elastin and Granuloma

This article reviews the diseases that may show epidermal perforation as a histologic feature. Many of these represent examples of transepithelial elimination (TEE), a mechanism by which the skin rids itself of abnormal substances. After a review of disorders in which perforation is an occasional finding, four diseases that have been considered essential perforating disorders are discussed: elastosis perforans serpiginosa (EPS), reactive perforating collagenosis (RPC), perforating folliculitis (PF), and Kyrle 's disease (KD). A review of the literature, including recent reports of perforating diseases associated with chronic renal failure, suggests that there may be considerable clinical and histologic overlap among PF, KD, and the adult form of "perforating collagenosis." A working classification for the perforating disorders is suggested.

Topics: Collagen Diseases; Elastic Tissue; Elastin; Folliculitis; Granuloma; Humans; Keratosis; Kidney Failure, Chronic; Microscopy, Electron; Pseudoxanthoma Elasticum; Skin; Skin Diseases

Topics: Cosmetics; Elastin; Female; Granuloma; Humans; Hypersensitivity, Delayed; Injections, Subcutaneous; Middle Aged

In the normal, healthy lung, elastin production is restricted to periods of development and growth. However, elastin expression in the adult lung has been observed in some forms of pulmonary injury, including pulmonary fibrosis. Here, we report that elastin production is significantly increased within precise interstitial compartments of the lung in an experimental model of granulomatous lung disease. An increase in the number and volume of elastic fibers within the alveolar walls was apparent on histological examination of Verhoeff-van Gieson-stained sections of silicotic rat lungs. Quantitation of mature elastin cross-links indicated that silicosis was accompanied by a 17-fold increase in lung elastin content when compared with values from saline-treated controls. In situ hybridization for tropoelastin mRNA revealed that elastin production was absent from granulomatous lesions yet was prominent at nonfibrotic alveolar septal tips, where a high density of elastic fibers is seen in the normal lung. Immunohistochemistry indicated tropoelastin was being expressed by alpha-smooth muscle actin-containing cells. Transforming growth factor-beta was immunolocalized to granulomatous regions of the silicotic lung but was absent from regions showing increased tropoelastin expression. These data indicate that the reinitiation of tropoelastin gene expression is associated with granulomatous lung disease, and this expression leads to the aberrant accumulation of mature elastin in the lung.

Topics: Actins; Animals; Elastin; Gene Expression; Granuloma; Lung Diseases; Male; Muscle, Smooth; Pulmonary Alveoli; Rats; Rats, Sprague-Dawley; Silicosis; Solubility; Tissue Distribution; Transforming Growth Factor beta; Tropoelastin

Patients with the floppy eyelid syndrome have chronic papillary conjunctivitis with easily everted upper eyelids and a soft, pliant upper tarsus. The purpose of this study is to describe the clinical features and the histopathologic correlate in a group of patients with floppy eyelid syndrome.. The authors examined eight patients with floppy eyelid syndrome, four of whom underwent surgical management with horizontal eyelid shortening. Eyelid tissue from these patients was examined using light microscopy, electron microscopy, and immunohistochemistry and compared with controls with unrelated eyelid or orbital disorders.. Clinical findings included obesity or eye rubbing, lash ptosis, and, less commonly, blepharoptosis. Two patients had documented sleep apnea with abnormal sleep electroencephalogram. Light microscopy of the surgical specimens showed chronic conjunctival inflammation, papillary conjunctivitis, and meibomian gland abnormalities, including granuloma formation. Verhoeff's modified elastin stain demonstrated a marked decrease in the amount of elastin fibers in tarsus from patients with floppy eyelid syndrome compared with controls. Immunohistochemical staining for elastin also showed a marked decrease of tarsal elastin in floppy eyelid patients compared with controls. In contrast, immunohistochemical stains showed that the distribution of collagen types I and III was similar between patients with floppy eyelid syndrome and controls. Electron microscopy demonstrated that tarsal collagen was comparable in patients and controls, and that there was a reduced amount of tarsal elastin in floppy eyelid syndrome compared with controls.. These findings demonstrate that tarsal elastin is decreased in the floppy eyelid syndrome, which may contribute to the laxity of the tarsus in this disorder.

Topics: Adult; Aged; Collagen; Conjunctivitis, Allergic; Elastin; Eyelid Diseases; Eyelids; Female; Fluorescent Antibody Technique; Granuloma; Humans; Male; Meibomian Glands; Middle Aged; Syndrome

The cellular composition of suppurative granulomas was investigated by the application of monoclonal and polyclonal antibodies to paraffin sections and compared with nonsuppurative, hypersensitivity-type granulomas. Macrophages, T cells, and dendritic cells showed a similar distribution in both types of granulomas. In addition to the presence of granulocytes, a major difference between suppurative granulomas and hypersensitive-type granulomas concerned their relationship with B lymphocytes. Hypersensitive-type granulomas were surrounded by small mantle B cells, but they did not contain any B lymphocytes. In contrast, variable numbers of B cells were found either at the periphery or in the center of suppurative granulomas. In view of their morphology (medium size, pale cytoplasm, irregular nuclear shape) and phenotype (L26 +/LN1 -/MB2 +/MT2 +) these B lymphocytes closely resembled monocytoid B cells. The monocytoid B cells might have a role in the recruitment of polymorphonuclear granulocytes and in the development of the necrosis, which occur within suppurative granulomas.

Topics: Acid Phosphatase; Alkaline Phosphatase; Antibodies, Monoclonal; B-Lymphocytes; Biopsy; Carcinoembryonic Antigen; Cell Nucleus; Cytoplasm; Dendritic Cells; Elastin; Granuloma; Humans; Immunohistochemistry; Lymph Nodes; Lymphadenitis; Macrophages; T-Lymphocytes

The connective matrix participates directly in early pathological events observed in the cutaneous lesion of leishmaniasis, due to Leishmania braziliensis guyanensis. A sample of 19 skin biopsies was examined by light and electron microscopy, in order to identify the matrix components (collagen isotypes I to IV, elastin and membrane associated proteins) of the dermal infiltrate, and the pattern of organization of the reparative connective matrix. An extensive remodelling process of apparently parasite-independent nature involves different fibroblast sub-populations. The original organization of this immune-mediated lesion offers a rare opportunity to study in situ the local inflammatory mediators inducing the activation of fibroblasts and macrophages.

Topics: Adolescent; Adult; Animals; Biopsy; Collagen; Connective Tissue; Elastin; Extracellular Matrix; Fibroblasts; Fluorescent Antibody Technique; Granuloma; Host-Parasite Interactions; Humans; Leishmaniasis, Cutaneous; Male; Membrane Proteins; Microscopy, Electron; Phenotype

This report reviews thirteen cases of generalized granuloma annulare. The light and electron microscopic appearance of intracellular elastin particles in eleven of these cases is described. These bodies were also noted in deep granuloma annulare, elastosis perforans serpiginosa, and a small percentage of localized granuloma annulare. They were not found in necrobiosis lipoidica.

Topics: Adult; Aged; Biopsy; Elastic Tissue; Elastin; Female; Granuloma; Granuloma, Giant Cell; Histiocytes; Histocytochemistry; Humans; Male; Middle Aged; Skin; Skin Diseases

Topics: Animals; Cell Wall; Collagen; Connective Tissue; DNA; Elastin; Female; Granuloma; Lung Diseases; Mycobacterium bovis; Rats; Rats, Inbred F344