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Lupus erythematosus profundus: Clinical and pathological features of 23 cases
JSID Abstracts / Journal of Dermatological Science 69 (2013) e1–e46
and the severity of AD, eruption type, and epidermal barrier function using a non-invasive method in a sizeable group of the patients. Stratum corneum tissue was obtained from AD patients by tape stripping, and the stratum corneum TSLP (scTSLP) concentration was evaluated using a TSLP-specific antibody followed by image analysis. The correlations between the scTSLP concentration and the severity scoring of AD (SCORAD) index and epidermal barrier function, such as stratum corneum hydration and transepidermal water loss (TEWL), were analyzed. The changes in the scTSLP level induced by the application of moisturizer were also examined.The scTSLP concentration was increased in AD patients compared with healthy subjects and was correlated with SCORAD, especially with the dry skin score, and stratum corneum hydration. Moisturizer application resulted in reduced scTSLP levels.The scTSLP concentration can be used as a biomarker of AD severity and particularly epidermal barrier status. http://dx.doi.org/10.1016/j.jdermsci.2012.11.348 P01-51 Effects of benzo(a)pyrene on gene expression in threedimensionally cultured human keratinocytes Ami Oizumi 1,2,∗ , Chihiro Iwahara 1 , Yasushi Suga 2 , Hideoki Ogawa 1 , Kenji Takamori 1 , Kazuhisa Iwabuchi 1,3 1
Institute for Environmental and Gender-specific Medicine Juntendo University Graduate School of Medicine, Chiba, Japan 2 Department of Dermatology, Juntendo University Urayasu Hospital, Chiba, Japan 3 Laboratory of Biochemistry, Juntendo University School of Health Care and Nursing, Chiba, Japan The immune system is characterized by the ability to recognize and react specifically to foreign macromolecular material. The effects of many chemical compounds to immune system have been investigated, and some of them have been reported to have immunological effects. Benzo(a)pyrene is a polycyclic aromatic hydrocarbon (PAH) found in coal tar, the metabolites of which are mutagenic and highly carcinogenic. Benzo(a)pyrene has been reported to be a direct skin irritant and was also shown to be a skin sensitizer, i.e., it causes an allergic skin response in animals and humans. However, the effect of benzo(a)pyrene on inflammatory responses of human keratinocytes is still unclear. The present study was performed to elucidate the effects of benzo(a)pyrene on gene expression in three-dimensionally cultured human keratinocytes. DNA microarray analysis revealed that benzo(a)pyrene enhanced gene expression of interleukin 15 (IL-15) and kallikrein (KLK)-5, -7, and -14. Quantitative realtime RT-PCR analysis showed that benzo(a)pyrene marlkedly induced gene expression of IL15. However, benzo(a)pyrene hardly affected gene expressions of KLKs by the qRT-PCR analysis. As IL-15 regulates T and natural killer (NK) cell activation and proliferation, and provides survival signals that maintain memory T cells. Thus, it is likely that benzo(a)pyrene modulates immunological IL15-mediated functions in skin. Benzo(a)pyrene also enhanced gene expression of Lympho-Epithelial Kazal-Type-related Inhibitor (LEKTI). LEKTI has been demonstrated to be an inhibitor of various KLKs and is thought to play a role in the regulation of skin desquamation. Therefore, benzo(a)pyrene might modulate stratum corneum barrier function through LEKTI. http://dx.doi.org/10.1016/j.jdermsci.2012.11.349
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P01-52 Lupus erythematosus profundus: Clinical and pathological features of 23 cases Azusa Miyashita ∗ , Satoshi Fukushima, Takamitsu Makino, Yuichiro Yoshino, Junji Yamashita, Noritoshi Honda, Jun Aoi, Masatoshi Jinnin, Yuji Inoue, Hironobu Ihn Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan Lupus erythematosus profundus (LEP) is an inflammatory disorder of the subcutaneous fat in patients with lupus erythematosus (LE). It may be observed in patients with discoid lupus erythematosu (DLE), systemic lupus erythematosus or as an isolated phenomenon without systemic or other cutaneous findings. Previous reports suggested that plasmacytoid dendritic cells (pDC) play a central proinflammatory role in the pathogenesis of LE. In this study, we investigated the clinical, histopathological and immunohistochemical features of LEP. We analyzed 23 skin specimens from patients with LEP. We evaluated the degrees of infiltrated lymphocytes and classified the histopathological patterns of the cases into 3 types. Type 1:involves all layers of the skin (associated with DLE), Type 2:involves dermis and fat only, Type 3:involves only fat tissue. In addition, immunohistochemical staining for CD123 was performed as surface marker of pDC. As a result, 12 cases (52%) were classified into Type 1, 7 cases (30%) were Type 2 and 4 cases (17%) were Type 3. All patients classified into Type 1 responded for the treatments. Moderate to strong lymphocytic infiltrations were obserbed in all cases of Type 1. The cases of Type 2 and 3 who presented with minimal lymphocytic inflammation and hyalinized fat necrosis showed poor response to the treatments. The prevalence of CD123 positive cells in Type 1 was higher than that in Type 3 (P = 0.019). Furthermore, the prevalence of positive CD123 in the patients who showed good response to the therapy was higher than that in the patients with poor response (P = 0.02). In conclusion, the prognosis of LE could be predicted from the histopathological features. http://dx.doi.org/10.1016/j.jdermsci.2012.11.350 P01-53 Clinicopathological analysis of mechanic’s hand associated with dermatomyositis. Tatsuhiko Mori ∗ , Tomoko Hiraiwa, Takenobu Otsuka, Toshiyuki Yamamoto
Ohashi, Mikio
Department of Dermatology, School of Medicine, Fukushima Medical University, Fukushima, Japan“Mechanic’s hand” is occasionally seen in the fingers of patients with dermatomyositis. This eruption is frequently associated with anti–aminoacyl tRNA synthetase (ARS) antibodies syndrome and interstitial lung fibrosis.We analyzed the clinical and histological characteristics of patients with mechanic’s hand who had visited our hospital these 5 years. Seven cases were biopsy–proven.As a specific eruption of dermatomyositis other than mechanic’s hand, Gottron’s sign (6/7), periungual erythema (4/7), and heliotrope rash (2/7) were observed. Histological findings revealed hyperkeratosis, parakeratosis, and colloid bodies in all cases. Interstitial pneumonia was observed in six cases, and serum KL–6 levels were elevated in six cases. Six cases were accompanied by myopathy, but none of all cases had anti–Jo–1 antibodies.Mechanic’s hand is one of the important skin
and the severity of AD, eruption type, and epidermal barrier function using a non-invasive method in a sizeable group of the patients. Stratum corneum tissue was obtained from AD patients by tape stripping, and the stratum corneum TSLP (scTSLP) concentration was evaluated using a TSLP-specific antibody followed by image analysis. The correlations between the scTSLP concentration and the severity scoring of AD (SCORAD) index and epidermal barrier function, such as stratum corneum hydration and transepidermal water loss (TEWL), were analyzed. The changes in the scTSLP level induced by the application of moisturizer were also examined.The scTSLP concentration was increased in AD patients compared with healthy subjects and was correlated with SCORAD, especially with the dry skin score, and stratum corneum hydration. Moisturizer application resulted in reduced scTSLP levels.The scTSLP concentration can be used as a biomarker of AD severity and particularly epidermal barrier status. http://dx.doi.org/10.1016/j.jdermsci.2012.11.348 P01-51 Effects of benzo(a)pyrene on gene expression in threedimensionally cultured human keratinocytes Ami Oizumi 1,2,∗ , Chihiro Iwahara 1 , Yasushi Suga 2 , Hideoki Ogawa 1 , Kenji Takamori 1 , Kazuhisa Iwabuchi 1,3 1
Institute for Environmental and Gender-specific Medicine Juntendo University Graduate School of Medicine, Chiba, Japan 2 Department of Dermatology, Juntendo University Urayasu Hospital, Chiba, Japan 3 Laboratory of Biochemistry, Juntendo University School of Health Care and Nursing, Chiba, Japan The immune system is characterized by the ability to recognize and react specifically to foreign macromolecular material. The effects of many chemical compounds to immune system have been investigated, and some of them have been reported to have immunological effects. Benzo(a)pyrene is a polycyclic aromatic hydrocarbon (PAH) found in coal tar, the metabolites of which are mutagenic and highly carcinogenic. Benzo(a)pyrene has been reported to be a direct skin irritant and was also shown to be a skin sensitizer, i.e., it causes an allergic skin response in animals and humans. However, the effect of benzo(a)pyrene on inflammatory responses of human keratinocytes is still unclear. The present study was performed to elucidate the effects of benzo(a)pyrene on gene expression in three-dimensionally cultured human keratinocytes. DNA microarray analysis revealed that benzo(a)pyrene enhanced gene expression of interleukin 15 (IL-15) and kallikrein (KLK)-5, -7, and -14. Quantitative realtime RT-PCR analysis showed that benzo(a)pyrene marlkedly induced gene expression of IL15. However, benzo(a)pyrene hardly affected gene expressions of KLKs by the qRT-PCR analysis. As IL-15 regulates T and natural killer (NK) cell activation and proliferation, and provides survival signals that maintain memory T cells. Thus, it is likely that benzo(a)pyrene modulates immunological IL15-mediated functions in skin. Benzo(a)pyrene also enhanced gene expression of Lympho-Epithelial Kazal-Type-related Inhibitor (LEKTI). LEKTI has been demonstrated to be an inhibitor of various KLKs and is thought to play a role in the regulation of skin desquamation. Therefore, benzo(a)pyrene might modulate stratum corneum barrier function through LEKTI. http://dx.doi.org/10.1016/j.jdermsci.2012.11.349
e17
P01-52 Lupus erythematosus profundus: Clinical and pathological features of 23 cases Azusa Miyashita ∗ , Satoshi Fukushima, Takamitsu Makino, Yuichiro Yoshino, Junji Yamashita, Noritoshi Honda, Jun Aoi, Masatoshi Jinnin, Yuji Inoue, Hironobu Ihn Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan Lupus erythematosus profundus (LEP) is an inflammatory disorder of the subcutaneous fat in patients with lupus erythematosus (LE). It may be observed in patients with discoid lupus erythematosu (DLE), systemic lupus erythematosus or as an isolated phenomenon without systemic or other cutaneous findings. Previous reports suggested that plasmacytoid dendritic cells (pDC) play a central proinflammatory role in the pathogenesis of LE. In this study, we investigated the clinical, histopathological and immunohistochemical features of LEP. We analyzed 23 skin specimens from patients with LEP. We evaluated the degrees of infiltrated lymphocytes and classified the histopathological patterns of the cases into 3 types. Type 1:involves all layers of the skin (associated with DLE), Type 2:involves dermis and fat only, Type 3:involves only fat tissue. In addition, immunohistochemical staining for CD123 was performed as surface marker of pDC. As a result, 12 cases (52%) were classified into Type 1, 7 cases (30%) were Type 2 and 4 cases (17%) were Type 3. All patients classified into Type 1 responded for the treatments. Moderate to strong lymphocytic infiltrations were obserbed in all cases of Type 1. The cases of Type 2 and 3 who presented with minimal lymphocytic inflammation and hyalinized fat necrosis showed poor response to the treatments. The prevalence of CD123 positive cells in Type 1 was higher than that in Type 3 (P = 0.019). Furthermore, the prevalence of positive CD123 in the patients who showed good response to the therapy was higher than that in the patients with poor response (P = 0.02). In conclusion, the prognosis of LE could be predicted from the histopathological features. http://dx.doi.org/10.1016/j.jdermsci.2012.11.350 P01-53 Clinicopathological analysis of mechanic’s hand associated with dermatomyositis. Tatsuhiko Mori ∗ , Tomoko Hiraiwa, Takenobu Otsuka, Toshiyuki Yamamoto
Ohashi, Mikio
Department of Dermatology, School of Medicine, Fukushima Medical University, Fukushima, Japan