elastin and Carcinoma--Basal-Cell

To investigate histopathologic alterations of eyelid biopsy specimens from patients with floppy eyelid syndrome (FES) with special regard to elastic fiber content and ultrastructure as well as to the expression of elastin-degrading enzymes to elucidate the pathogenesis of this disorder.. Retrospective, interventional case series.. Eleven consecutive patients with FES and 10 age-matched control patients with basal cell carcinoma of the eyelid.. Horizontal pentagonal eyelid resections of 16 upper lids were performed in 11 patients with FES. Full-thickness eyelid biopsy specimens from study and control patients were examined by light and transmission electron microscopy, semiquantitative morphometry, and immunohistochemistry using antibodies against matrix metalloproteinase (MMP)-2, MMP-7, MMP-9, and MMP-12 and neutrophil elastase.. All patients treated with surgical horizontal eyelid shortening were asymptomatic at follow-up. Histopathologic analysis of the surgical specimens showed, apart from unspecific signs of chronic inflammation, a significant decrease in the amount of elastin within the tarsal plate and eyelid skin as compared with controls. Residual elastic fibers revealed an abnormal ultrastructure with a diminished elastin core. Immunohistochemistry demonstrated an increased immunoreactivity for elastolytic proteases, particularly MMP-7 and MMP-9, in areas of elastin depletion in FES specimens as compared with controls.. The findings indicate that upregulation of elastolytic enzymes, most probably induced by repeated mechanical stress, participates in elastic fiber degradation and subsequent tarsal laxity and eyelash ptosis in FES.

Topics: Aged; Biopsy; Carcinoma, Basal Cell; Elastic Tissue; Elastin; Eyelid Diseases; Eyelid Neoplasms; Female; Humans; Immunoenzyme Techniques; Male; Matrix Metalloproteinase 12; Matrix Metalloproteinase 2; Matrix Metalloproteinase 7; Matrix Metalloproteinase 9; Matrix Metalloproteinases; Metalloendopeptidases; Middle Aged; Retrospective Studies; Syndrome

After a short compilation of the descriptions of the elastic globes offered in the literature, the results of 446 tissue specimens of five different dermatoses (lichen planus, erythematodes chronicus discoides, tuberculosis cutis luposa, basal cell carcinoma, and nervus cell nevi). An increased appearance of elastic globes was found in erythematodes chronicus discoides and tuberculosis cutis luposa, compared with the other dermatoses. Elastic globes were not limited to special areas of the body, but there were topographical preferences. Elastic globes are common in the aged. The histopathology is descripted.

Topics: Adult; Age Factors; Aged; Carcinoma, Basal Cell; Child, Preschool; Elastic Tissue; Elastin; Extremities; Face; Female; Hair; Head; Humans; Lichen Planus; Lupus Erythematosus, Discoid; Lupus Vulgaris; Male; Middle Aged; Nevus; Skin; Skin Neoplasms

Topics: Carcinoma, Basal Cell; Connective Tissue; Elastic Tissue; Elastin; Glycosaminoglycans; Humans; Microscopy, Electron; Skin; Skin Diseases; Skin Neoplasms; Tuberculosis, Cutaneous