bromochloroacetic-acid and Erythema

Milia en plaque, a rare inflammatory plaque type of milia is generally located in the periauricular area. Bilateral retroauricular milia en plaque is very rarely reported. Here, we report another case of bilateral retroauricular milia en plaque and review the previous cases.

Topics: Adult; Biopsy; Ear, External; Epidermal Cyst; Erythema; Female; Humans; Keratins; Neck

Topics: Epidermolysis Bullosa Simplex; Erythema; Humans; Keratins

Exposure of human skin to ultraviolet radiation (UVR) results in erythema, pigment darkening, skin cancer and photoageing. In addition to conventional organochemical and the physical-mineral type sunscreens (SS), other non-SS protective strategies have been investigated, including antioxidants (AOx) and topical DNA repair enzymes.. To investigate whether AOx could improve the protection provided by a broad-spectrum sunscreen (SS) preparation.. Volunteers were exposed to repetitive solar-simulated (ss)UVR at 1.5 times minimal erythema dose for four consecutive days. Thirty minutes before each exposure and 6, 24 and 48 h after the last exposure, the test materials [vehicle, SS (sun protection factor 25) alone, AOx alone and SS plus AOx] were applied to four different sites. Another two sites received ssUVR only, or SS plus AOx only, and a third site was left untreated (neither ssUVR or product). Erythema and pigmentation were measured using a Mexameter. Biopsy specimens were taken 72 h after the last irradiation. The thickness of the stratum corneum and epidermis were measured by microscopy. Expression of cytokeratins (CKs), matrix metalloproteinases (MMPs) and CD1a-positive Langerhans cells (LCs) analysed by immunohistochemical staining, and relative expression levels were compared between all seven sites.. AOx alone did not reduce erythema. There was a significant reduction in pigmentation, and the product almost completely protected against LC depletion. AOx plus SS gave better protection against pigment formation and CK5/6 induction than SS alone. AOx alone protected against ssUVR-induced hyperproliferation, as shown by epidermal thickness and CK16 biomarkers, and was better than SS alone. Interestingly, although protection against induction of MMP-9, a marker of photoageing, did not reach significance when either SS or AOx were applied separately, there was complete protection against MMP-9 induction when these were combined.. Non-SS materials such as AOx can contribute significantly to sun protection when added to a broad-spectrum SS and applied topically to human skin in vivo.

Topics: Antioxidants; Cell Proliferation; Drug Therapy, Combination; Epidermis; Erythema; Female; Humans; Keratins; Langerhans Cells; Matrix Metalloproteinases; Melanins; Radiation Injuries; Skin Aging; Skin Pigmentation; Sunscreening Agents; Ultraviolet Rays

New therapeutic approaches have to be considered in the treatment of irritant contact dermatitis (ICD). Recently, phosphodiesterase 4 (PDE-4) inhibitors have been introduced as nonsteroidal, antiinflammatory agents. These agents inhibit the secretion of the cytokines thought to be involved in the pathogenesis of ICD. We investigated the effect of a new selective PDE-4 inhibitor (cipamfylline) in human models using single and repeated exposures to an irritant in a blind, randomized pilot study with healthy volunteers. We compared the effect of cipamfylline ointment with a strong corticosteroid (betamethasone-17-valerate) and with a placebo ointment.. Ten volunteers were patch tested at four investigation sites with sodium dodecyl sulphate (1%) for 24 h. In a model that simulates chronic damage, 11 volunteers were patch tested with sodium dodecyl sulphate (0.2%) for 4 h daily for four consecutive days. The investigation sites were treated once a day with the above-mentioned agents. One site was left untreated. We used erythema scoring, measurements of transepidermal water loss (TEWL) and several immunohistochemical markers for epidermal proliferation and differentiation.. Repeated application revealed that betamethasone-17-valerate caused a statistically significant reduction in erythema and TEWL compared to cipamfylline and placebo. We also observed a significant suppression of proliferating cells and cytokeratin 16 expression at sites treated with betamethasone compared to the other sites. In the model for acute ICD, no significant differences were seen between the investigated sites.. Our results show that betamethasone-17-valerate may modulate the response in ICD. In this human model of ICD we could not confirm the efficacy of cipamfylline. Clinical studies are needed before the effect of PDE-4 inhibitors in ICD can be refuted with certainty.

Topics: 3',5'-Cyclic-AMP Phosphodiesterases; Adult; Aged; Betamethasone Valerate; Cell Division; Cyclic Nucleotide Phosphodiesterases, Type 4; Dermatitis, Irritant; Dose-Response Relationship, Drug; Double-Blind Method; Enzyme Inhibitors; Erythema; Female; Glucocorticoids; Humans; Keratins; Male; Middle Aged; Pilot Projects; Sodium Dodecyl Sulfate; Surface-Active Agents; Water Loss, Insensible; Xanthines

To determine whether inflamed and uninflamed epidermoid cysts differ in the number and/or type of bacteria inhabiting them.. A controlled study. We obtained aerobic and anaerobic bacterial culture specimens from 25 inflamed and 25 uninflamed epidermoid cysts.. A university medical center.. Nonimmunocompromised adults without recent systemic use of antibiotics.. The 2 groups did not differ significantly with respect to number of bacterial isolates, "no growth" cultures, and aerobic, anaerobic, or potential pathogens cultured.. The microbiological milieu of inflamed epidermoid cysts is similar to that of uninflamed cysts. Possible mechanisms for inflammation are discussed.

Topics: Adult; Aged; Bacteria, Aerobic; Bacteria, Anaerobic; Colony Count, Microbial; Cysts; Erythema; Female; Gram-Positive Bacterial Infections; Humans; Inflammation; Keratins; Male; Middle Aged; Peptostreptococcus; Skin Diseases; Staphylococcal Infections; Staphylococcus aureus; Suppuration

Objective comparison of different antipsoriatic therapies requires quantitative assessment of disease severity. However, clinical assessment with the widely used Psoriasis Area and Severity Index (PASI) introduces inaccuracy. An alternative is the quantitative analysis of different epidermal cell parameters using multiparameter flow cytometry. Our aim in the present study was to compare the clinical and flow cytometric approach to monitor disease activity and to evaluate antipsoriatic efficacy. Clinical scores for erythema, induration and scaling were assessed and biopsies for flow cytometric analysis were obtained from the psoriatic plaques of 89 patients before and after treatment with different therapeutic regimens consisting of vitamin D3 analogues and corticosteroids. In total, 219 epidermal cell suspensions were analysed using triple-labelling, with the simultaneous staining of markers for epidermal proliferation (DNA dye TO-PRO-3), differentiation (antikeratin 10), and inflammation (antivimentin). Correlation analysis was performed on 166 paired values obtained from 83 patients. A highly significant correlation was observed between erythema and the percentage of vimentin-positive cells, between scaling and the percentage of keratin 10 positive keratinocytes, and between induration and the number of basal keratinocytes in the S- and G2M phase, when all 166 biopsies were assessed. The correlation remained in the same range if the analysis was restricted to the 83 pretreatment biopsies. In contrast to the clinical scores, the flow cytometric analysis permitted a clear separation between the antiproliferative and anti-inflammatory or keratinization-enhancing effects of antipsoriatic treatment. The vitamin D3 analogues proved to exert a mainly antiproliferative effect. The combination of calcipotriol and a topical corticosteroid improved all cell biological markers substantially, and clobetasol monotherapy had a powerful effect on these markers. In conclusion, multiparameter flow cytometry has been shown to be a sensitive tool to evaluate the growth inhibiting, anti-inflammatory and keratinization-enhancing effects of antipsoriatic therapies.

Topics: Biomarkers; Cell Cycle; Epidermis; Erythema; Flow Cytometry; Humans; Keratins; Psoriasis; Severity of Illness Index; Treatment Outcome; Vimentin

The relevance of salicylic acid in dithranol creams was evaluated in a double-blind study. Patients with chronic plaque psoriasis were treated using a short-contact schedule for dithranol on an outpatient basis. A left-right comparison was carried out between sites treated with either dithranol with 2% salicylic acid (D + S) or dithranol in the same base without salicylic acid (D-S). Clinical results were evaluated once a week using the psoriasis area severity index. In order to quantify the improvement, flow cytometric measurements were done using the monoclonal antibody Ks8.12, recognizing keratin 16 in normal and lesional epidermis. Simultaneously, relative DNA content was quantified which previously was described as a useful method to monitor a therapeutic effect. Both PASI scores and Ks8.12 binding decreased after 6 weeks treatment with D + S and D-S. However, percentages of cells in SG2M phases did not show a significant change. No significant difference was observed between sites treated with either D + S or D-S. Therefore we conclude that the addition of salicylic acid in a concentration of 2% does not enhance the efficacy of dithranol creams and we confirm that Ks8.12 is a useful quantitative marker for therapeutic efficacy.

Topics: Adolescent; Adult; Anthralin; DNA; Double-Blind Method; Erythema; Female; Flow Cytometry; Humans; Keratins; Male; Middle Aged; Ointments; Psoriasis; Randomized Controlled Trials as Topic; Salicylates; Salicylic Acid; Skin

Ultraviolet (UV) radiation damages the stratum corneum (SC) and disrupts the skin barrier. The damaged skin changes in the molecular composition of the SC, including its water content. However, it is difficult to examine the in vivo SC changes with existing methods, so those have not been well characterized. Therefore, we investigated in vivo changes of UV-induced SC damage using confocal Raman spectroscopy.. We irradiated the volar forearm of 10 subjects with 0.5, 1, and 1.5 minimal erythemal doses of UV radiation. Then, we examined erythema, the transepidermal water loss (TEWL), the water content, the natural moisturizing factor (NMF), and the lipids of the skin.. After UV irradiation, erythema and TEWL of the skin were both increased. The bound water content of the SC was also increased following UV irradiation. The NMF of the SC revealed different tendencies. All free amino acids (FAAs) of the NMF were increased after UV irradiation, except proline. trans-urocanic acid, pyrrolidone carboxylic acid, lactate, and urea, which are NMF components produced by the subsequent catabolism of FAAs and sweat, were decreased after UV irradiation. The amount of ceramide in the SC was also decreased after UV exposure, while cholesterol was increased.. The bound water content of the SC was increased by UV exposure along with increasing TEWL, several NMF components, and cholesterol. These in vivo results for UV-damaged SC obtained via Raman spectroscopy could be applied to research with regard to protecting the SC from UV radiation and treating UV-damaged SC.

Topics: Adult; Epidermis; Erythema; Female; Humans; Keratins; Male; Radiation Exposure; Spectrum Analysis, Raman; Ultraviolet Rays; Water Loss, Insensible; Young Adult

Topics: Biomarkers; Cell Differentiation; Cell Proliferation; Erythema; Female; Hand Dermatoses; Humans; Keratins; Keratosis; Middle Aged

The erbium:yttrium-aluminum-garnet (Er:YAG) laser is used for surgical resurfacing. It has ablative properties with water as its main chromophore.. This study attempted to establish the cutaneous effect and cellular response to Er:YAG laser irradiation using different fluences (7.5 and 15 J/cm(2)).. Female nude mouse was used as the animal model in the study. Physiological parameters were examined and histology was evaluated at 4, 24 and 96 h after laser exposure. A proteomic analysis and immunoblotting were also used to determine the mechanisms of the laser's effect on the skin.. Both fluences were associated with a significant increase in transepidermal water loss (TEWL), erythema (a*), and the skin pH at 4 and 24h. In contrast, at 96 h, the levels of these parameters had generally decreased to the baseline. The histology examined by light microscopy and transmission electron microscopy (TEM) showed vacuolization, hydropic degeneration and epidermal necrosis of laser-irradiated skin. The higher fluence (15 J/cm(2)) exhibited more-severe disruption of the skin. Bulous and scarring were observed in skin treated with the higher fluence during the recovery period. p53 and p21 proteins were significantly activated in skin following exposure to the laser. However, proliferating cell nuclear antigen and cytokeratin expressions were downregulated by the low fluence (7.5 J/cm(2)).. Both proliferation and apoptosis occurred when the laser-irradiated the skin.

Topics: Animals; Antigens, Nuclear; Apoptosis; Cell Proliferation; Cicatrix; Cyclin-Dependent Kinase Inhibitor p21; Erythema; Female; Keratins; Lasers, Solid-State; Mice; Mice, Nude; Models, Animal; Necrosis; Proteomics; Skin; Tumor Suppressor Protein p53

Necrolytic migratory erythema (NME) is an uncommon inflammatory dermatosis with a distinctive clinical and histological appearance. It shows irregular erythema, bullae, erosion, crusts and pigmentation. While it is typically associated with glucagonoma, some cases of NME without glucagonoma have been reported. Herein, we report a case of necrolytic migratory erythema associated with malabsorption 30 years after ileocolectomy. She presented erosive erythema with scale or partly flaccid bullae on her intergluteal cleft, buttock and extremities. Her laboratory data revealed essential amino acid deficiency and a slightly decreased serum zinc level, while her plasma glucagon level was low. With diagnosis of non-glucagonoma-associated NME with malabsorption due to short-bowel syndrome, she was treated and improved by i.v. amino acid supplement. Histological findings of NME include necrotic changes of keratinocytes in the upper epidermis, proliferation of those in the lower epidermis and inflammatory cell infiltration of upper dermis. We also examined the expression pattern of epidermal keratins (K6, K10) and Ki-67, one of the markers of proliferative activity, to assess the proliferation and differentiation of keratinocytes in a NME lesion by immunostaining. The findings with these immunostainings support the characteristics of HE-staining, and suggest hyponutrition may induce changing differentiation/proliferation of keratinocytes.

Topics: Cell Differentiation; Cell Proliferation; Erythema; Female; Humans; Keratinocytes; Keratins; Middle Aged; Short Bowel Syndrome

Viral-associated trichodysplasia of immunosuppression is a newly described clinicopathologic entity found in patients who are undergoing drug-induced immunosuppression to prevent organ transplant rejection. Patients have numerous erythematous papules concentrated in the central portion of the face and variable degrees of hair loss, most severely affecting facial hair. Histologic findings of facial papules are highly distinctive and unique, and suggest that the entire machinery of the follicular bulb is devoted to the manufacture of inner root sheath-type keratin. Electron microscopy reveals intranuclear viral particles, but precise viral identification has not yet been achieved.

Topics: Adolescent; Alopecia; Erythema; Facial Dermatoses; Female; Hair Follicle; Humans; Immunocompromised Host; Immunosuppression Therapy; Immunosuppressive Agents; Keratins; Kidney Transplantation; Microscopy, Electron

We report here two unrelated families in Japan and Korea having patients with a unique type of epidermolysis bullosa simplex and a novel mutation in the keratin gene KRT5, i.e., a frameshift and delayed stop codon inconsistent with any subtype described before. The patients showed migratory circinate erythema and multiple vesicles on the circular belt-like areas affected by erythema. Electron microscopy of skin biopsies showed a reduction in the number of keratin intermediate filaments in the basal cells without tonofilament clumping. We identified a novel heterozygous deletion mutation (1649delG of KRT5) in both cases. This deletion is predicted to produce a mutant keratin 5 protein with a frameshift of its terminal 41 amino acids and 35 amino acids longer than the wild-type keratin 5 protein due to a delayed termination codon. As the same abnormal elongated mutant KRT5 gene was found in the independent families, the predicted abnormal elongated keratin protein is likely to lead to an atypical clinical phenotype that has never been reported, possibly by interfering with the functional interaction between keratin and its associated proteins.

Topics: Amino Acid Sequence; Child, Preschool; Codon, Terminator; Epidermolysis Bullosa Simplex; Erythema; Female; Frameshift Mutation; Gene Deletion; Heterozygote; Humans; Infant; Keratin-5; Keratins; Molecular Sequence Data; Phenotype

During evolution, placental mammals appear to have lost cyclobutane pyrimidine dimer (CPD) photolyase, an enzyme that efficiently removes UV-induced CPDs from DNA in a light-dependent manner. As a consequence, they have to rely solely on the more complex, and for this lesion less efficient, nucleotide excision repair pathway. To assess the contribution of poor repair of CPDs to various biological effects of UV, we generated mice expressing a marsupial CPD photolyase transgene. Expression from the ubiquitous beta-actin promoter allowed rapid repair of CPDs in epidermis and dermis. UV-exposed cultured dermal fibroblasts from these mice displayed superior survival when treated with photoreactivating light. Moreover, photoreactivation of CPDs in intact skin dramatically reduced acute UV effects like erythema (sunburn), hyperplasia and apoptosis. Mice expressing the photolyase from keratin 14 promoter photo reactivate CPDs in basal and early differentiating keratinocytes only. Strikingly, in these animals, the anti-apoptotic effect appears to extend to other skin compartments, suggesting the presence of intercellular apoptotic signals. Thus, providing mice with CPD photolyase significantly improves repair and uncovers the biological effects of CPD lesions.

Topics: Actins; Animals; Apoptosis; Cells, Cultured; Deoxyribodipyrimidine Photo-Lyase; DNA; DNA Damage; DNA Repair; Epidermis; Erythema; Fibroblasts; Glutathione Transferase; Humans; Hyperplasia; Keratinocytes; Keratins; Macropodidae; Mice; Mice, Transgenic; Promoter Regions, Genetic; Pyrimidine Dimers; Radiation Injuries, Experimental; Radiation Tolerance; Recombinant Fusion Proteins; Skin; Transgenes; Ultraviolet Rays

Erythrokeratodermia variabilis (EKV) is an autosomal dominant keratinization disorder characterized by migratory erythematous lesions and fixed keratotic plaques. All families with EKV show mapping to chromosome 1p34-p35, and mutations in the gene for connexin 31 (Cx31) have been reported in some but not all families. We studied eight affected and three healthy subjects in an Israeli family, of Kurdish origin, with EKV. After having mapped the disorder to chromosome 1p34-p35, we found no mutations in the genes for Cx31, Cx31.1, and Cx37. Further investigation revealed a heterozygous T-->C transition leading to the missense mutation (F137L) in the human gene for Cx30.3 that colocalizes on chromosome 1p34-p35. This nucleotide change cosegregated with the disease and was not found in 200 alleles from normal individuals. This mutation concerns a highly conserved phenylalanine, in the third transmembrane region of the Cx30.3 molecule, known to be implicated in the wall formation of the gap-junction pore. Our results show that mutations in the gene for Cx30.3 can be causally involved in EKV and point to genetic heterogeneity of this disorder. Furthermore, we suggest that our family presents a new type of EKV because of the hitherto unreported association with erythema gyratum repens.

Topics: Adult; Alleles; Amino Acid Sequence; Base Sequence; Child; Chromosome Mapping; Chromosomes, Human, Pair 1; Connexins; DNA Mutational Analysis; Erythema; Female; Genetic Heterogeneity; Genetic Linkage; Haplotypes; Humans; Israel; Keratins; Male; Molecular Sequence Data; Mutation, Missense; Pedigree; RNA, Messenger; Sequence Alignment

The purpose of this study was to investigate the histological changes following short-term smokeless tobacco application in humans. Sixteen smokeless tobacco-using subjects participated in this trial. Each subject had used at least 3 cans of snuff per week for the previous 2 yr and had an existing lesion at the site of habitual snuff placement. The experimental design included subject placement of moist snuff (University of Kentucky reference tobacco brand 1S3) at a new site in the mandibular arch. At either 2 or 7 d, biopsies were taken from the new lesions and from a non-placement site in the opposing arch. The volume density of inflammatory cells was determined by point counting. Keratin and epithelial thickness were evaluated by digitizing morphometry. Data were analyzed by repeated measures analysis of variance. In 7-d lesions, increased keratin thickness was observed at the new sites compared to the non-placement sites (p = 0.05). Increased volume density of fibroblasts (p = 0.027) and decreased volume densities of macrophages (p = 0.0083) and mast cells (p = 0.05) were observed at 2 d in new versus non-placement sites. Clinically, the new sites showed erythema, erythema plus ulceration, or white striations. This study demonstrated histological and clinical changes at new snuff placement sites in as few as 2-7 d, underscoring the rapidity of tissue alterations following snuff use.

Topics: Adult; Analysis of Variance; Cell Count; Epithelium; Erythema; Fibroblasts; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Keratins; Macrophages; Male; Mandible; Mast Cells; Mouth Diseases; Mouth Mucosa; Neutrophils; Oral Ulcer; Plants, Toxic; Tobacco, Smokeless

Four mixed Merkel cell and squamous cell carcinomas of the skin are described. The patients ranged in age from 74 to 90 years and demonstrated or had a history of previous ultraviolet or infrared damage to the skin, manifested by basal cell carcinoma, squamous cell carcinoma, actinic keratoses, solar elastosis, and erythema ab igne. Light microscopic examination of all 4 cases revealed invasive neoplasms consisting of 2 distinct but admixed cell types. The predominant cell type was consistent with Merkel cell carcinoma and was characterized by scant cytoplasm, a small dark polygonal nucleus with granular chromatin, a high mitotic rate, and cytokeratin 20 positivity. In each case, the Merkel cell component merged with a cytokeratin 20 negative squamous component characterized by abundant eosinophilic cytoplasm, intercellular bridges, and keratinization with focal squamous pearl formation. Immunohistochemical staining patterns were consistent with the usual pattern for that cell type; transitional cells were not demonstrated. The intimate admixture of the 2 antigenically different neoplastic cell types, and common etiologic role of ultraviolet and possibly infrared damage, lend support to the theory that some Merkel cell carcinomas and squamous cell carcinomas may arise from a pluripotent epidermal stem cell.

Topics: Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Merkel Cell; Carcinoma, Squamous Cell; Cell Nucleus; Cytoplasm; Elastic Tissue; Erythema; Female; Humans; Infrared Rays; Keratins; Keratosis; Male; Mitosis; Neoplasms, Multiple Primary; Skin Aging; Skin Neoplasms; Ultraviolet Rays

Milia en plaque is an uncommon skin condition usually seen in adult women, typically in the retroauricular region. We report a new localization in a young child.. A 6-year-old girl with an uneventful history had developed over the last 7 months an erythematous plaque with numerous whitish-yellow microcysts on the left internal canthus. No local or general favoring factor was found. Skin biopsy showed numerous cystic cavities with an epidermal lining containing layers of keratin within a moderately inflammatory infiltration. The lesion resolved after enucleation of the cysts and no recurrence has been observed after 9 months follow-up.. Milia en plaque is a charateristic erythematous lesion covered with cysts. The usual localization is the retroauricular region, but other localizations have been reported, mainly on the head. This is the first report involving the internal canthus and also in such a young child. One case of a 15-year-old boy has been discribed. Milia en plaque is often a primary condition as in our case although local or general factors may rarely be inductive. Our case illustrates the different localizations possible for milia en plaque, with predominance on the head, and the possibility of childhood cases. We prefer the term milia en plaque rather than retroauricular milia en plaque.

Topics: Child; Diagnosis, Differential; Epidermal Cyst; Erythema; Facial Dermatoses; Female; Follow-Up Studies; Humans; Keratins; Skin Diseases

Keratolytic winter erythema (KWE), also known as "Oudtshoorn skin disease," or "erythrokeratolysis hiemalis," is an autosomal dominant skin disorder of unknown etiology characterized by a cyclical erythema, hyperkeratosis, and recurrent and intermittent peeling of the palms and soles, particularly during winter. Initially KWE was believed to be unique to South Africa, but recently a large pedigree of German origin has been identified. The disorder occurs with a prevalence of 1/7,000 in the South African Afrikaans-speaking Caucasoid population, and this high frequency has been attributed to founder effect. After a number of candidate regions were excluded from linkage to KWE in both the German family and several South African families, a genomewide analysis was embarked on. Linkage to the microsatellite marker D8S550 on chromosome 8p22-p23 was initially observed, with a maximum LOD score (Z(max)) of 9.2 at a maximum recombination fraction (theta(max)) of .0 in the German family. Linkage was also demonstrated in five of the larger South African families, with Z(max) = 7.4 at theta(max) = .02. When haplotypes were constructed, 11 of 14 South African KWE families had the complete "ancestral" haplotype, and 3 demonstrated conservation of parts of this haplotype, supporting the hypothesis of founder effect. The chromosome segregating with the disease in the German family demonstrated a different haplotype, suggesting that these chromosomes do not have a common origin. Recombination events place the KWE gene in a 6-cM interval between D8S550 and D8S552. If it is assumed that there was a single South African founder, a proposed ancestral recombinant suggests that the gene is most likely in a 1-cM interval between D8S550 and D8S265.

Topics: Chromosome Mapping; Chromosomes, Human, Pair 8; Dermatitis, Exfoliative; Erythema; Female; Founder Effect; Genes, Dominant; Genetic Linkage; Germany; Haplotypes; Humans; Keratins; Keratoderma, Palmoplantar; Lod Score; Male; Microsatellite Repeats; Pedigree; Periodicity; Seasons; South Africa

Although the induction of acute irritant dermatitis by detergents has been studied extensively in recent years, our understanding of the cell biological events in the repair phase, and its relevance for the development of chronic irritant dermatitis is limited. Here we studied the reaction pattern of human skin to short-term application of sodium dodecyl sulphate (SDS) in a model that induced a minimal acute inflammatory reaction (absence of polymorphonuclear leucocytes, PMN) and did not have cytopathic effects on the epidermal keratinocytes as determined by histological investigation. All parameters were measured up to 14 days after exposure to SDS. Application of SDS caused disturbances of barrier function as measured by transepidermal water loss and had vascular effects as judged by erythema. Several cell biological markers for epidermal growth and differentiation were examined by immunohistochemistry. A rapid and strong induction of the cornified envelope precursor protein involucrin was seen in the stratum spinosum, with a peak at 24 h. Within 24 h a strong upregulation of epidermal fatty acid binding protein (E-FABP) was noted, with a peak at 7 days after injury. Cellular proliferation in the basal layer was increased fivefold as assessed by nuclear staining for the Ki-67 antigen, showing a peak at 48 h. Surprisingly, no significant induction of cytokeratin 16 and SKALP/elafin expression, two markers associated with epidermal hyper-proliferation and inflammation, was seen. These findings suggest that the cellular changes following exposure to detergent are distinct from those seen in other forms of skin injury. We would speculate that the epidermal response to detergent exposure is primarily directed at restoration of barrier function.

Topics: Adult; Biomarkers; Carrier Proteins; Cell Differentiation; Cell Division; Dermatitis, Irritant; Detergents; Epidermis; Erythema; Fatty Acid-Binding Protein 7; Fatty Acid-Binding Proteins; Female; Humans; Keratinocytes; Keratins; Ki-67 Antigen; Male; Models, Biological; Myelin P2 Protein; Neoplasm Proteins; Protein Precursors; Proteinase Inhibitory Proteins, Secretory; Proteins; Sodium Dodecyl Sulfate; Time Factors; Tumor Suppressor Proteins

50 patients with oral lichen planus (LP) were investigated for current anxiety and depression and for related personality factors. Anxiety levels, as measured on the Hospital Anxiety and Depression (HAD) Scale, were elevated in 50% of cases while depression scores, measured on the same scale, were low in all but a few. The sample profile showed a slight tendency towards anxiety, as measured by the Cattell 16 PF Questionnaire, but did not confirm previous reports of high intelligence and intellectual orientation. There were no statistically significant associations between erosive oral LP and either anxiety or depression, as measured on the HAD Scale, or anxiety as measured by the Cattell 16 PF Questionnaire.

Topics: Adult; Aged; Anxiety; Depression; Epithelium; Erythema; Female; Humans; Intelligence; Keratins; Lichen Planus, Oral; Lymphocytes; Male; Middle Aged; Personality; Personality Inventory; Ulcer

The topical application of a hydrocolloid occlusive dressing (HCD) has been shown in various studies to have an antipsoriatic effect as monotherapy but especially in combination with a topical corticosteroid. The aim of the present study was to assess the effect of 3 weeks of HCD monotherapy at the immunohistochemical level. Ten patients were treated. Before and after treatment, a biopsy was taken, and immunohistochemical stainings were carried out with markers for epidermal growth, keratinization, inflammation and endothelium. Suprabasal expression of keratin 16, the number of cycling epidermal cells and the number of polymorphonuclear leucocytes and T lymphocytes tended to decrease during treatment. The endothelial markers did not change during HCD treatment. This study confirms the antipsoriatic effect of HCD and demonstrates that its effect upon some markers of inflammation, epidermal proliferation and keratinization is modest.

Topics: Adult; Aged; Bandages, Hydrocolloid; Cell Cycle; Colloids; Endothelium, Vascular; Epidermis; Erythema; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Neutrophils; Occlusive Dressings; Psoriasis; Staining and Labeling; T-Lymphocytes

Merkel cells (MC) were identified immunohistochemically using antibodies specific for cytokeratin (CK) 20 within human epidermis 12 to 72 h after exposure to UVB (4 MED). 12 h after exposure all MC were normally localized within the epidermal basal layer. However, 24 h after exposure 4% of the MC were detected suprabasally, the remaining 96% still being situated in the basal layer. Surprisingly, at 48 h and 72 h more than 50% had lost contact with the basal membrane. The MC of hair follicles did not show any obvious changes. These results argue, in the context of acute epidermal UV damage, for an abnormal turnover in dermatitis.

Topics: Acute Disease; Epidermis; Erythema; Female; Humans; Keratins; Male; Ultraviolet Rays

Skin biopsies were investigated with two different immunohistochemical techniques, thus revealing HLA-DQ antigens on HLA-DR-expressing keratinocytes in the late skin manifestations of a Borrelia spirochete infection. In the early skin lesions only HLA-DR antigens were present on the keratinocytes. The invariant gamma chain of class II transplantation antigens was observed on keratinocytes in 1:5 of the late cases. Upon penicillin treatment detectable HLA-DR and HLA-DQ antigens disappeared completely from the keratinocytes. Furthermore, the mononuclear cell infiltrates dominated by anti-Leu 1 and anti-Leu 3a-reactive cells and containing many cells with markers for activation (HLA-DR, HLA-DQ, transferrin, and interleukin 2 receptors) diminished markedly. The possibility that the expression of different class II transplantation antigens on keratinocytes might reflect separate functional demands of these cells or an altered immunological reactivity in the host, is discussed. The precise functional role of the temporary expression of the class II antigens on non-lymphoid cells, however, remains an enigma.

Topics: Acrodermatitis; Borrelia Infections; Epidermal Cells; Erythema; Histocompatibility Antigens Class II; HLA-DQ Antigens; Humans; Keratins; Skin

A 30-year-old woman with erythrokeratodermia variabilis was treated with oral isotretinoin for four months. Clinical and light and electron microscopic observations were made before and after treatment. A characteristic electron microscopic feature was subnormal numbers of keratinosomes within the stratum granulosum of hyperkeratotic plaques. Isotretinoin therapy resulted in almost complete clinical clearing of these plaques and restoration of normal numbers of epidermal keratinosomes. In addition, distinctive dyskeratotic cells containing clumped tonofilaments were observed within the stratum granulosum by electron microscopy. These cells persisted after retinoid treatment.

Topics: Adult; Biopsy; Epidermal Cells; Erythema; Female; Humans; Isotretinoin; Keratins; Keratoderma, Palmoplantar; Keratosis; Microscopy, Electron; Skin; Time Factors; Tretinoin

Infantile acropustulosis is a syndrome characterized by recurrent crops of 1- to 2-mm pruritic vesiculopustules, which appear predominantly on distal extremities of infants. Nine biopsy specimens from six cases of infantile acropustulosis have been studied. We found that necrolysis of keratinocytes is the initial event leading to an inflammatory reaction and to an intraepidermal pustule, which progresses to a subcorneal pustule. These different histologic stages are correlated with clinical features. We found that the pustules may be filled with neutrophils or eosinophils, without particular significance. We have not found a correlation among blood eosinophilia, composition of cutaneous infiltrate, age of infant, and course of eruption.

Topics: Diagnosis, Differential; Eosinophils; Epidermis; Erythema; Humans; Infant; Keratins; Male; Necrosis; Neutrophils; Recurrence; Skin Diseases, Vesiculobullous

The authors have studied skin color modifications in 3 cases of phenylketonuria and have observed the characteristic changes; fair skin and fair hair. In addition they noted hundred of pigmented pin point or slightly larger patches in the two more affected patients, in the areas exposed to sunshine. With regard to the ultrastructural study of the epidermis basal layer, the proportion of melanocytes in the two most severe cases was slightly higher than in the normal skin of 6 control subjects. Langerhans cells could not be acertained. The more severe was the disease the greater was the tendency for a lower proportion of keratinocytes containing melanin. There is a certain parallelism between the skin color modifications the biochemical examinations (blood level of phenylalanin and tyrosine) and the ultrastructural changes. The higher the blood level of phenlalanine and/or the more pronounced the disorders of skin color, the more evident would be the ultrastructural changes: higher proportion of melanocytes that usually do not produce the melanosomes, and lower percentage of keratinocytes with melanin. On the other hand, the ultrastructure of the basal layer would suggest the seriousness of clinical manifestations and/or the intesity of the metabolic error.

Topics: Child; Epidermis; Erythema; Female; Hair Color; Humans; Keratins; Male; Melanins; Phenylalanine; Phenylketonurias; Pigmentation Disorders; Tyrosine

Topical application of a 2.5 per cent indomethacin (IM) solution to the sunburned skin of humans and guinea pigs resulted in a marked decrease in ultraviolet light (UVL) -induced erythema. In humans, a decrease in skin temperatute and hyperalgesia to near normal levels was also observed. Epidermal responses to UVL injury such as keratinocyte cell death and altered DNA synthesis proceeded unmodified by IM. Repeated applications of IM in the 48-hr period following UVL exposure did not improve upon the results obtained following a single treatment. Guinea-pig skin provides a relevant model system for evaluating the effects of topical nosteroidal anti-inflammatory agents on sunburn.

Topics: Administration, Topical; Animals; Cell Survival; Depression, Chemical; DNA; Erythema; Female; Guinea Pigs; Humans; Hyperalgesia; Indomethacin; Keratins; Prostaglandin Antagonists; Prostaglandins; Radiation Effects; Skin; Skin Temperature; Sunburn; Thymidine; Ultraviolet Rays

Topics: Birth Injuries; Blister; Drug Eruptions; Epidermolysis Bullosa; Erythema; Female; Herpes Simplex; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Keratins; Listeria monocytogenes; Lupus Erythematosus, Systemic; Male; Maternal-Fetal Exchange; Miliaria; Nevus; Pregnancy; Pregnancy Complications; Rubella; Skin Diseases; Skin Diseases, Infectious; Stevens-Johnson Syndrome; Sucking Behavior; Syphilis, Congenital; Urticaria Pigmentosa

Topics: Adolescent; Erythema; Female; Humans; Keratins; Radiodermatitis; Skin; Ultraviolet Rays

Topics: Acids; Alcohols; Aldehydes; Capsules; Child; Erythema; Female; Humans; Ichthyosis; Keratins; Ointments; Vitamin A

Topics: Albinism; Black People; Body Temperature; Erythema; Humans; Keratins; Pellagra; Pigmentation; Skin; Sunburn; Ultraviolet Rays

Topics: Animals; Antigen-Antibody Reactions; Caseins; Cattle; Cyanides; Dermatitis; Dermatitis, Allergic Contact; Dermatitis, Atopic; Erythema; gamma-Globulins; Gelatin; Hydrogen-Ion Concentration; Keratins; Nickel; Proteins; Research; Serum Albumin; Serum Albumin, Bovine; Sulfides; Toxicology