Osteopontin and Regulatory T Cells in Effector Phase of Allergic Contact Dermatitis.

Studies have shown that osteopontin (OPN) and regulatory T cells play a role in allergic contact dermatitis (ACD), but the mechanisms responsible for their function are poorly understood. The study aimed to determine CD4 T lymphocytes producing intracellular osteopontin (iOPN T cells) and assess the selected T lymphocyte subsets including regulatory T cells in the blood of patients with ACD. Twenty-six patients with a disseminated form of allergic contact dermatitis and 21 healthy controls were enrolled in the study. Blood samples were taken twice: in the acute phase of the disease and during remission. The samples were analyzed by the flow cytometry method. Patients with acute ACD showed significantly higher percentage of iOPN T cells compared with healthy controls which persisted during remission. An increase in the percentage of CD4CD25 and a reduced percentage of regulatory T lymphocytes (CD4CD25highCD127low) were also found in the patients with acute stage of ACD. The percentage of CD4CD25 T lymphocytes showed a positive correlation with the EASI index. The increase in the iOPN T cells can indicate their participation in acute ACD. The decreased percentage of regulatory T lymphocytes in the acute stage of ACD may be related to the transformation of Tregs into CD4CD25 T cells. It may also indicate their increased recruitment to the skin. The positive correlation between the percentage of CD4CD25 lymphocytes and the EASI index may be indirect evidence for the importance of activated lymphocytes-CD4CD25 in addition to CD8 lymphocytes as effector cells in ACD.

Secondary syphilis with ocular involvement in a HIV-infected patient - case report.

We describe the case of a HIV-infected patient, in whom a secondary syphilis with skin lesions and ocular involvement developed. On admission papular skin rash and partial visual loss with left eye were observed. Serological tests for syphilis were positive in very high titers. Ophthalmological examination revealed ocular abnormalities indicating ocular syphilis. Cerebrospinal fluid (CSF) tests showed elevated concentration of immunoglobulin G (IgG) with normal white blood count and albumin concentration, serological treponemal tests for syphilis were positive. Intravenous therapy with Penicillinum Crystallisatum (Benzylpenicillinum kalicum) was administered, according to the neurosyphilis treatment schedule, achieving resolution of the skin lesions and partial vision improvement, a month after the end of the treatment a complete recovery of the vision was noted. Serological tests` for syphilis titers decreased fourfold. Described case confirms reasonability of examination for syphilis in patients with sudden vision disturbances, especially those HIV-infected. It also indicates that early appropriate treatment of the ocular syphilis prevents permanent loss of vision.

Paraphenylenediamine and related chemicals as allergens responsible for allergic contact dermatitis.

INTRODUCTION: Paraphenylenediamine (PPDA) is a chemical with strong sensitizing properties used for dyeing of hair and textiles. Paraphenylenediamine can cross-react, resulting in allergy to other related compounds. The prevalence of PPDA sensitization varies widely. The objectives were to assess the frequency of positive patch test reactions to PPDA and related chemicals among patients with allergic contact dermatitis (ACD) and to analyze them regarding their clinical pattern, occupation and cross-reactions. MATERIAL AND METHODS: The sociodemographic and clinical data of patients with positive patch tests to PPDA, N-isopropyl-N-phenyl-4-phenylenediamine (IPPD), ethylenediamine (EDA), triethylenetetramine (TETA) and toluene-2,5-diamine (TDA) were analyzed. The frequency, strength and cross-reactions with other chemicals were assessed. RESULTS: Of 4087 ACD patients patch-tested between 2006 and 2015, positive reactions to PPDA and other amines were found in 166 (4.1%). The occupational character of PPDA allergy was established in 34.3% of patients. Personal history of atopy was reported by 36.7% of patients. In 98% of those examined, allergy presented as ACD, most frequently affecting hands. Hypersensitivity to PPDA was diagnosed in 77.1%, to IPPD in 20.5%, to TDA in 6%, to TETA in 1.2%, and to EDA in 0.6% of cases. The patients with an extremely strong PPDA reaction significantly more frequently showed reactions to other para group chemicals, especially to benzocaine. CONCLUSIONS: Paraphenylenediamine was a major cause of contact allergy of diverse clinical picture more often affecting women, especially with atopy. Every fifth PPDA-allergic person exhibited hypersensitivity to other related compounds. Strong reactions to PPDA increased the risk of cross-reactions.

Serum osteopontin levels in disseminated allergic contact dermatitis.

PURPOSE: The aim of the study was to evaluate serum osteopontin (OPN) concentrations in patients with disseminated form of allergic contact dermatitis (ACD), and to assess the relationship between serum OPN level and disease severity. PATIENTS AND METHODS: Twenty-four patients with numerous allergic contact dermatitis lesions and twenty-two age- and sex-matched healthy subjects as a control group were enrolled in the study. Serum osteopontin levels were measured in the ACD patients twice: in the acute stage and during disease remission by ELISA. RESULTS: Serum OPN concentrations were significantly increased in patients with disseminated ACD examined in the acute stage as compared to healthy subjects and ACD patients during remission (p<0.01 and p<0.001, respectively). In the ACD patients with extensive skin lesions (EASI>10), OPN serum levels were significantly higher than in those with mild disease (EASI<10). CONCLUSIONS: Acute disseminated ACD is characterized by elevated serum concentrations of osteopontin, with levels depending on ACD severity, which indicates its role in the elicitation phase of allergic contact dermatitis. The possibility of inhibition of OPN activity may create a new therapeutic perspective in severe forms of this troublesome skin disease.

Patch test results in patients with allergic contact dermatitis in the Podlasie region.

INTRODUCTION: The aim of the study was to provide current data on the incidence of allergy to various contact allergens in patients with allergic contact eczema and the analysis of selected socio-demographic data of the patients. MATERIAL AND METHODS: The study included 1532 patients (1010 women and 522 men) treated for allergic contact dermatitis at the Department of Dermatology and Venereology and at the Dermatology Outpatient Clinic in Bialystok in 2007-2011. The assessment of selected demographic data and skin lesions was based on the MOAHFLA index, while the results of patch tests were analyzed with modified Baseline European Series consisting of 31 allergens. RESULTS: In the group of patients with eczema, 34.1% were men, and 55% of all respondents were people over 40 years of age. The occupational character of skin lesions was found in 22.5%. Most frequently (38.9%) skin lesions were localized on the hands, rarely involved legs (3.98%). Atopic dermatitis was diagnosed in 4.5% of patients. The ten most frequent allergens were: nickel sulfate (24%), cobalt chloride (15.3%), fragrance mix (8.25%), potassium dichromate (6.8%), balsam of Peru (5.5%), neomycin (4.42%), paraphenylenediamine (3.85%), Quatermium-15 (2.1%), detreomycin (1.83%) and budesonide (1.44% of tested patients). CONCLUSIONS: Frequent allergy to detreomycin indicates the need of patch testing for this allergen of all examined patients with allergic contact dermatitis. The increased frequency of the nickel allergy is a worrying problem and indicates the need for education about the risk factors for nickel allergy development and the implementation of appropriate legal regulations.

CD4+CD25+ and CD4+CD2+high regulatory T cells in disseminated and localized forms of allergic contact dermatitis: relation to specific cytokines.

The aim of this study was to evaluate regulatory T lymphocytes (Tregs) in the course of allergic contact dermatitis (ACD) and to elucidate the role of IL-10 and TGF-ß in Tregs activity. Peripheral blood CD4(+)CD25(+) and CD4(+)CD25(high) cells were determined by flow cytometry in patients with acute disseminated ACD ('ad', n = 36), acute localized ACD ('al', n = 26), and disseminated ACD during remission ('rd', n = 27) as well as in controls (n = 22). Serum levels of cytokines were measured using ELISA. The mean percentage of CD4(+)CD25(+) and CD4(+)CD25(high) cells in patients with ad ACD was significantly higher than in controls (p < 0.01) and the remaining patients (p < 0.05). Both cell populations were significantly elevated in persons with widespread skin lesions (p < 0.05). In ad patients the CD4(+)CD25(+) increased during three weeks of disease, although the significant increase of CD4(+)CD25(high) was noted only in the third week. Patients with ad ACD showed a significantly decreased serum level of TGF-ß1 as compared with controls and the remaining ACD patients. IL-10 level did not differ between all groups. The elevated population of CD4(+)CD25(high) cells in ad ACD patients, and its dependence on the extension of skin lesions, suggest a role of Tregs in regulating the course of ACD. The growing Tregs percentages may indicate their peripheral generation during ACD. The development of lesions despite an increased population of Tregs suggests their functional defect. The role of TGF-ß1 in the suppressive activity of Tregs cannot be excluded.

Tissue inhibitors of matrix metalloproteinase-1 levels are increased in serum of patients with allergic contact dermatitis.

Allergic contact dermatitis (ACD) is an antigen-specific, T-cell-mediated skin inflammatory disease. Matrix metalloproteinases (MMPs) and their tissue inhibitors of matrix metalloproteinases (TIMPs) play a role in degradation of extracellular matrix and subsequent tissue remodelling during inflammatory process. The objective of this study was to examine a possible role of TIMP-1 and MMP-9 in the pathogenesis of ACD. The serum levels of MMP-9 and TIMP-1 have been measured using enzyme-linked immunosorbent assay in patients with disseminated ACD during exacerbation of skin lesions and the remission stage (n= 20) and were compared with healthy subjects (n= 20). The mean serum levels of TIMP-1 were significantly higher in patients with ACD than in control group (42.8 +/- 4.9 ng/ml). This difference was more prominent in patients with ACD during remission (69.01 +/- 6.99 ng/ml, P < 0.0001) than in patients with exacerbation of disease (46.8 +/- 3.6 ng/ml, P= 0.0054). Mean values of serum MMP-9 did not differ significantly between patients with ACD, both in the acute and in the remission stage, compared with healthy persons (P= 0.76 and P= 0.29, respectively). TIMP-1 might be involved in pathogenesis of ACD. It seems that moderately increased levels of TIMP-1 could reflect degree of activity of skin inflammation, whereas markedly increased levels could contribute to the maintenance of the remission of disease.

[Lichen sclerosus et atrophicus]. / Lichen sclerosus et atrophicus--liszaj twardzinowy i zanikowy.

A case of 43-year-old woman with skin and genital lesions of lichen sclerosus et atrophicus was presented. It was paid attention to simultaneously examination of the skin and genital areas. For this reason it is necessary closed cooperation between dermatologists and gynaecologists for determination of proper diagnosis.

Permeability of human skin to selected anions and cations--in vitro studies.

Among the many factors influencing the human body every day, metal cations and anions are some of the most important and are constantly present in atmospheric fallout. Some of them such as sulfate or nitrate anions along with different detergents may cause pathological changes within the skin. The aim of this study was to estimate whether sulfate (SO4(2-)) and nitrate anions (NO3-) as well as metal cations, magnesium (Mg2+) and calcium (Ca2+) are able to pass through isolated patches of human skin and to investigate the dynamics of ion diffusion. Concentrations of the substances corresponded to those observed in the atmospheric fallout in two regions of Poland with low (Bialowieza) and high (Katowice) pollution rate. Ion chromatography method was used to determine cations and anions levels. In vitro, we found human skin to be permeable to magnesium and calcium ions as well as sulfate and nitrate anions at concentrations observed in the atmospheric fallout in two regions of Poland having different levels of pollution. Diverse influence of sodium lauryl sulfate (SLS) detergent on the grade of metal ion permeability (acceleration in the first 10 hours of experiment) and anion permeability (lack of SO4(2-) influence) suggest the presence of different routes of ions penetration through the skin. It is also supported by different transportation characteristics of individual ions through the skin over time.