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Ingen-Housz-Oro S, Ortonne N. [Surface membrane markers (clusters of differentiation) used in dermatopathology (2): Inflammatory infiltrates]. Ann Dermatol Venereol 2016; 143:311-7. [PMID: 26988384 DOI: 10.1016/j.annder.2016.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/05/2016] [Accepted: 01/29/2016] [Indexed: 10/22/2022]
Affiliation(s)
- S Ingen-Housz-Oro
- Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - N Ortonne
- Département de pathologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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52
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Antonova OV, Trofimov PN, Khairutdinov VR, Belousova IE, Samtsov AV. Modern concepts of skin dendritic cells. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-1-17-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Based on the literature review this article is about the latest data of the classification and functions of dendritic cells in healthy skin and in disease.
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53
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Haber JS, Ker KJ, Werth VP, Rubin A. Ice-pack Dermatosis: A Diagnositic Pitfall for Dermatopathologists that Mimics Lupus Erythematosus. J Cutan Pathol 2016; 43:1-4. [DOI: 10.1111/cup.12658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jessica S. Haber
- Corporal Michael J. Crescenz VAMC (Philadelphia); Philadelphia PA
- Department of Dermatology; Perelman School of Medicine at the University of Pennsylvania; Philadelphia PA
| | - Khor Jia Ker
- Corporal Michael J. Crescenz VAMC (Philadelphia); Philadelphia PA
- Department of Dermatology; Perelman School of Medicine at the University of Pennsylvania; Philadelphia PA
| | - Victoria P. Werth
- Corporal Michael J. Crescenz VAMC (Philadelphia); Philadelphia PA
- Department of Dermatology; Perelman School of Medicine at the University of Pennsylvania; Philadelphia PA
| | - Adam Rubin
- Department of Dermatology; Perelman School of Medicine at the University of Pennsylvania; Philadelphia PA
- Department of Pathology and Laboratory Medicine, and Division of Dermatology; The Children's Hospital of Philadelphia; Philadelphia PA
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54
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Trophymov PN, Antonova OV, Khairutdinov VR, Belousova IE, Samtsov AV. Pathomorphological changes in patients with Jessner>s lymphocytic infiltrate of skin, reticular erythematous mucinosis and lupus tumidus. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-6-41-49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Jessner’s lymphocytic infiltrate of skin, reticular erythematous mucinosis and lupus tumidus are the group of rare, insufficiently explored dermatosis with common clinical and histological features, whose nosology is controversial today. Plasmacytoid dendritic cells play the key role in autoimmune disease induction The target of our study was the analysis of pathomorphological features of lesional skin and the research of plasmacytoid dendritic cells in the skin of patients with Jessner’s lymphocytic infiltrate of skin, reticular erythematous mucinosis and lupus tumidus. Material and methods. Histological and indirect immunohistochemistry examination (anti-CD123 antibodies) of lesional skin of 36 patients was held (JLIS - 12, REM - 10, LT - 14) and 10 healthy people. Result. The main pathomorphological changes of skin in all groups were found in dermis: dense perivascular and perifollicular infiltration and deposit of mucin between collagen fibers. Deposits of mucin in papillary dermis were found between patients with JLIS, REM and LT in 10/12 (83%), 7/10 (70%) and 12/14 (86%) of cases, there were no mucin found in skin of healthy people 0/10 (0%) In all dermatosis the distribution of CD123 cells in lesional skin, in immunohistochemistry study, was corresponded clusters model of infiltrate - plasmacytoid DC concentrate in groups around vessels of superficial and profundus networks and perivascular. The comparative analysis of density and localization of perivascular infiltration, number of CD123-cells and their correspondence in dermis perivascular infiltrates didn’t reveal statistically significant differences between JLIS, REM and LT. Results. Our results allow us to consider JLIS and LT as identical decease, and REM as similar in clinical-pathomorphological features dermatosis.
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Pellerin A, Otero K, Czerkowicz JM, Kerns HM, Shapiro RI, Ranger AM, Otipoby KL, Taylor FR, Cameron TO, Viney JL, Rabah D. Anti-BDCA2 monoclonal antibody inhibits plasmacytoid dendritic cell activation through Fc-dependent and Fc-independent mechanisms. EMBO Mol Med 2015; 7:464-76. [PMID: 25762615 PMCID: PMC4403047 DOI: 10.15252/emmm.201404719] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Type I interferons (IFN-I) are implicated in the pathogenesis of systemic lupus erythematosus (SLE). In SLE, immune complexes bind to the CD32a (FcγRIIa) receptor on the surface of plasmacytoid dendritic cells (pDCs) and stimulate the secretion of IFN-I from pDCs. BDCA2 is a pDC-specific receptor that, when engaged, inhibits the production of IFN-I in human pDCs. BDCA2 engagement, therefore, represents an attractive therapeutic target for inhibiting pDC-derived IFN-I and may be an effective therapy for the treatment of SLE. In this study, we show that 24F4A, a humanized monoclonal antibody (mAb) against BDCA2, engages BDCA2 and leads to its internalization and the consequent inhibition of TLR-induced IFN-I by pDCs in vitro using blood from both healthy and SLE donors. These effects were confirmed in vivo using a single injection of 24F4A in cynomolgus monkeys. 24F4A also inhibited pDC activation by SLE-associated immune complexes (IC). In addition to the inhibitory effect of 24F4A through engagement of BDCA2, the Fc region of 24F4A was critical for potent inhibition of IC-induced IFN-I production through internalization of CD32a. This study highlights the novel therapeutic potential of an effector-competent anti-BDCA2 mAb that demonstrates a dual mechanism to dampen pDC responses for enhanced clinical efficacy in SLE.
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Affiliation(s)
- Alex Pellerin
- Immunology Research, Biogen Idec, Cambridge, MA, USA
| | - Karel Otero
- Immunology Research, Biogen Idec, Cambridge, MA, USA
| | | | | | | | - Ann M Ranger
- Immunology Research, Biogen Idec, Cambridge, MA, USA
| | | | | | | | | | - Dania Rabah
- Immunology Research, Biogen Idec, Cambridge, MA, USA
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Kuhn A, Wenzel J, Bijl M. Lupus erythematosus revisited. Semin Immunopathol 2015; 38:97-112. [PMID: 26637330 DOI: 10.1007/s00281-015-0550-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/03/2015] [Indexed: 12/18/2022]
Abstract
Lupus erythematosus (LE) is a multifactorial autoimmune disease with clinical manifestations of differing severity. The exact pathomechanisms and interactions resulting in the inflammatory and immunological processes of this heterogeneous disease remain elusive. Approaches in the understanding of the pathomechanisms revealed that the clinical expression of LE is predisposed by susceptibility genes and that various environmental factors are responsible for an abnormal immune response. Several studies demonstrated that ultraviolet (UV) light is one of the major factors in the pathogenesis of the disease. Standardized photoprovocation in patients with LE has been shown to be a safe and efficient model for evaluating the underlying pathomechanisms which lead to the production of autoantibodies and immune complexes. In particular, interferons were defined as important players in the early activation of the immune system and were observed to play a specific role in the immunological interface between the innate and the adaptive immune system. Abnormalities or disturbances in the different processes of cell death, such as apoptosis or necrosis, have also been recognized as crucial in the pathogenesis of LE. Although each process is different and characterized by unique features, the processes are interrelated and result in a complex disease.
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Affiliation(s)
- Annegret Kuhn
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
- Division of Immunogenetics, Tumor Immunology Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Joerg Wenzel
- Department of Dermatology, University Hospital Bonn, Bonn, Germany
| | - Marc Bijl
- Department of Internal Medicine and Rheumatology, Martini Hospital, Groningen, Netherlands
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Dargent JL, Henne S, Pranger D, Balzarini P, Sartenaer D, Bulliard G, Rack K, Facchetti F. Tumor-forming plasmacytoid dendritic cells associated with myeloid neoplasms. Report of a peculiar case with histopathologic features masquerading as lupus erythematosus. J Cutan Pathol 2015; 43:280-6. [DOI: 10.1111/cup.12639] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 10/04/2015] [Accepted: 10/05/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Jean-Louis Dargent
- Pathology; Institut de Pathologie et de Génétique (IPG); Gosselies Belgium
| | - Stéphanie Henne
- Department of Dermatology; Grand Hôpital de Charleroi (GHDC); Loverval Belgium
| | - Delphine Pranger
- Department of Oncology; Grand Hôpital de Charleroi (GHDC); Charleroi Belgium
| | - Piera Balzarini
- Department of Molecular and Translational Medicine, Section of Pathology, School of Medicine; University of Brescia; Brescia Italy
| | - Daniel Sartenaer
- Pathology; Institut de Pathologie et de Génétique (IPG); Gosselies Belgium
| | - Geneviève Bulliard
- Laboratory of Clinical Biology; Grand Hôpital de Charleroi (GHDC); Charleroi Belgium
| | - Katrina Rack
- Pathology; Institut de Pathologie et de Génétique (IPG); Gosselies Belgium
| | - Fabio Facchetti
- Department of Molecular and Translational Medicine, Section of Pathology, School of Medicine; University of Brescia; Brescia Italy
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Granulomatous foreign-body reactions to permanent fillers: detection of CD123+ plasmacytoid dendritic cells. Am J Dermatopathol 2015; 37:107-14. [PMID: 25406851 DOI: 10.1097/dad.0000000000000239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Soft-tissue augmentation with permanent fillers can lead to severe granulomatous foreign-body reactions (GFBRs), but the immune pathomechanism of this complication is still unknown. We performed conventional histologic examination and immunostaining for plasmacytoid dendritic cells (pDCs) in skin sections from patients with GFBR to 4 permanent filler agents, which have been widely used in recent decades. METHODS Twenty-one skin biopsies were studied from 19 patients with GFBR to polyalkylimide 4% gel (PAIG, n = 10), polyacrylamide 2.5% gel (PAAG, n = 2), hydroxyethyl methacrylate/ethyl methacrylate in hyaluronic acid (HEMA/EMA, n = 4), or liquid injectable silicone (n = 5). GFBRs were analyzed in hematoxylin and eosin stained sections and pDCs detected using CD123 antibodies. Anti-CD11c immunostaining was performed for comparison. RESULTS Grading of the inflammatory infiltrates observed histologically did not correlate with the clinical features of inflammation. Immunostaining for CD123 did not detect pDCs in 8 of 10 polyalkylimide gel, 1 of 2 polyacrylamide gel, and the 5 liquid injectable silicone biopsies. In contrast, all 4 HEMA/EMA biopsies contained collections of pDCs in lymphocytic infiltrates close to filler particles and adjacent sarcoidal granulomas. CONCLUSIONS Our data suggest that pDCs contribute to the sarcoidal granulomas associated with injected HEMA/EMA. Recruited pDCs may exert their pro-inflammatory effects by the release of interferon-α at the site of these filler deposits.
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Sleiman R, Kurban M, Abbas O. Evaluation of the Diagnostic Value of Plasmacytoid Dendritic Cells in Differentiating the Lymphocytic Cicatricial Alopecias. Dermatology 2015; 231:158-63. [DOI: 10.1159/000431174] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/04/2015] [Indexed: 11/19/2022] Open
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60
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Vincent JG, Chan MP. Specificity of dermal mucin in the diagnosis of lupus erythematosus: comparison with other dermatitides and normal skin. J Cutan Pathol 2015; 42:722-9. [DOI: 10.1111/cup.12504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/14/2015] [Accepted: 03/15/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - May P. Chan
- Department of Pathology; University of Michigan; Ann Arbor MI USA
- Department of Dermatology; University of Michigan; Ann Arbor MI USA
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61
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Photosensitivity, apoptosis, and cytokines in the pathogenesis of lupus erythematosus: a critical review. Clin Rev Allergy Immunol 2015; 47:148-62. [PMID: 24420508 DOI: 10.1007/s12016-013-8403-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The underlying pathomechanisms of lupus erythematosus (LE), a multifactorial autoimmune disease, remain elusive. Due to the clinical evidence demonstrating a clear relationship between ultraviolet (UV) light exposure and skin lesions of LE, photosensitivity has been proven to be an important factor in the pathogenesis of the disease. Standardised photoprovocation with UVA and UVB irradiation has been shown to be a reliable model for evaluating photosensitivity in patients with cutaneous LE (CLE) and analysing the underlying medical conditions of the disease. In this respect, UV irradiation can cause aberrant induction of apoptosis in keratinocytes and contribute to the appearance of excessive apoptotic cells in the skin of CLE patients. Moreover, apoptotic cells that cannot be cleared by phagocytes may undergo secondary necrosis and release proinflammatory compounds and potential autoantigens, which may contribute to the inflammatory micromilieu that leads to formation of skin lesions in the disease. In addition to UV-mediated induction of apoptosis, the molecular and cellular factors that may cause the abnormal long-lasting photoreactivity in CLE include mediators of inflammation, such as cytokines and chemokines. In particular, interferons (IFNs) are important players in the early activation of the immune system and have a specific role in the immunological interface between the innate and the adaptive immune system. The fact that treatment with recombinant type I IFNs (α and β) can induce not only systemic organ manifestations but also LE-like skin lesions provides additional evidence for a pathogenetic role of these IFNs in the disease.
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Walsh NM, Lai J, Hanly JG, Green PJ, Bosisio F, Garcias-Ladaria J, Cerroni L. Plasmacytoid dendritic cells in hypertrophic discoid lupus erythematosus: an objective evaluation of their diagnostic value. J Cutan Pathol 2014; 42:32-8. [DOI: 10.1111/cup.12416] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Noreen M. Walsh
- Department of Pathology; Capital District Health Authority and Dalhousie University; Halifax NS Canada
| | - Jonathan Lai
- Department of Pathology; Capital District Health Authority and Dalhousie University; Halifax NS Canada
| | - John G. Hanly
- Department of Medicine; Capital District Health Authority and Dalhousie University; Halifax NS Canada
| | - Peter J. Green
- Department of Medicine; Capital District Health Authority and Dalhousie University; Halifax NS Canada
| | - Francesca Bosisio
- Research Unit Dermatopathology, Department of Dermatology; Medical University of Graz; Graz Austria
- Department of Surgical Sciences; Milano-Bicocca University; Monza Italy
| | - Juan Garcias-Ladaria
- Research Unit Dermatopathology, Department of Dermatology; Medical University of Graz; Graz Austria
- Department of Dermatology; Hospital General Universitario de Valencia; Valencia Spain
| | - Lorenzo Cerroni
- Research Unit Dermatopathology, Department of Dermatology; Medical University of Graz; Graz Austria
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63
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Lehman JS, Gibson LE, el-Azhary RA, Chavan RN, Hashmi SK, Lohse CM, Flotte TJ. Acute cutaneous graft-vs.-host disease compared to drug hypersensitivity reaction with vacuolar interface changes: a blinded study of microscopic and immunohistochemical features. J Cutan Pathol 2014; 42:39-45. [DOI: 10.1111/cup.12427] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 06/13/2014] [Accepted: 07/19/2014] [Indexed: 01/09/2023]
Affiliation(s)
- Julia S. Lehman
- Department of Dermatology; Mayo Clinic; Rochester MN USA
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester MN USA
| | - Lawrence E. Gibson
- Department of Dermatology; Mayo Clinic; Rochester MN USA
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester MN USA
| | | | | | | | | | - Thomas J. Flotte
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester MN USA
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64
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Cinotti E, Merlo V, Kempf W, Carli C, Kanitakis J, Parodi A, Rongioletti F. Reticular erythematous mucinosis: histopathological and immunohistochemical features of 25 patients compared with 25 cases of lupus erythematosus tumidus. J Eur Acad Dermatol Venereol 2014; 29:689-97. [PMID: 25087914 DOI: 10.1111/jdv.12654] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Reticular erythematous mucinosis (REM) and lupus erythematosus tumidus (LET) share similarities. However, to our knowledge no study extensively compared the histological features of these two conditions. The aim of this study is to compare the histological and immunohistochemical features of REM and LET. METHODS We evaluated epidermal thickness, hyperkeratosis, dermo-epidermal junction changes, interstitial mucin deposition, vessel dilatation and pattern, type and density of the inflammatory infiltrate in 25 cases of REM and LET. Anti-CD3, anti-CD20, anti-CD68, anti-CD4, anti-CD8, anti-CD123, anti-CD2AP, anti-IgG and anti-C3 antibodies were tested in a subset of patients. RESULTS Both diseases are characterized by perivascular dermal infiltrates of lymphocytes mainly CD4+ positive and increased dermal mucin. However, REM tended to show more scattered and more superficial lymphocytes with more superficial mucin and to have less frequent immunoglobulin and complement depositions along the dermo-epidermal junction. Plasmacytoid dendritic cells (PDCs) were less represented in REM, and were mainly found as single cells differently from LET. CONCLUSIONS REM and LET present some differences in the infiltrate, including PDCs, the mucin deposition and the immunoreactant deposition at the dermo-epidermal junction that justify the distinction of the two diseases and suggest different pathogenetic mechanisms.
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Affiliation(s)
- E Cinotti
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa and IRCCS San Martino-IST University Hospital, Genoa, Italy; Section of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
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65
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Brown TT, Choi EYK, Thomas DG, Hristov AC, Chan MP. Comparative analysis of rosacea and cutaneous lupus erythematosus: Histopathologic features, T-cell subsets, and plasmacytoid dendritic cells. J Am Acad Dermatol 2014; 71:100-7. [DOI: 10.1016/j.jaad.2014.01.892] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/17/2014] [Accepted: 01/21/2014] [Indexed: 01/14/2023]
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Bertolotti A, Boniface K, Vergier B, Mossalayi D, Taieb A, Ezzedine K, Seneschal J. Type I interferon signature in the initiation of the immune response in vitiligo. Pigment Cell Melanoma Res 2014; 27:398-407. [DOI: 10.1111/pcmr.12219] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 01/14/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Antoine Bertolotti
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Saint-André and Pellegrin Hospital; Bordeaux France
| | - Katia Boniface
- INSERM U1035; Immunodermatology Team; Université Bordeaux Segalen; Bordeaux France
| | | | - Djavad Mossalayi
- INSERM U1035; Immunodermatology Team; Université Bordeaux Segalen; Bordeaux France
| | - Alain Taieb
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Saint-André and Pellegrin Hospital; Bordeaux France
- INSERM U1035; Immunodermatology Team; Université Bordeaux Segalen; Bordeaux France
| | - Khaled Ezzedine
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Saint-André and Pellegrin Hospital; Bordeaux France
- INSERM U1035; Immunodermatology Team; Université Bordeaux Segalen; Bordeaux France
| | - Julien Seneschal
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Saint-André and Pellegrin Hospital; Bordeaux France
- INSERM U1035; Immunodermatology Team; Université Bordeaux Segalen; Bordeaux France
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Arps DP, Patel RM. Cutaneous Hypertrophic Lupus Erythematosus: A Challenging Histopathologic Diagnosis in the Absence of Clinical Information. Arch Pathol Lab Med 2013; 137:1205-10. [DOI: 10.5858/arpa.2013-0241-cr] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hypertrophic lupus erythematosus (HLE) is rare variant of chronic cutaneous lupus characterized histologically by irregular epidermal hyperplasia associated with features of classic chronic cutaneous lupus, including interface changes. Lesions frequently demonstrate reactive squamous atypia of the basal layer and may show histopathologic overlap with other more common cutaneous atypical squamoproliferative lesions. Typical histologic features of cutaneous lupus, such as follicular plugging, angiocentric lymphocytic inflammation, and dermal mucin, are very helpful clues to the diagnosis of hypertrophic lupus erythematosus. Recently, immunohistochemistry for CD123 used to detect increased plasmacytoid dendrocytes in hypertrophic lupus erythematosus has proven to be diagnostically useful. A high index of suspicion for hypertrophic lupus erythematosus is essential to avoid overdiagnosis of squamous neoplasia, particularly in limited cutaneous biopsies in the absence of adequate clinical information.
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Affiliation(s)
- David P. Arps
- From the Departments of Pathology (Drs Arps and Patel) and Dermatology (Dr Patel), University of Michigan Health System, Ann Arbor
| | - Rajiv M. Patel
- From the Departments of Pathology (Drs Arps and Patel) and Dermatology (Dr Patel), University of Michigan Health System, Ann Arbor
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Liau JY, Chuang SS, Chu CY, Ku WH, Tsai JH, Shih TF. The presence of clusters of plasmacytoid dendritic cells is a helpful feature for differentiating lupus panniculitis from subcutaneous panniculitis-like T-cell lymphoma. Histopathology 2013; 62:1057-66. [DOI: 10.1111/his.12105] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 01/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Jau-Yu Liau
- Department of Pathology; College of Medicine; National Taiwan University Hospital; National Taiwan University; Taipei; Taiwan
| | - Shih-Sung Chuang
- Department of Pathology; Chi-Mei Medical Centre; Tainan and Taipei Medical University; Taipei; Taiwan
| | - Chia-Yu Chu
- Department of Dermatology; College of Medicine; National Taiwan University Hospital; National Taiwan University; Taipei; Taiwan
| | - Wen-Hui Ku
- Department of Pathology and Laboratory Medicine; Koo Foundation; Sun Yat-Sen Cancer Centre; Taipei; Taiwan
| | - Jia-Huei Tsai
- Department of Pathology; College of Medicine; National Taiwan University Hospital; National Taiwan University; Taipei; Taiwan
| | - Teng-Fu Shih
- Department of Pathology; Yuan's General Hospital; Kaohsiung; Taiwan
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69
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Molina-Ruiz AM, Sanmartín O, Santonja C, Kutzner H, Requena L. Spring and summer eruption of the elbows: A peculiar localized variant of polymorphous light eruption. J Am Acad Dermatol 2013. [DOI: 10.1016/j.jaad.2012.08.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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70
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Peripheral blood CD4 T-cell and plasmacytoid dendritic cell (pDC) reactivity to herpes simplex virus 2 and pDC number do not correlate with the clinical or virologic severity of recurrent genital herpes. J Virol 2012; 86:9952-63. [PMID: 22761381 DOI: 10.1128/jvi.00829-12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Leukocytes participate in the immune control of herpes simplex virus (HSV). Data from HIV coinfections, germ line mutations, and case reports suggest involvement of CD4 T cells and plasmacytoid dendritic cells (pDC). We investigated the relationships between these cells and recurrent genital herpes disease severity in the general population. Circulating CD4 T-cell responses to HSV-2 were measured in specimens from 67 immunocompetent individuals with measured genital lesion and HSV shedding rates. Similarly, pDC number and functional responses to HSV-2 were analyzed in 40 persons. CD4 responses and pDC concentrations and responses ranged as much as 100-fold between persons while displaying moderate within-person consistency over time. No correlations were observed between these immune response parameters and genital HSV-2 severity. Cytomegalovirus (CMV) coinfection was not correlated with differences in HSV-2-specific CD4 T-cell responses. The CD4 T-cell response to HSV-2 was much more polyfunctional than was the response to CMV. These data suggest that other immune cell subsets with alternate phenotypes or anatomical locations may be responsible for genital herpes control in chronically infected individuals.
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72
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Ko CJ, Srivastava B, Braverman I, Antaya RJ, McNiff JM. Hypertrophic lupus erythematosus: the diagnostic utility of CD123 staining. J Cutan Pathol 2012; 38:889-92. [PMID: 21955314 DOI: 10.1111/j.1600-0560.2011.01779.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CD123-positive plasmacytoid dendrocytes are prominent in the infiltrate of discoid lupus erythematosus (LE). We hypothesized that these cells would also be present in hypertrophic LE and would aid in the histopathologic distinction from squamous cell carcinoma (SCC) and hypertrophic actinic keratosis (AK). Five cases of hypertrophic LE and 10 cases each of SCC and hypertrophic AK were stained with CD123. A heavy band of CD123-positive cells was present at the epidermal-dermal junction in all cases of hypertrophic LE, and only single or rare scattered clusters of CD123-positive cells were seen in SCC and actinic keratoses. The pattern of CD123 staining can be a useful feature to distinguish hypertrophic LE from SCC and hypertrophic AK.
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Affiliation(s)
- Christine J Ko
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
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Dargent JL, Delannoy A, Pieron P, Husson B, Debecker C, Petrella T. Cutaneous accumulation of plasmacytoid dendritic cells associated with acute myeloid leukemia: a rare condition distinct from blastic plasmacytoid dendritic cell neoplasm. J Cutan Pathol 2011; 38:893-8. [DOI: 10.1111/j.1600-0560.2011.01777.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saggini A, Saraceno R, Chimenti S. Exaggerated Imiquimod Application Site Reactions in the Context of Systemic Tumor Necrosis Factor-Alpha Inhibition: More Than a Coincidental Occurrence? Int J Immunopathol Pharmacol 2011; 24:509-15. [DOI: 10.1177/039463201102400225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Topical imiquimod and tumor necrosis factor (TNF)-α inhibitors have gained wide acceptance as safe and effective treatments for non-melanoma skin cancer (NMSC) and moderate to severe psoriasis, respectively. While mild to moderate application site reactions (ASRs) are a well-known and common phenomenon associated with imiquimod, the potential of TNF-α blockers to elicit cutaneous inflammatory reactions has only recently been recognized. We present two cases of severe, atypical ASRs which occurred during NMSC treatment with imiquimod in the context of infliximab administration for psoriasis, and consider the grounds supporting a non-fortuitous association. To date, no relation has ever been suggested between TNF-α inhibitors and increased susceptibility to developing exaggerated ASRs with imiquimod. We believe that this subject deserves further analysis; meanwhile, increased attention should be drawn to the possibility of this adverse interaction, as simultaneous treatment with TNF-α blockers and imiquimod is becoming increasingly frequent in daily practice.
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Affiliation(s)
- A. Saggini
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - R. Saraceno
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - S. Chimenti
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
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McCalmont TH. Dealing with loss. J Cutan Pathol 2011; 38:391-3. [PMID: 21443561 DOI: 10.1111/j.1600-0560.2011.01698.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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