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Dermatopathology (Basel, Switzerland) 2019This study describes the clinical characteristics and microscopic findings of nails from 25 patients with palmoplantar pustulosis.
UNLABELLED
This study describes the clinical characteristics and microscopic findings of nails from 25 patients with palmoplantar pustulosis.
METHODS
This is a cross-sectional study of adult patients with clear-cut palmoplantar pustulosis. Onychodystrophy severity was evaluated in fingernails using the nail psoriasis severity index (NAPSI). A fragment of the most dystrophic fingernail was collected from each patient and submitted to routine histotechnical processing. The following microscopic parameters were evaluated: nail plate and subungual region thickness, presence or absence of parakeratosis, number of layers of parakeratosis, and presence of neutrophils, serous lakes, bacteria, blood, and fungi.
RESULTS
Twenty-one patients (84%) presented onychodystrophy with a mean NAPSI score of 12.67. The most common nail change was pitting (76.19% of patients). On average, nail plate thickness and subungual region thickness measured 0.42 and 0.14 mm, respectively. Neutrophils and fungi were not observed, but serous lakes were found in 4.7%, bacteria in 28.57%, blood in 4.76%, and parakeratosis in 19.05% of the patients.
CONCLUSIONS
although palmoplantar pustulosis is a disease with great amounts of neutrophils in the epidermis, those cells were not found in the nail clippings studied herein. Furthermore, when clinical aspects and microscopic findings of palmoplantar pustulosis are compared to those of similar studies in psoriasis vulgaris, they show different characteristics.
PubMed: 31828062
DOI: 10.1159/000503704 -
Effect of Total Glucosides of Paeony on Imiquimod-Induced Psoriatic Skin Lesions by Regulating VEGF.Clinical, Cosmetic and Investigational... 2021The purpose of this study was to use a murine model of psoriasis to examine the effect of total glycosides of paeony (TGP) on psoriatic skin lesions and on the...
PURPOSE
The purpose of this study was to use a murine model of psoriasis to examine the effect of total glycosides of paeony (TGP) on psoriatic skin lesions and on the expression of vascular endothelial growth factor (VEGF) in skin lesions and blood.
METHODS
A murine model of psoriasis was produced by shaving the backs of the mice and applying 5% imiquimod cream, 50 mg, to the backs of the mice once a day. Mice were killed on day 8, and skin and blood samples were obtained for histopathological examination and analysis of VEGF mRNA expression.
RESULTS
By day 8 of the application of imiquimod cream, skin lesions characteristic of psoriasis were evident, and histopathological examination of skin sections showed changes consistent with psoriasis (corneum thickening and parakeratosis, attenuation of the stratum granulosum, thickening of the stratum spinosum, and lengthening of the epidermal ridge). In the treatment group, 7 days of treatment with TGP resulted in resolution of the skin lesions, and histopathological examination showed the epidermis and dermis are approximately normal, without corneum thickening, hyperkeratosis, and parakeratosis. On day 7 of treatment, skin expression of VEGF mRNA was significantly lower in the treatment group than in the group that did not receive treatment (p < 0.05). Blood VEGF mRNA expression was not different between the groups.
CONCLUSION
TGP is effective for the treatment of psoriasis and may act by decreasing lesion VEGF mRNA expression.
PubMed: 34992404
DOI: 10.2147/CCID.S339627 -
International Medical Case Reports... 2022Kyrle's disease (KD) is a rare type of acquired perforating dermatosis (APD) associated with various systemic diseases, particularly chronic kidney disease and diabetes...
Kyrle's disease (KD) is a rare type of acquired perforating dermatosis (APD) associated with various systemic diseases, particularly chronic kidney disease and diabetes mellitus (DM). It most commonly occurs at the lower extremities. Generalized lesions of KD are rare. We report a case of generalized KD in a 29-year-old woman with chronic kidney disease and DM. Physical examination revealed multiple hyperkeratotic and hyperpigmented papules, plaques, and nodules with central umbilication and keratotic plugs on almost all parts of the body. Histopathological examination showed keratinized epithelial layer with acanthosis and hyperkeratosis, invagination with the formation of keratin plugs, and basophilic cell debris accompanied by parakeratosis and abnormal keratinization of epithelial cells. These histopathological findings fulfilled the Constantine and Carter criteria for KD. This condition is characterized clinically by umbilicated, round, erythematous or hyperpigmented papules and nodules with central crusts or keratotic plug, predominantly involving the extensor surfaces of the extremities and the trunk. Although uncommon, it may also involve the face or the scalp. Nevertheless, generalized lesions involving faces are rarely found in KD.
PubMed: 35437356
DOI: 10.2147/IMCRJ.S358523 -
Ear, Nose, & Throat Journal Nov 2022Leukoplakia is a precancerous lesion considered to be within the spectrum of histopathological results from parakeratosis, through stages of dysplasia to invasive... (Review)
Review
INTRODUCTION
Leukoplakia is a precancerous lesion considered to be within the spectrum of histopathological results from parakeratosis, through stages of dysplasia to invasive cancer. Narrow band imaging (NBI) endoscopy has been introduced to improve early diagnosis of benign and malignant laryngeal lesions. The aim of this literature review was to evaluate the accuracy of preoperative evaluation of vocal fold leukoplakia with NBI endoscopy in comparison with histology.
METHODS
A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using 3 different databases: PubMed, Embase, and Scopus. The included articles in the systematic review were identified combining each of the following terms: "narrow band imaging" OR "NBI," [AND] with each of these terms: "laryngeal leukoplakia," OR "vocal fold leukoplakia," OR "vocal cord leukoplakia."
RESULTS
The articles that fully met the inclusion criteria were 5 case series, conducted between January 2010 and February 2018, and published between 2017 and 2019. The selected articles included 312 patients (86% males and 14% females), affected by 382 vocal cord leukoplakia, evaluated with NBI endoscopy and that underwent surgical microlaryngoscopy with biopsy. Based on the studies included in the review, accuracy of NBI in predicting malignancy within leukoplakia ranged from 81% to 97.8%, demonstrating to be an accurate method to predict the risk of malignant transformation of vocal fold leukoplakia.
CONCLUSION
Narrow band imaging can help otolaryngologists in the decision-making process on the necessity to perform a biopsy and transoral surgery or long-term follow-up. Larger studies are necessary to confirm the high association of NBI evaluation of the epithelium surrounding the leukoplakia with the histological diagnosis.
Topics: Endoscopy; Endoscopy, Gastrointestinal; Female; Humans; Laryngeal Neoplasms; Leukoplakia; Male; Narrow Band Imaging; Vocal Cords
PubMed: 33213196
DOI: 10.1177/0145561320973770 -
Cureus May 2023Diffuse esophageal hyperkeratosis (DEH) is a very intriguing and impressive mucosal finding that is quite easily identified on endoscopy and histology. A distinction...
Diffuse esophageal hyperkeratosis (DEH) is a very intriguing and impressive mucosal finding that is quite easily identified on endoscopy and histology. A distinction must be made between microscopic/focal hyperkeratosis and endoscopically visible DEH. Microscopic hyperkeratosis is not uncommon in histological studies, while diffuse hyperkeratosis is seen very rarely. Over the past century, only a handful of cases have been reported. The endoscopic appearance of hyperkeratosis is of thick, white, piled-up mucosa. On histology, there is a prominent thickening of the stratum corneum, the squamous cells are anuclear, and there is no hyperplasia of the squamous epithelium. These histological characteristics distinguish benign orthokeratotic hyperkeratosis from other premalignant entities such as parakeratosis or leukoplakia where hyperplastic squamous cells retain pyknotic nuclei, lack keratohyalin granules, and also lack complete keratinization in superficial epithelial cells. The clinical presentation of hyperkeratosis includes gastroesophageal reflux, hiatal hernia, and associated symptoms. Our case highlights a very rare endoscopic finding associated with a common clinical presentation. The nearly 10-year follow-up reinforces the benign nature of ortho-hyperkeratosis and our report underscores the features that distinguish DEH from premalignant conditions. It merits additional research into factors that lead to hyperkeratinization of the esophageal mucosa as opposed to the more common columnar metaplasia. The concomitant presence of Barrett's esophagus in some patients is even more intriguing. Animal models with variable pH and content of the refluxate may shed light on the role played by duodenogastric/non-acid reflux in this condition. Larger, prospective, multicenter studies may provide the answers.
PubMed: 37180542
DOI: 10.7759/cureus.38757 -
Iranian Journal of Parasitology 2022Cutaneous leishmaniasis (CL) is a chronic granulomatous dermatitis (CGD). Approximately, 90% of CL patients are from seven countries including Iran. We explain PCR)...
BACKGROUND
Cutaneous leishmaniasis (CL) is a chronic granulomatous dermatitis (CGD). Approximately, 90% of CL patients are from seven countries including Iran. We explain PCR) diagnostic technique for chronic granulomatosis dermatoses including CL in Mashhad, Iran.
METHODS
This study enrolled 64 patients within 2009-2013 with chronic granulomatosis dermatitis referred to dermatology and pathology departments of Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. We gathered demographic data from archived folders. Histological light microscopic evaluation and parasitological tests were done on selected specimens. We used PCR diagnostic test on specimens. Statistical analysis was done by SPSS version 15.
RESULTS
Generally, 7 out of 64 specimens had DNA and other samples had no DNA. The mean age of patients was 46 ± 18.77 years; disease duration was 7 ± 6.73 months ranging from 1-24 months. Most of the lesions were located on face and upper limb. Totally, 5 out of 7 samples were and 2 out of 7 samples were . Tuberculoid granuloma was present in samples and 3 of samples. Other light microscopic changes were as follow: 42 suppurative granuloma, and epidermal changes including atrophy, pseudoepitheliomatous hyperplasia, and parakeratosis with dermal changes including, plasma cell, involvement of papillary and reticular dermis, and distribution of granuloma to hypodermis.
CONCLUSION
Our results addressed PCR-based diagnosis of chronic cutaneous leishmaniasis, which is resulted from and .
PubMed: 36694566
DOI: 10.18502/ijpa.v17i4.11285 -
The Journal of Investigative Dermatology Dec 2016Trex2 is a keratinocyte-specific 3'-deoxyribonuclease that participates in the maintenance of skin homeostasis after DNA damage. Here, we show that this exonuclease is... (Comparative Study)
Comparative Study
Trex2 is a keratinocyte-specific 3'-deoxyribonuclease that participates in the maintenance of skin homeostasis after DNA damage. Here, we show that this exonuclease is strongly upregulated in human psoriasis, a hyperproliferative and inflammatory skin disease. Similarly, the imiquimod (IMQ)- and Il23-induced mouse psoriasis was associated with a substantial upregulation of Trex2, which was recruited into fragmented chromatin in keratinocytes that were undergoing impaired proliferation, differentiation, and cell death, indicating an important role in DNA processing. Using Trex2 knockout mice, we have found that Trex2 deficiency attenuated IMQ-induced psoriasis-like skin inflammation and enhanced IMQ-induced parakeratosis. Also, Il23-induced ear swelling was diminished in Trex2 knockout mice in comparison with wild-type (wt) mice. Transcriptome analysis identified multiple genes that were deregulated by Trex2 loss after treatment with IMQ. Specifically, immune response genes and pathways normally associated with inflammation were downregulated, whereas those related to skin differentiation and chromatin biology showed increased expression. Interestingly, Trex2 deficiency led to decreased IMQ-induced keratinocyte death via both cell autonomous and noncell autonomous mechanisms. Hence, our data indicate that Trex2 acts as a critical factor in the pathogenesis of psoriasis by promoting keratinocyte apoptosis and enucleation and thereby influencing skin immune responses.
Topics: Aminoquinolines; Animals; Apoptosis; Biopsy, Needle; Case-Control Studies; Cell Survival; Cells, Cultured; Disease Models, Animal; Exodeoxyribonucleases; Gene Expression Regulation; Humans; Imiquimod; Immunohistochemistry; Keratinocytes; Mice; Mice, Knockout; Phenotype; Prognosis; Psoriasis; Severity of Illness Index; Up-Regulation
PubMed: 27365293
DOI: 10.1016/j.jid.2016.05.122 -
Biomedicine & Pharmacotherapy =... Mar 2023Psoriasis, a chronic autoimmune disease characterized by the hyperproliferation of keratinocytes in the epidermis and parakeratosis, significantly impacts quality of...
Psoriasis, a chronic autoimmune disease characterized by the hyperproliferation of keratinocytes in the epidermis and parakeratosis, significantly impacts quality of life. Interleukin (IL)- 17A dominates the pathogenesis of psoriasis and facilitates reactive oxygen species (ROS) accumulation, which exacerbates local psoriatic lesions. Biologic treatment provides remarkable clinical efficacy, but its high cost and unignorable side effects limit its applications. 3 H-1,2-Dithiole-3-thione (D3T) possesses compelling antioxidative capacities against several diseases through the nuclear factor erythroid 2-related factor 2 (Nrf2) cascade. Hence, we aimed to evaluate the effect and mechanism of D3T in psoriasis. We found that D3T attenuates skin thickening and scaling by inhibiting IL-17A-secreting γδT cells in imiquimod (IMQ)-induced psoriatic mice. Interleukin-17A markedly enhanced IL-6 and IL-8 expression, lipid peroxidation, the contents of nitric oxide and hydrogen peroxide, oxidative phosphorylation and the MAPK/NF-κB pathways in keratinocytes. IL-17A also inhibited the Nrf2-NQO1-HO-1 axis and the activities of superoxide dismutase and glutathione peroxidase. D3T significantly reversed these parameters in IL-17A-treated keratinocytes. ML-385, a Nrf2 neutralizer, failed to improve D3T-induced anti-inflammatory and antioxidative effects in IL-17A-treated keratinocytes. We conclude that targeting Nrf2 with D3T to diminish oxidative and inflammatory damage in keratinocytes may attenuate psoriasis.
Topics: Mice; Animals; Interleukin-17; NF-E2-Related Factor 2; Quality of Life; Oxidative Stress; Psoriasis; Keratinocytes; Antioxidants
PubMed: 36706632
DOI: 10.1016/j.biopha.2023.114294 -
Scientific Reports Jan 2023Skin homeostasis is a complex regulated process relying on the crosstalk of keratinocytes, fibroblasts and immune cells. Imbalances of T-cell subsets and the cytokine...
Skin homeostasis is a complex regulated process relying on the crosstalk of keratinocytes, fibroblasts and immune cells. Imbalances of T-cell subsets and the cytokine environment can lead to inflammatory skin diseases such as psoriasis (Ps) and atopic dermatitis (AD). Modern tissue engineering provides several in vitro models mimicking Ps and AD phenotypes. However, these models are either limited in their pathological features, life span, sample availability, reproducibility, controlled handling or simplicity. Some models further lack intensive characterization as they solely focus on differentiation and proliferation aspects. This study introduces a self-assembly model in which the pathological T-cell-signalling of Ps and AD was simulated by subcutaneous Th1 and Th2 cytokine stimulation. The self-established dermal fibroblast-derived matrices of these models were hypothesized to be beneficial for proximal cytokine signalling on epidermal keratinocytes. Comprehensive histological and mRNA analyses of the diseased skin models showed a weakened barrier, distinct differentiation defects, reduced cellular adhesion, inflammation and parakeratosis formation. A keratin shift of declining physiological cytokeratin-10 (CK10) towards increasing inflammatory CK16 was observed upon Th1 or Th2 stimulation. Antimicrobial peptides (AMPs) were upregulated in Ps and downregulated in AD models. The AD biomarker genes CA2, NELL2 and CCL26 were further induced in AD. While Ps samples featured basal hyperproliferation, cells in AD models displayed apoptotic signs. In accordance, these well-controllable three-dimensional in vitro models exhibited Ps and AD-like phenotypes with a high potential for disease research and therapeutic drug testing.
Topics: Humans; Dermatitis, Atopic; Reproducibility of Results; Psoriasis; Fibroblasts; Phenotype
PubMed: 36720910
DOI: 10.1038/s41598-023-28822-7 -
International Journal of Molecular... Dec 2023The epidermis serves many vital roles, including protecting the body from external influences and healing eventual injuries. It is maintained by an incredibly complex... (Review)
Review
The epidermis serves many vital roles, including protecting the body from external influences and healing eventual injuries. It is maintained by an incredibly complex and perfectly coordinated keratinization process. In this process, desquamation is essential for the differentiation of epidermal basal progenitor cells into enucleated corneocytes, which subsequently desquamate through programmed death. Numerous factors control keratinocyte differentiation: epidermal growth factor, transforming growth factor-α, keratinocyte growth factor, interleukins IL-1-β and IL-6, elevated vitamin A levels, and changes in Ca concentration. The backbone of the keratinocyte transformation process from mitotically active basal cells into fully differentiated, enucleated corneocytes is the expression of specific proteins and the creation of a Ca and pH gradient at precise locations within the epidermis. Skin keratinization disorders (histologically characterized predominantly by dyskeratosis, parakeratosis, and hyperkeratosis) may be categorized into three groups: defects in the α-helical rod pattern, defects outside the α-helical rod domain, and disorders of keratin-associated proteins. Understanding the process of keratinization is essential for the pathogenesis of many dermatological diseases because improper desquamation and epidermopoiesis/keratinization (due to genetic mutations of factors or due to immune pathological processes) can lead to various conditions (ichthyoses, palmoplantar keratodermas, psoriasis, pityriasis rubra pilaris, epidermolytic hyperkeratosis, and others).
Topics: Humans; Skin; Epidermis; Cell Differentiation; Keratinocytes; Psoriasis
PubMed: 38203406
DOI: 10.3390/ijms25010236