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Roy SF, Ko CJ, Moeckel GW, Mcniff JM. Hypergranulotic dyscornification: 30 cases of a striking epithelial reaction pattern. J Cutan Pathol 2019; 46:742-747. [PMID: 31157457 DOI: 10.1111/cup.13522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/13/2019] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypergranulotic dyscornification (HD) is a rarely reported histological reaction pattern that may be observed in solitary benign keratoses. OBJECTIVE AND METHODS We retrospectively reviewed all cases described as displaying "hypergranulotic dyscornification" at our institution between January 1st 1990 to September 1st 2018. We excluded cases that on retrospective review displayed changes of epidermolytic hyperkeratosis. We conducted electron microscopy (EM) of two lesions. RESULTS Thirty cases were identified in our search. Eleven patients were men and 19 were women. Their mean age was 56.9 ± 21.2 years. In contrast to previous reports, we found that HD does not spare the head and neck area. Frequent clinical impressions were inflamed seborrheic keratosis, Bowen disease or inflamed verruca. The most distinctive histopathologic finding was the presence of a prominent granular layer with clumped perinuclear keratohyaline granules. Some cases had mounds of rounded, anucleate glassy eosinophilic corneocytes in the stratum corneum. We observed one case of incidental HD occurring in an epidermoid cyst. EM of HD showed dense perinuclear bands which appeared to match areas of positive staining by keratin immunohistochemistry, without evidence of pale cytoplasmic areas devoid of keratin filaments, characteristic of epidermolytic hyperkeratosis. CONCLUSION HD is a reproducible finding in some benign keratoses, probably because of abnormal keratinization. Awareness of this unique reaction pattern will help prevent misdiagnosis.
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Affiliation(s)
- Simon F Roy
- Department of Pathology, University of Montréal, Montréal, Canada
| | - Christine J Ko
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Gilbert W Moeckel
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Jennifer M Mcniff
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
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Celli A, Crumrine D, Meyer JM, Mauro TM. Endoplasmic Reticulum Calcium Regulates Epidermal Barrier Response and Desmosomal Structure. J Invest Dermatol 2016; 136:1840-1847. [PMID: 27255610 PMCID: PMC5070468 DOI: 10.1016/j.jid.2016.05.100] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/28/2016] [Accepted: 05/05/2016] [Indexed: 11/15/2022]
Abstract
Ca(2+) fluxes direct keratinocyte differentiation, cell-to-cell adhesion, migration, and epidermal barrier homeostasis. We previously showed that intracellular Ca(2+) stores constitute a major portion of the calcium gradient especially in the stratum granulosum. Loss of the calcium gradient triggers epidermal barrier homeostatic responses. In this report, using unfixed ex vivo epidermis and human epidermal equivalents we show that endoplasmic reticulum (ER) Ca(2+) is released in response to barrier perturbation, and that this release constitutes the major shift in epidermal Ca(2+) seen after barrier perturbation. We find that ER Ca(2+) release correlates with a transient increase in extracellular Ca(2+). Lastly, we show that ER calcium release resulting from barrier perturbation triggers transient desmosomal remodeling, seen as an increase in extracellular space and a loss of the desmosomal intercellular midline. Topical application of thapsigargin, which inhibits the ER Ca(2+) ATPase activity without compromising barrier integrity, also leads to desmosomal remodeling and loss of the midline structure. These experiments establish the ER Ca(2+) store as a master regulator of the Ca(2+) gradient response to epidermal barrier perturbation, and suggest that ER Ca(2+) homeostasis also modulates normal desmosomal reorganization, both at rest and after acute barrier perturbation.
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Affiliation(s)
- Anna Celli
- Dermatology Service, Department of Veterans Affairs Medical Center, and Department of Dermatology, University of California, San Francisco, California, USA.
| | - Debra Crumrine
- Dermatology Service, Department of Veterans Affairs Medical Center, and Department of Dermatology, University of California, San Francisco, California, USA
| | - Jason M Meyer
- Dermatology Service, Department of Veterans Affairs Medical Center, and Department of Dermatology, University of California, San Francisco, California, USA
| | - Theodora M Mauro
- Dermatology Service, Department of Veterans Affairs Medical Center, and Department of Dermatology, University of California, San Francisco, California, USA
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3
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Shull GE, Miller ML, Prasad V. Secretory pathway stress responses as possible mechanisms of disease involving Golgi Ca2+ pump dysfunction. Biofactors 2011; 37:150-8. [PMID: 21674634 PMCID: PMC3338190 DOI: 10.1002/biof.141] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 12/15/2010] [Indexed: 01/15/2023]
Abstract
In mammalian tissues, uptake of Ca(2+) and Mn(2+) by Golgi membranes is mediated by the secretory pathway Ca(2+) -ATPases, SPCA1 and SPCA2, encoded by the ATP2C1 and ATP2C2 genes. Loss of one copy of the ATP2C1 gene, which causes SPCA1 haploinsufficiency, leads to squamous cell tumors of keratinized epithelia in mice and to Hailey-Hailey disease, an acantholytic skin disease, in humans. Although the disease phenotypes resulting from SPCA1 haploinsufficiency in mice and humans are quite different, each species-specific phenotype is remarkably similar to those arising as a result of null mutations in one copy of the ATP2A2 gene, encoding SERCA2, the endoplasmic reticulum (ER) Ca(2+) pump. SERCA2 haploinsufficiency, like SPCA1 haploinsufficiency, causes squamous cell tumors in mice and Darier's disease, also an acantholytic skin disease, in humans. The phenotypic similarities between SPCA1 and SERCA2 haploinsufficiency in the two species, and the general functions of the two pumps in consecutive compartments of the secretory pathway, suggest that the underlying disease mechanisms are similar. In this review, we discuss evidence supporting the view that chronic Golgi stress and/or ER stress resulting from Ca(2+) pump haploinsufficiencies leads to activation of cellular stress responses in keratinocytes, with the predominance of proapoptotic pathways (although not necessarily apoptosis itself) leading to acantholytic skin disease in humans and the predominance of prosurvival pathways leading to tumors in mice.
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Affiliation(s)
- Gary E Shull
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati, College of Medicine, OH, USA.
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4
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Mak RKH, Reynaert SMB, Agar N, Black MM. Hailey-Hailey disease failing to respond to treatment. Clin Exp Dermatol 2005; 30:598-9. [PMID: 16045714 DOI: 10.1111/j.1365-2230.2005.01830.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Fairclough RJ, Lonie L, Van Baelen K, Haftek M, Munro CS, Burge SM, Hovnanian A. Hailey–Hailey Disease: Identification of Novel Mutations in ATP2C1 and Effect of Missense Mutation A528P on Protein Expression Levels. J Invest Dermatol 2004; 123:67-71. [PMID: 15191544 DOI: 10.1111/j.0022-202x.2004.22713.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ATP2C1, encoding the human secretory pathway Ca(2+)-ATPase (hSPCA1), was recently identified as the defective gene in Hailey-Hailey disease (HHD), an autosomal dominant skin disorder characterized by abnormal keratinocyte adhesion in the suprabasal layers of the epidermis. In this study, we used denaturing high-performance liquid chromatography to screen all 28 exons and flanking intron boundaries of ATP2C1 for mutations in 9 HHD patients. Nine different mutations were identified. Five of these mutations, including one nonsense, one deletion, two splice-site, and one missense mutation, have not been previously reported. Recently, functional analysis of a series of site-specific mutants, designed to mimic missense mutations found in ATP2C1, uncovered specific defects in Ca(2+) and/or Mn(2+) transport and protein expression in mutant hSPCA1 polypeptides. In order to investigate the molecular and physiological basis of HHD in the patient carrying missense mutation A528P, located in the putative nucleotide binding domain of the molecule, site-directed mutagenesis was employed to introduce this mutation into the wild-type ATP2C1 (hSPCA1) sequence. Functional analyses of HHD-mutant A528P demonstrated a low level of protein expression, despite normal levels of mRNA and correct targeting to the Golgi, suggesting instability or abnormal folding of the mutated hSPCA1 polypeptides. Analogous to conclusions drawn from our previous studies, these results further support the theory of haploinsufficiency as a prevalent mechanism for the dominant inheritance of HHD, by suggesting that the level of hSPCA1 in epidermal cells is critical.
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6
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Dobson-Stone C, Fairclough R, Dunne E, Brown J, Dissanayake M, Munro CS, Strachan T, Burge S, Sudbrak R, Monaco AP, Hovnanian A. Hailey-Hailey disease: molecular and clinical characterization of novel mutations in the ATP2C1 gene. J Invest Dermatol 2002; 118:338-43. [PMID: 11841554 DOI: 10.1046/j.0022-202x.2001.01675.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hailey-Hailey disease is an autosomal dominant skin disorder characterized by suprabasal cell separation (acantholysis) of the epidermis. Mutations in ATP2C1, the gene encoding a novel, P-type Ca2+-transport ATPase, were recently found to cause Hailey-Hailey disease. In this study, we used conformation-sensitive gel electrophoresis to screen all 28 translated exons of ATP2C1 in 24 Hailey-Hailey disease families and three sporadic cases with the disorder. We identified 22 different mutations, 18 of which have not previously been reported, in 25 probands. The novel mutations comprise three nonsense, six insertion/deletion, three splice-site, and six missense mutations and are distributed throughout the ATP2C1 gene. Six mutations were found in multiple families investigated here or in our previous study. Haplotype analysis revealed that two of these are recurrent mutations that have not been inherited from a common ancestor. Comparison between genotype and phenotype in 23 families failed to yield any clear correlation between the nature of the mutation and clinical features of Hailey-Hailey disease. The extensive interfamilial and intrafamilial phenotypic variability observed suggests that modifying genes and/or environmental factors may greatly influence the clinical features of this disease.
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Bernards M, Korge BP. Desmosome assembly and keratin network formation after Ca2+/serum induction and UVB radiation in Hailey-Hailey keratinocytes. J Invest Dermatol 2000; 114:1058-61. [PMID: 10792570 DOI: 10.1046/j.1523-1747.2000.00960-2.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Hakuno M, Shimizu H, Akiyama M, Amagai M, Wahl JK, Wheelock MJ, Nishikawa T. Dissociation of intra- and extracellular domains of desmosomal cadherins and E-cadherin in Hailey-Hailey disease and Darier's disease. Br J Dermatol 2000; 142:702-11. [PMID: 10792220 DOI: 10.1046/j.1365-2133.2000.03415.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In order to clarify the pathomechanism of acantholysis in Hailey-Hailey disease (HHD) and Darier's disease (DD), the distribution of desmosomal and adherens junction-associated proteins was studied in the skin of patients with HHD (n = 4) and DD (n = 3). Domain-specific antibodies were used to determine the cellular localization of the desmosomal transmembrane glycoproteins (desmogleins 1 and 3 and desmocollin), desmosomal plaque proteins (desmoplakin, plakophilin and plakoglobin) and adherens junction-associated proteins (E-cadherin, alpha-catenin, beta-catenin and actin). A significant difference in staining patterns between intra- and extracellular domains of desmosomal cadherins and E-cadherin was demonstrated in acantholytic cells in both HHD and DD, but not in those in pemphigus vulgaris and pemphigus foliaceus samples used as controls. In acantholytic cells in HHD and DD, antibodies against attachment plaque proteins and intracellular epitopes of desmosomal cadherins exhibited diffuse cytoplasmic staining, whereas markedly reduced staining was observed with antibodies against extracellular epitopes of the desmogleins. Similarly, membrane staining of an intracellular epitope of E-cadherin was preserved, while immunoreactivity of an extracellular epitope of E-cadherin was destroyed. While the DD gene has been identified as ATP2A2, the gene for HHD has not been clarified. The dissociation of intra- and extracellular domains of desmosomal cadherin and E-cadherin is characteristic of the acantholytic cells in HHD and DD, and not of pemphigus. This common phenomenon in HHD and DD might be closely related to the pathophysiological mechanisms in both conditions.
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Affiliation(s)
- M Hakuno
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
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SUEKI H, SHANLEY K, GOLDSCHMIDT M, LAZARUS G, MURPHY G. Dominantly inherited epidermal acantholysis in dogs, simulating human benign familial chronic pemphigus (Hailey–Hailey disease). Br J Dermatol 1997. [DOI: 10.1111/j.1365-2133.1997.tb14894.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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SUEKI H, SHANLEY K, GOLDSCHMIDT M, LAZARUS G, MURPHY G. Dominantly inherited epidermal acantholysis in dogs, simulating human benign familial chronic pemphigus (Hailey-Hailey disease). Br J Dermatol 1997. [DOI: 10.1046/j.1365-2133.1997.d01-1167.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Cooley JE, Briggaman RA, Cronce DJ, Banes AJ, O'Keefe EJ. Hailey-Hailey disease keratinocytes: normal assembly of cell-cell junctions in vitro. J Invest Dermatol 1996; 107:877-81. [PMID: 8941678 DOI: 10.1111/1523-1747.ep12331167] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The blisters in the inherited disorder, Hailey-Hailey disease, may be caused by defective epidermal junctional complexes. We evaluated these structural complexes in vivo and in vitro. We induced a vesicular lesion in the apparently normal skin of a patient with Hailey-Hailey disease and studied a biopsy of this lesion by transmission electron microscopy. To determine whether acantholysis was related to a defect in the number or assembly of intercellular junctions, we cultured Hailey-Hailey disease keratinocytes in medium containing 0.1 mM Ca2+ and increased the [Ca2+] to 1.1 mM in order to induce assembly of cell-cell junctions. Keratinocytes were examined by double immunofluorescence with antibodies to the desmosome protein, desmoplakin, and the adherens junction protein, vinculin, at intervals after the increase in [Ca2+]. Characteristic Hailey-Hailey disease histopathology was observed by electron microscopy of the patient's skin after trauma, but we found no splitting of desmosomes. Based on the location, intensity, and rate of change of immunofluorescent staining, Hailey-Hailey and normal keratinocytes did not differ in their ability to assemble desmosomes and adherens junctions. Furthermore, we observed no significant morphologic differences between normal and Hailey-Hailey keratinocytes cultured in low and high [Ca2+]-containing media; Hailey-Hailey cells contained abundant normal-appearing desmosomes in 1.1 mM [Ca2+]. Since Hailey-Hailey disease keratinocytes can assemble normal-appearing adherens junctions and desmosomes in vitro, the functional defect may not lie in assembly of cell-cell adhering junctions, or additional perturbation may be required to expose the defect.
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Affiliation(s)
- J E Cooley
- Department of Dermatology, University of North Carolina, Chapel Hill 27599, USA
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12
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Hunt MJ, Salisbury EL, Painter DM, Lee S. Vesiculobullous Hailey-Hailey disease: successful treatment with oral retinoids. Australas J Dermatol 1996; 37:196-8. [PMID: 8961587 DOI: 10.1111/j.1440-0960.1996.tb01053.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 56-year-old male presented with a pruritic, generalized vesiculobullous eruption. His past history revealed classical symptoms of limited Hailey-Hailey disease for 34 years. Clinically, vesicles, bullae and occasional pustules were present and multiple biopsies confirmed this to be an unusual presentation of Hailey-Hailey disease. Various therapeutic modalities including topical and oral antibiotics, oral prednisone and dapsone failed to achieve sustained remission. Treatment with low-dose oral etretinate (25 mg daily) produced marked clinical improvement with complete suppression of new vesicle formation after 6 weeks.
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Affiliation(s)
- M J Hunt
- Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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13
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Metze D, Hamm H, Schorat A, Luger T. Involvement of the adherens junction-actin filament system in acantholytic dyskeratosis of Hailey-Hailey disease. A histological, ultrastructural, and histochemical study of lesional and non-lesional skin. J Cutan Pathol 1996; 23:211-22. [PMID: 8793655 DOI: 10.1111/j.1600-0560.1996.tb01469.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hailey-Hailey disease is a blistering genodermatosis that shows acantholytic dyskeratosis throughout the epidermis. The aim of our study was to investigate the involvement of adherens structures and cytofilaments in this particular type of acantholysis. Both lesional and non-lesional skin from 18 patients was studied histologically and ultrastructurally. Additionally, the samples were stained for desmosomes, adherens junctions, keratin filaments, actin filaments, and actin-associated proteins, and finally investigated with an electron and a confocal laser scanning microscope (CLSM), respectively. Acantholytic dyskeratosis was not only confined to lesions, but was also focally detectable in clinically unaffected skin. Despite disruption and internalization of the desmosomes, keratinocytes remained linked together by well-preserved adherens junctions. Staining for actin filaments with fluorochrome-labeled phalloidin showed a remarkable formation of actin stress fibers in these keratinocytes. Thus, incomplete acantholysis, as demonstrable in both lesional and non-lesional skin of Hailey-Hailey patients, may be due to a cohesive function of the adherens junction-actin system succeeding the dissolution of desmosomes. Most remarkably, none of the adnexal epithelia expressed the intrinsic defect of cell adhesion. This finding offers an explanation for the successful treatment of Hailey-Hailey disease by dermabrasion, which after complete removal of the involved epidermis results in reepithelialization from skin appendages.
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Affiliation(s)
- D Metze
- Department of Dermatology, Ludwig Boltzmann Institute for Cellbiology and Immunobiology of the Skin, University of Münster, Germany
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Hashimoto K, Fujiwara K, Tada J, Harada M, Setoyama M, Eto H. Desmosomal dissolution in Grover's disease, Hailey-Hailey's disease and Darier's disease. J Cutan Pathol 1995; 22:488-501. [PMID: 8835169 DOI: 10.1111/j.1600-0560.1995.tb01145.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Proteins involved in the formation of desmosomes and simpler adherens junctions were studied in three types of non-immune acantholytic diseases; specifically, four cases of Grover's disease (GD), one case of Hailey-Hailey's disease (HHD) and one case of Darier's disease (DD), and these were compared to two cases of immune-mediated acantholytic disease pemphigus vulgaris (PV). The proteins studied included: 1. The intracellular desmosomal proteins, desmoplakin I and II and plakoglobin; 2. The intercellular desmosomal proteins, desmoglein and CD44; and 3. vinculin, which is a major intracellular protein of the simpler aherens junctions. In GD, HHD and DD, immunostaining showed a loss of desmoplakin I and II and plakoglobin from the desmosomes, and a diffuse staining in the cytoplasm. In contrast, in pemphigus vulgaris, these proteins seemed intact and were localized to dot-like spots on the cell surface. Also, desmoglein, and CD44 were slightly affected in GD, and moderately affected in HHD and DD. Absence of desmosomal attachment plaques, the lack of labeling with desmoglein in the affected desmosomes and a diffusion of the labels into cytoplasm were demonstrated with electron microscopy using an immunogold technique. In PV, desmoglein III is one of the target antigens for the autoantibodies in this disease and was only partially preserved in a small number of lesional cells, while CD44 was mostly preserved. Vinculin was intact in GD, HHD and DD, but was lost in PV. This study, our previous work, and that of others, suggest that: 1. In GD, HHD and DD, the proteins of the desmosomal attachment plaque are primarily affected; 2. In PV, the intercellular glycoproteins are primarily involved; and 3. Simple adherens junctions are intact in GD, HHD and DD, but are damaged in PV.
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Affiliation(s)
- K Hashimoto
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI 48201, USA
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Richard G, Korge BP, Wright AR, Mazzanti C, Harth W, Annicchiarico-Petruzzelli M, Compton JG, Bale SJ. Hailey-Hailey disease maps to a 5 cM interval on chromosome 3q21-q24. J Invest Dermatol 1995; 105:357-60. [PMID: 7665912 DOI: 10.1111/1523-1747.ep12320741] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Hailey-Hailey disease (HHD) is a rare autosomal dominant genodermatosis characterized by disturbed keratinocyte adhesion. The disease has recently been mapped to a 14 cM region on chromosome 3q. We have further refined the location of the HHD gene by linkage analysis in six HHD families from Germany and Italy using 11 polymorphic microsatellite markers and found no evidence for genetic heterogeneity. We observed complete cosegregation between HHD and marker D3S1587, with a maximal lod score of 4.54. Detailed haplotype analyses allowed us to narrow the interval containing the HHD locus to 5 cM, flanked by D3S1589 and D3S1290.
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Affiliation(s)
- G Richard
- Laboratory of Skin Biology, NIAMS, National Institutes of Health, Bethesda, Maryland, USA
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Welsh EA, Ikeda S, Peluso AM, Bonifas JM, Bare JW, Woodley DT, Epstein EH. Hailey-Hailey disease is not allelic to Darier's disease. J Invest Dermatol 1994; 102:992-3. [PMID: 7516400 DOI: 10.1111/1523-1747.ep12384283] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Hailey-Hailey (Familial Benign Chronic Pemphigus) Disease is a rare autosomal dominant disorder characterized by blisters caused by suprabasal epidermal acantholysis. Another autosomal dominant skin disease, Darier's disease, has clinical and histologic features which overlap those of Hailey-Hailey disease and recently has been mapped to chromosome 12q23-q24.1. We have used linkage analysis to test whether or not a mutation in this region might also underlie Hailey-Hailey disease. This analysis, using polymorphic loci tightly linked to Darier's disease, excluded this region as the site for the disease-causing mutation in two kindreds affected with Hailey-Hailey disease.
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Affiliation(s)
- E A Welsh
- Department of Dermatology, Stanford University School of Medicine, California
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17
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Abstract
Fifty-eight individuals with Hailey-Hailey disease were studied to delineate the clinical features, response to treatment and prognosis. The disease generally presented between the second and fourth decades, but the morphology of lesions was varied and a delay in diagnosis was common. Nail changes have not been documented in previous studies of Hailey-Hailey disease, but asymptomatic longitudinal white bands were present in the fingernails in 71% of 38 patients examined and are a helpful physical sign. The disease is predominantly flexural. Friction and heat or sweating exacerbate the lesions and pain may limit physical activities. The prognosis was assessed in 27 patients with longstanding disease and the long-term outlook is generally good. Seventeen patients had improved and the disease was static in seven patients. Three patients deteriorated with age. Topical corticosteroids with or without added antibiotics were an effective treatment.
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Affiliation(s)
- S M Burge
- Department of Dermatology, Slade Hospital, Oxford, U.K
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Akiyama M, Sugiura M, Shimizu H, Nishikawa T. No significant change of glycoconjugates exists in the epidermis of familial benign chronic pemphigus. Arch Dermatol Res 1991; 283:537-9. [PMID: 1723871 DOI: 10.1007/bf00371931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M Akiyama
- Department of Dermatology, Keio University School of Medicine
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19
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Burge SM, Cederholm-Williams SA, Garrod DR, Ryan TJ. Cell adhesion in Hailey-Hailey disease and Darier's disease: immunocytological and explant-tissue-culture studies. Br J Dermatol 1991; 125:426-35. [PMID: 1751348 DOI: 10.1111/j.1365-2133.1991.tb14767.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The pathogenesis of Hailey-Hailey disease and Darier's disease was investigated using immunocytological and explant-tissue-culture techniques. There was breakdown of the intercellular adhesions between keratinocytes in explants from clinically uninvolved skin of patients with Hailey-Hailey disease or Darier's disease. The major desmosomal components were present in the cultures and were expressed in a punctate peripheral pattern at cell-cell contact sites, but there was diffuse staining of acantholytic cells. Plasminogen, which is expressed by basal keratinocytes in normal skin, was detected in association with suprabasal acantholytic cells in skin biopsies from these diseases. Plasminogen was reversibly displaced from the cells by 6-aminohexanoic acid, suggesting that binding is mediated by a reaction with the lysine receptor on the plasminogen molecule. Plasminogen was also detected in separating cells in explant cultures and there was cytoplasmic expression of the plasminogen activator urokinase by these cells. These abnormalities are not unique to either disease and do not account for the phenotypic differences between Darier's disease and Hailey-Hailey disease, but plasmin generation may have a role in perpetuating cell separation.
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Affiliation(s)
- S M Burge
- Department of Dermatology, Slade Hospital, Oxford, U.K
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20
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Ikeda S, Ogawa H. Effects of steroid, retinoid, and protease inhibitors on the formation of acantholysis induced in organ culture of skins from patients with benign familial chronic pemphigus. J Invest Dermatol 1991; 97:644-8. [PMID: 1940435 DOI: 10.1111/1523-1747.ep12483596] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Skin explants from two lesional areas and four normal-appearing areas of four patients with benign familial chronic pemphigus (BFCP) were organ cultured with and without various reagents. After 24-h culturing of involved skin with medium only, dissociation of keratinocytes, which was also observed prior to culturing, was exacerbated, and the epidermis became edematous, with a large section detaching from the dermis. These phenomena were not suppressed even when betamethasone, retinol acetate, or camostat mesilate (serine protease inhibitor) was added to the medium. On the other hand, in the cultures of uninvolved skin explants with medium only, widened intercellular spaces were observed 24-48 h after initiation of culture, and dissociation of keratinocytes and acantholytic clefts became apparent after 72 h. Such culture-induced acantholysis was almost completely suppressed by the addition of betamethasone, but not suppressed by the addition of retinol acetate, EDTA, N-ethylmaleimaide, or pepstatin A. Camostat and SBTI incompletely suppressed the acantholysis. These findings suggest the possibility that steroid may reduce blistering and that an organ culture of non-lesional benign familial chronic pemphigus (BFCP) skin may be useful for clarifying the pathogenesis, as well as for discovering new drugs for the treatment of BFCP. Further experiments are required to clarify the role of serine proteases in the acantholysis in this disease.
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Affiliation(s)
- S Ikeda
- Department of Dermatology, Juntendo University, School of Medicine, Tokyo, Japan
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21
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Setoyama M, Hashimoto K, Tashiro M. Immunolocalization of desmoglein I ("band 3" polypeptide) on acantholytic cells in pemphigus vulgaris, Darier's disease, and Hailey-Hailey's disease. J Dermatol 1991; 18:500-5. [PMID: 1787220 DOI: 10.1111/j.1346-8138.1991.tb03123.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Acantholysis is defined as loss of coherence between epithelial cells and is histologically shown in several bullous diseases. It was postulated that desmoglein I, one of the major transmembrane glycoproteins of the desmosome, may adhere to the attachment plaque inside the cell and contribute to desmoglea outside the cell. In this study we used a well characterized antibody against desmoglein I for immunofluorescence and immunoelectron microscopic techniques on 2 cases each of pemphigus vulgaris and Darier's disease and one case of Hailey-Hailey's disease. In the normal epidermis desmosomes were demonstrated in dotted or rim-like patterns along cell periphery on immunofluorescence study. In pemphigus vulgaris dotted or rim-like patterns were still identified in many acantholytic cells, particularly in early phase of acantholysis. In Darier's disease and Hailey-Hailey's disease, dotted or rim-like patterns were already lost in early acantholysis and immunoreactive desmoglein I proteins were observed diffusely in the cytoplasm. Immunoelectron microscopy confirmed these immunofluorescence observations. It was suggested that in pemphigus vulgaris desmoglein I is unlikely to be the primary site of acantholysis because dotted or rim-like patterns of immunoreactive desmoglein I are relatively preserved on lesional cells, whereas in genodermatoses such as Darier's disease and Hailey-Hailey's disease primary abnormalities of desmosomes may be involved in their acantholysis.
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Affiliation(s)
- M Setoyama
- Department of Dermatology, Faculty of Medicine, Kagoshima University, Japan
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22
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Abstract
Suction has been used to investigate cell adhesion in clinically normal skin in Hailey-Hailey disease. We have demonstrated that there is a widespread subclinical abnormality in keratinocyte adhesion in this disease. There may be a synthesis of functionally deficient adhesion junctions, increased breakdown of adhesion junctions or abnormalities in other adhesion proteins in the epidermis in Hailey-Hailey disease. The findings contrast with those in Darier's disease in which abnormal cell adhesion was only demonstrable in clinically involved skin.
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Affiliation(s)
- S M Burge
- Department of Dermatology, Slade Hospital, Oxford, U.K
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Burge SM, Garrod DR. An immunohistological study of desmosomes in Darier's disease and Hailey-Hailey disease. Br J Dermatol 1991; 124:242-51. [PMID: 2018730 DOI: 10.1111/j.1365-2133.1991.tb00568.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The immunocytochemical distribution of desmosomal components was determined in involved skin from eight patients with Darier's disease, five patients with Hailey-Hailey disease and two patients with transient acantholytic dermatosis as well as skin from four normal controls. Sections were stained using monoclonal antibodies to the desmosomal proteins dp1 and dp2 (desmoplakins) and the desmosomal glycoproteins dg1 (desmoglein), and dg2 and dg3 (desmocollins). There was normal expression of desmosomal proteins and glycoproteins at the periphery of the keratinocytes in the perilesional skin in Darier's disease, in Hailey-Hailey disease and in transient acantholytic dermatosis. In the lesional skin there was reduced expression of desmosomal proteins and glycoproteins in the basaloid 'buds' at the base of the lesions, but there was bright diffuse staining of the acantholytic cells. Focal intracellular staining was detected within many of the acantholytic keratinocytes in Hailey-Hailey disease and within some of these cells in Darier's disease. Suction blisters were used to induce fresh acantholysis in lesional skin in Darier's disease and clinically uninvolved skin in Hailey-Hailey disease. The results indicated that acantholysis precedes the development of intracellular staining. Although there are immunopathological abnormalities in the distribution of desmosomal proteins and glycoproteins in both Darier's disease and Hailey-Hailey disease, the changes are probably secondary to internalization of desmosomal components with breakdown and redistribution of antigens rather than a primary deficiency in the synthesis of these proteins. Focal internalization was more widespread in Hailey-Hailey disease than in Darier's disease and the differences in the distribution of desmosomal components in these diseases confirm that they are distinct entities.
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Affiliation(s)
- S M Burge
- Department of Dermatology, Slade Hospital, Oxford, U.K
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24
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Setoyama M, Choi KC, Hashimoto K, Ishihara M, Predeteanu GS, Dinehart S, Predeteanu C, Hamzavi LH, Etoh H. Desmoplakin I and II in acantholytic dermatoses: preservation in pemphigus vulgaris and pemphigus erythematosus and dissolution in Hailey-Hailey's disease and Darier's disease. J Dermatol Sci 1991; 2:9-17. [PMID: 2054341 DOI: 10.1016/0923-1811(91)90037-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Desmoplakin I and II are important components of the attachment plaque of the desmosome which mediates cell to cell adhesion, in epithelial cells. In this study we used well-characterized antibody against desmoplakin I and II immunohistochemically and immunoelectron microscopically on two cases of pemphigus vulgaris and one case of pemphigus erythematosus and two cases each of Hailey-Hailey's disease and Darier's disease. In the normal human epidermis the desmosomes were demonstrated in a dotted pattern along cell periphery. In pemphigus vulgaris and pemphigus erythematosus acantholytic cells and the perilesional cells exhibited normal dotted pattern along the cell periphery. In Hailey-Hailey's disease and Darier's disease, the dotted pattern is lost in acantholysed and perilesional areas and anti-desmoplakin I + II positive proteins were observed diffusely in the cytoplasm. Immunoelectron microscopical findings correspond to these light microscopical observations. It is concluded that in autoimmune acantholytic disease such as pemphigus vulgaris and pemphigus erythematosus, desmoplakins are intact even in acantholytic cells, whereas in genodermatoses such as vulgaris and pemphigus erythematosus, desmoplakins are intact even in acantholytic cells, whereas in genodermatoses such as Hailey-Hailey's disease and Darier's disease primary or secondary abnormalities abnormalities of desmosomes may be involved in their pathogenesis.
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Affiliation(s)
- M Setoyama
- Department of Dermatology and Syphilology, Wayne State University School of Medicine, Detroit, Michigan
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25
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Abstract
We describe a 33-year-old man with an unusual epidermal naevus that followed the lines of Blaschko. There were filiform hyperkeratoses, large cutaneous horns and lesions that resembled giant comedones and linear hyperkeratotic plaques. All of these lesions showed acantholysis without dyskeratosis. As the disorder is characterized by multiple small or large horn-like processes, we propose the term 'naevus corniculatus'.
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Affiliation(s)
- R Happle
- Department of Dermatology, University of Nijmegen, The Netherlands
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26
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Jaworski RC, Commens C. Ultrastructural appearances of disseminated superficial actinic porokeratosis. Ultrastruct Pathol 1988; 12:643-9. [PMID: 3238808 DOI: 10.3109/01913128809056489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The ultrastructure of the cornoid lamella and adjacent epidermis was studied by transmission electron microscopy in seven patients with disseminated superficial actinic porokeratosis (DSAP). In the region of the cornoid lamella similar ultrastructural changes were seen in various degrees in all cases. The main changes were seen in various degrees in all cases. The main changes included reduplication of the basal lamina at the dermo-epidermal junction, vacuolar change in the keratinocytes with numerous autophagic vacuoles, glycogen accumulation, dyskeratotic cells, parakeratotic cells containing degraded organelles, and a reduced granular layer.
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Affiliation(s)
- R C Jaworski
- Department of Anatomical Pathology, Westmead Hospital, New South Wales, Australia
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27
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Don PC, Carney PS, Lynch WS, Zaim MT, Hassan MO. Carbon dioxide laserabrasion: a new approach to management of familial benign chronic pemphigus (Hailey-Hailey disease). THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1987; 13:1187-94. [PMID: 3117856 DOI: 10.1111/j.1524-4725.1987.tb02430.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Familial benign chronic pemphigus (FBCP), or Hailey-Hailey disease, can be a debilitating condition. Treatment is palliative and only excision of lesional skin followed by split-thickness grafting may be curative. The success of surgery is attributed to the removal of adnexal structures and a decrease in sweating and maceration. This is the first report of successful carbon dioxide (CO2) laserabrasion of a patient with FBCP. The procedure spared the underlying adnexae which contributed to the reepithelialization of the epidermis. The selective destructive property of the CO2 laser may contribute to understanding the pathophysiology of FBCP.
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Affiliation(s)
- P C Don
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
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Haftek M, Viac J, Schmitt D, Gaucherand M, Thivolet J. Ultrastructural quantitation of desmosome and differentiation-related keratinocyte membrane antigen. Arch Dermatol Res 1986; 278:283-92. [PMID: 2427039 DOI: 10.1007/bf00407739] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The keratinocyte membrane antigen KM 48 was defined by a new monoclonal antibody obtained after mouse immunization with normal human epidermal cell suspension. Specific reactivity of the antibody with desmosomal regions of keratinocyte cell membrane was demonstrated by immunoelectronmicroscopy. Langerhans cells, melanocytes, and indeterminate cells did not express the KM 48 antigen. Immunogold labelling permitted ultrastructural quantitation of KM 48 antibody binding on keratinocytes from various epidermal layers. A gradual increase in desmosome-related KM 48 antigen expression accompanied differentiation of keratinocytes during their transit from basal to granular layer. Distribution of the antigen on individual cells was uneven. The upper pole of a keratinocyte facing overlying more differentiated cells was always found to be laden with an immunogold marker about twice that of the opposite, lower surface of the cell. The results support the previous reports on gradual development of desmosomes during epidermal cell maturation and open up new possibilities for keratinocyte differentiation studies. They also underline the virtues of the immunogold-labelling method used for cell-surface antigen tracing and quantitation.
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Abstract
A 5-year-old girl with a unilateral linear systematized skin lesion showing the clinical, histological and ultrastructural features of Hailey-Hailey disease is described. We suggest that this relapsing linear acantholytic dermatosis represents a new distinct entity within the spectrum of unilateral linear skin diseases.
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Ishibashi Y, Kajiwara Y, Andoh I, Inoue Y, Kukita A. The nature and pathogenesis of dyskeratosis in Hailey-Hailey's disease and Darier's disease. J Dermatol 1984; 11:335-53. [PMID: 6392380 DOI: 10.1111/j.1346-8138.1984.tb01487.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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34
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Löning T, Burkhardt A. Dyskeratosis in human and experimental oral precancer and cancer. An immunohistochemical and ultrastructural study in men, mice and rats. Arch Oral Biol 1982; 27:361-6. [PMID: 6180717 DOI: 10.1016/0003-9969(82)90144-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Dyskeratotic cells were examined with light and electron microscopy in human oral leukoplakias and carcinomas and in chemically-induced oral premalignant and malignant lesions of mice and rats. Specific antisera against small and large keratins were used to analyse the distribution of keratin polypeptides. In normal oral mucosa, basal cells did not react with antibodies against large keratins in contrast to the suprabasal cells which did react. Small keratins were found in all epithelial cell layers. In human and experimental premalignant and malignant lesions, intensely labelled dyskeratotic cells were seen, which contained small and large keratins regardless of their position in the epithelium. At the ultrastructural level, these cells showed dense aggregates of tonofilaments. Dyskeratotic cells were often seen in advanced stages of degeneration of phagocytosis of these cells by macrophages and giant cells was frequent. The disturbance of the keratinization process in oral precancer and cancer is easily visualized using keratin antisera. Keratin analysis can give new insights in epithelial maturation and may be helpful for the classification of oral leukoplakia.
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35
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Abstract
An occlusive dressing was applied to the unaffected skin of the back of a patient with familial benign chronic pemphigus (FBCP). Small lesions of FBCP appeared after 48 h, and the ultrastructure of successive biopsies was studied. It was concluded that: (a) the initial phenomenon in FBCP is the result of an insufficiency of cellular adhesion. This confirms several previous reports. (b) desmosomes are separated in two halves, invaginated in vacuoles and later deeply included in the cell. The particular fate of these disrupted desmosomes has already been observed after the action of several enzymes on the epidermis and in Darier's disease.
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36
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Abstract
A woman of 60 developed a generalized erythroderma. The case history revealed classical symptoms of Hailey-Hailey disease for 17 years. Light- and electron microscopic investigations confirmed the diagnosis of generalized Hailey-Hailey disease--an extremely rare condition. Two additional cases with widespread clinical manifestations are presented. These observations underline the fact that the whole epidermis is genetically disturbed and may react to various insults with suprabasal acantholysis.
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37
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Abstract
Biospy specimens from three patients with morbus Darier were studied by electron microscopy: Grains appeared in groups in the midst of dyskeratotic lesions and were recognized as being the result of more advanced acantholysis and precocious keratinization. Corps ronds were formed individually in the regions lateral to that of grains, where hypergranulosis was prominent in contrast to a mild dyskeratosis. Therefore, the formation of grains and corps ronds seem to be independent of each other. While in the literature acantholysis has mainly been ascribed to the separat;on of desmosones into two segments, another initial process seems to be the primary disappearance of the attachment plaque along with the connecting tonofilaments. From the existence of the other contact complexes, it seems likely that a restoration of desmosomes between acantholytic cells should take place. In early stages of dyskeratotic cells, keratinosomes were increased in number and some of them persisted inside the plasma membrane without a release into the intercellular spaces, and thus they were present in grains and corps ronds. The dyskeratosis in morbus Darier is characterized by a premature, incomplete and individual keratinization as evidenced by the existence of keratohyalin granules and keratinosomes as early as at the level of the 3rd epidermal layer and the absence of a keratin pattern in the dyskeratotic horny cells.
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38
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Sato A, Anton-Lamprecht I, Schnyder UW. Ultrastructure of inborm errors of keratinization. VII. Porokeratosis Mibelli and disseminated superficial actinic porokeratosis. Arch Dermatol Res 1976; 255:271-84. [PMID: 942256 DOI: 10.1007/bf00561498] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The cornoid lamella and the underlying epidermis were studied by electron microscopy on specimens biopsied from 2 patients with porokeratosis Mibelli and 1 patient with actinic porokeratosis. Findings on the two types of porokeratoses are essentially the same. The cornoid lamella was composed chiefly of extremely irregular dark cells and a few numbers of dyskeratotic cells. Both cells retained a nuclear remnant and many other degraded organelles. The epidermal cells just beneath the cornoid lamella simultaneously demonstrated productive and degenerative signs. Some of these epidermal cells underwent dyskeratosis and appeared as corps ronds-like bodies in the granular layer. Two contradictory phenomena should be attributed to the pathogenesis of cornoid lamella. In the cornoid lamella above the sweat pore microvilli-structures were found.
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39
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Proctor SJ, Sherman KC. Ultrastructural changes in bovine lingual epithelium infected with vesicular stomatitis virus. Vet Pathol 1975; 12:362-77. [PMID: 180646 DOI: 10.1177/0300985875012005-00603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Vesicular stomatitis virus was inoculated into the dorsal lingual epithelium of three cows. The reaction that developed in 72 h was characterized by severe acute diffuse glossitis with intercellular edema and necrosis of keratinocytes. Virions budded from the plasma membrane and were in the intercellular spaces. Reduplication of desmosomes was a prominent alteration, and normal desmosomes were within the cytoplasm. Intracytoplasmic desmosomes appeared to be formed by endocytosis after breaks occurred in the plasma membrane of one cell; endocytosis of loops of plasma membrane containing desmosomes; and formation of desmosomes on invagination of the plasma membrane.
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40
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Abstract
A radiation-induced autosomal recessive mutant in the rat called vibrissaeless (vb), has been described and studied. Mutants have abnormal hair growth, the hairs being reduced in number and length. Mutant animals form blisters which then erode, crust, and heal without scars. The blisters can be artificially produced by friction and result from intraepidermal separation which is suprabasilar in position. To date, we cannot correlate this abnormality in rats with any known inherited human blistering disease.
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41
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Allen TD, Potten CS. Desmosomal form, fate, and function in mammalian epidermis. JOURNAL OF ULTRASTRUCTURE RESEARCH 1975; 51:94-105. [PMID: 1127795 DOI: 10.1016/s0022-5320(75)80011-6] [Citation(s) in RCA: 81] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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42
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Abstract
From their ultrastructural study of incontinenti pigmenti, the authors confirm that in this condition there is no pigmentary anomaly, but that pigmentation is the last step of a still unknown process. At birth those who are affected display an intracellular edema which leads to the formation of a vesocobulla. In all 3 stages, the epidermis shows dyskeratotic cells and a transient pigmentary discharge.
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43
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Goldsmith LA, Kang E, Bienfang DC, Jimbow K, Gerald P, Baden HP. Tyrosinemia with plantar and palmar keratosis and keratitis. J Pediatr 1973; 83:798-805. [PMID: 4270265 DOI: 10.1016/s0022-3476(73)80372-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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44
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Abstract
A disease in Angus calves was characterised by shedding of the epidermis with ulceration and inflammation of the oral mucosa and the skin of carpus, metacarpal-phalangeal joints, phalanges, coronary border, and with partial separation of the hooves. The pathogenesis of these lesions involves a breakdown of intercellular adhesions associated with anomalous development of the desmosome-tonofilament complexes in the basal and prickle cells of the epidermis. The breeding and clinical history suggested a genetic cause. The disease was called ‘familial acantholysis of Angus calves’.
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45
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Sato A, Seiji M. Electron microscopic observations of leukoplakia. ARCHIV FUR DERMATOLOGISCHE FORSCHUNG 1973; 247:211-20. [PMID: 4748767 DOI: 10.1007/bf00596240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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46
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47
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Hasler JF. The role of immunofluorescence in the diagnosis of oral vesiculobullous disorders. Report of four cases. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1972; 33:362-74. [PMID: 4551232 DOI: 10.1016/0030-4220(72)90466-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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48
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Karásek J, Pitha J, Oehlert W, Konrád B. Dyskeratosis in Bowen's disease: the ultrastructure and fate of keratinocytes with altered tonofilament-desmosome complexes. Br J Dermatol 1971; 85:348-56. [PMID: 5125638 DOI: 10.1111/j.1365-2133.1971.tb14029.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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