fibrin and Lupus-Erythematosus--Discoid

Topics: Adolescent; Adult; Aged; Biopsy; Child; Complement Activating Enzymes; Complement C1; Complement C1q; Complement C3; Diagnosis, Differential; Female; Fibrin; Fluorescent Antibody Technique; Humans; Immunoglobulins; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Male; Middle Aged; Skin; Skin Diseases

Eight of ten patients with chronic or subacute cutaneous lupus erythematosus completed 16 weeks of oral isotretinoin therapy (80 mg/day). All eight patients noted an excellent clinical response without significant side effects. (Two patients did not return to initial two-week follow-up.) Peripheral blood B- and T-cell counts were unaffected by therapy. Therapy was associated with resolution of routine histopathologic abnormalities, conversion of abnormal lesional direct immunofluorescence microscopy to normal, normalization of the epidermis on electron microscopy, and reduction of all T cells near the dermoepidermal junction without change in ratio of T-helper/inducer cells to T-suppressor/cytotoxic cells. Isotretinoin is a clinically effective short-term therapy for chronic or possibly for subacute cutaneous lupus erythematosus. The primary mechanism of action remains unestablished.

Topics: Administration, Oral; Adult; Basement Membrane; Chronic Disease; Complement C3; Drug Evaluation; Female; Fibrin; Fluorescent Antibody Technique; Humans; Immunoglobulin G; Isotretinoin; Lupus Erythematosus, Discoid; Lymphocytes; Male; Middle Aged; Skin; Tretinoin

Cytoid bodies represent ovoid, round or polygonal, approximately cellsized structures. In human skin such bodies may occur under normal as well as under pathological conditions. A number of heterogenous materials contribute to the morphogenesis of cytoid bodies, but in sections of human skin prepared for routine histology, different groups of cytoid bodies can not always be distinguished from each other. However, such a differentiation is necessary, if their presence is to be utilized as a diagnostic parameter or interpreted as a sign of physiological or pathological events in the dermoepidermal junction area. The object of the present studies was to (i) characterize the different groups of cytoid bodies by histological, histochemical, immunological and electron microscopical techniques, (ii) elucidate their nature, origin and morphogenesis and (iii) determine their significance in the histology of the skin. The following results were obtained: (1) Elastic globes can easily be identified by their bright autofluorescence and their affinity for elastin stains. Electron microscopically they exhibit a mixture of amorphous, granular and filamentous material, thus showing simlarities with elastic fibers. They are regularly found in normal skin of the extremities and the face but usually are absent on the trunk. Therefore their demonstration may be of importance in forensic medicine by allowing a better determination of the origin of isolated skin pieces. (2) Russel bodies may show gross variations in their histological, histochemical and ultrastructural properties. They contain different amounts of carbohydrates, lipids, proteins and immunoglobulins. These variable component result in a polymorphous structure. Russel bodies are produced by plasma cells and can frequently be found in skin infiltrates with a predominant admixture of this cell type. Their presence may be correlated with an increased local production of immunoglobulins, but their differentiation from other cytoid bodies and fungal elements is also of importance. (3) Civatte bodies are also eosinophil, PAS-positive and exhibit a typical fibrillar ultrastructure. They may be localised intraepidermally as well as in the upper corium. Although most frequently ecountered in lichen planus they may also be found in numerous other dermatoses and even in clinically normal skin. As indicated by their characteristics, they originate from epidermal keratinocytes and probably represent a morphological substrate

Topics: Amyloid; Elastic Tissue; Elastin; Fibrin; Hematoxylin; Humans; Lupus Erythematosus, Discoid; Microscopy, Electron; Morphogenesis; Skin

Topics: Adolescent; Adult; Aged; Animals; Antifibrinolytic Agents; Biopsy; Child; Female; Fibrin; Fibrinolysis; Fluorescent Antibody Technique; Humans; Immunoglobulins; Lichen Planus; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Male; Microscopy, Fluorescence; Middle Aged; Rabbits; Skin

Topics: Adult; Autopsy; Biopsy; Connective Tissue; Elastic Tissue; Eosinophils; Female; Fibrin; Histocytochemistry; Humans; Inflammation; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Microscopy; Microscopy, Electron; Middle Aged; Necrosis

Topics: Adrenal Cortex Hormones; Adult; Antimalarials; Blood Vessels; Female; Fibrin; Humans; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Male; Middle Aged; Skin