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Balakirski G, Gäbelein-Wissing N, Hofmann SC. [Solar urticaria and polymorphous light eruption]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:518-527. [PMID: 38864900 DOI: 10.1007/s00105-024-05368-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/13/2024]
Abstract
Solar urticaria is a rare idiopathic photodermatosis. According to the current knowledge its pathogenesis is most likely based on an allergic type I reaction to an autoantigen activated by ultraviolet (UV) radiation or visible light. As many of the patients suffer from severe forms of the disease, it may therefore severely impair the quality of life of those affected. In contrast, polymorphous light eruption is a very common disease, which, according to the current data, can be interpreted as a type IV allergic reaction to a photoallergen induced by UV radiation. As the skin lesions heal despite continued sun exposure, the patients' quality of life is generally not significantly impaired. These two clinically and pathogenetically very different light dermatoses have shared diagnostics by means of light provocation and an important therapeutic option (light hardening). Herein, we present an overview of the clinical picture, pathogenesis, diagnosis and available treatment options for the above-mentioned diseases.
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Affiliation(s)
- Galina Balakirski
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Wuppertal, Deutschland.
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Wuppertal, Deutschland.
| | - Noemi Gäbelein-Wissing
- Hautarztpraxis Dr. med. Rainer Schmidt & Dr. med. Noemi Gäbelein-Wissing, Wuppertal, Deutschland
| | - Silke C Hofmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Wuppertal, Deutschland
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Zarfl M, Patra V, Bordag N, Quehenberger F, Golob-Schwarzl N, Gruber-Wackernagel A, Wolf P. Eradication of skin microbiota restores cytokine production and release in polymorphic light eruption. Exp Dermatol 2024; 33:e15034. [PMID: 38459631 DOI: 10.1111/exd.15034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 03/10/2024]
Abstract
Polymorphic light eruption (PLE) has been mechanistically linked to cytokine abnormalities. Emerging preclinical evidence posits the skin microbiome as a critical modulator of ultraviolet (UV)-induced cytokine expression, thereby influencing subsequent immune responses. This intricate relationship remains underexplored in the context of PLE. Hence, we investigated the differential responses between disinfected and non-disinfected skin following both single and repetitive exposures to solar-simulated UV radiation in patients with PLE. An experimental, half-body pilot study was conducted involving six PLE patients and 15 healthy controls. Participants' skin was exposed to single and multiple doses of solar-simulated UV radiation, both in disinfected and in non-disinfected skin areas. The co-primary outcomes were PLE score and cytokine expression in blister fluid analysed through OLINK proteomic profiling. Secondary outcomes were erythema, pigmentation, induction of apoptotic cells in vacuum-generated suction blisters, and density of infiltrate in skin biopsies of PLE patients. Among the 71 cytokines analysed, baseline expression levels of 20 specific cytokines-integral to processes such as apoptosis, inflammation, immune cell recruitment, cellular growth, and differentiation-were significantly impaired in PLE patients compared with healthy controls. Notably, skin disinfection reversed the observed cytokine imbalances following a single UV exposure at the minimal erythema dose (MED) level and exhibited even more pronounced effects after multiple UV exposures. However, no significant differences were evident in PLE score, erythema, pigmentation, or rates of apoptotic cell induction upon UV radiation. These findings provide evidence for UV-driven cytokine regulation by the skin microbiota and imply microbiome involvement in the PLE immune response.
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Affiliation(s)
- Maximilian Zarfl
- Department of Dermatology and Venereology, Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
| | - Vijaykumar Patra
- Department of Dermatology and Venereology, Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
- Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, U1111, Université Claude Bernard Lyon 1, Lyon, France
- Centre National de la Recherche Scientifique, UMR5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Lyon, France
| | - Natalie Bordag
- Department of Dermatology and Venereology, Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
| | - Franz Quehenberger
- Medical University of Graz, Institute for Medical Informatics, Statistics and Documentation, Graz, Austria
| | - Nicole Golob-Schwarzl
- Department of Dermatology and Venereology, Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
| | - Alexandra Gruber-Wackernagel
- Department of Dermatology and Venereology, Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Department of Dermatology and Venereology, Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
- Medical University of Graz, BioMedTech, Graz, Austria
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de Gálvez MV, Castillo-Muñoz RM, López-Navarro N, López-Jiménez P, Navarrete-de Gálvez E, Bosch-García R, Herrera-Acosta E, Aguilera J. Summer and spring elbow rashes is a variant of polymorphous light eruption: confirmation by photoprovocation and histopathology in a series of five cases. Front Med (Lausanne) 2023; 10:1260514. [PMID: 37928475 PMCID: PMC10625400 DOI: 10.3389/fmed.2023.1260514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/14/2023] [Indexed: 11/07/2023] Open
Abstract
Background Summer and spring eruptions on the elbows are a variant of polymorphous light eruption described on clinical and histopathological grounds; however, to our knowledge, they have not been confirmed by photobiological studies. Objective Based on photobiological studies, this study aimed to demonstrate the involvement of ultraviolet-A (UVA) radiation in this variant of polymorphous light eruption occurring exclusively on the elbows. Methods A series of five patients with polymorphous light eruption lesions on the elbows were included in our study. All patients underwent phototesting and photoprovocation of the skin lesions after exposure to a UVA light source [Philips UVA HPA lamp (400 W)]. All patients underwent punch biopsy and histopathological and immunohistochemical studies with anti-CD123. Results In all the cases, UVA irradiation caused the appearance of skin lesions on the elbows with characteristic polymorphous light eruption. Histological data showed edema in the superficial dermis and a perivascular lymphocytic infiltrate compatible with polymorphous light eruption. Immunohistochemical staining for CD1-23 showed negative results. Conclusions For the first time, photobiological photoprovocation studies demonstrated that repeated exposure to UVA radiation leads to the generation of skin lesions on the elbows, which are clinically and histologically consistent with summer and spring eruptions, confirming that elbow rash is a variant of polymorphous light eruption.
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Affiliation(s)
- María Victoria de Gálvez
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
| | | | - Norberto López-Navarro
- Dermatology Service, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Enrique Navarrete-de Gálvez
- Project Engineering Area, Department of Graphic Expression Design and Projects, School of Engineering, University of Málaga, Málaga, Spain
| | - Ricardo Bosch-García
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
- Dermatology Service, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | - Enrique Herrera-Acosta
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
- Dermatology Service, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | - José Aguilera
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
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Patra V, Strobl J, Atzmüller D, Reininger B, Kleissl L, Gruber-Wackernagel A, Nicolas JF, Stary G, Vocanson M, Wolf P. Accumulation of Cytotoxic Skin Resident Memory T Cells and Increased Expression of IL-15 in Lesional Skin of Polymorphic Light Eruption. Front Med (Lausanne) 2022; 9:908047. [PMID: 35755042 PMCID: PMC9226321 DOI: 10.3389/fmed.2022.908047] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Patients with polymorphic light eruption (PLE) develop lesions upon the first exposure to sun in spring/summer, but lesions usually subside during season due to the natural (or medical) photohardening. However, these lesions tend to reappear the following year and continue to do so in most patients, suggesting the presence of a disease memory. To study the potential role of skin resident memory T cells (Trm), we investigated the functional phenotype of Trm and the expression of IL-15 in PLE. IL-15 is known to drive Trm proliferation and survival. Multiplex immunofluorescence was used to quantify the expression of CD3, CD4, CD8, CD69, CD103, CD49a, CD11b, CD11c, CD68, granzyme B (GzmB), interferon-gamma (IFN-γ), and IL-15 in formalin-fixed, paraffin-embedded lesional skin samples from PLE patients and healthy skin from control subjects. Unlike the constitutive T cell population in healthy skin, a massive infiltration of T cells in the dermis and epidermis was observed in PLE, and the majority of these belonged to CD8+ T cells which express Trm markers (CD69, CD103, CD49a) and produced cytotoxic effector molecules GzmB and IFN-γ. Higher numbers of CD3+ T cells and CD11b+CD68+ macrophages produced IL-15 in the dermis as compared to healthy skin. The dominant accumulation of cytotoxic Trm cells and increased expression of IL-15 in lesional skin of PLE patients strongly indicates the potential role of skin Trm cells in the disease manifestation and recurrence.
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Affiliation(s)
- VijayKumar Patra
- Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, U1111, Université Claude Bernard Lyon 1, Centre National de la Recherche Scientifique, UMR 5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Lyon, France.,Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
| | - Johanna Strobl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Denise Atzmüller
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
| | - Bärbel Reininger
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Lisa Kleissl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
| | | | - Jean-Francois Nicolas
- Allergy and Clinical Immunology Department, Lyon Sud University Hospital, Pierre-Bénite, France
| | - Georg Stary
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria.,CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Marc Vocanson
- Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, U1111, Université Claude Bernard Lyon 1, Centre National de la Recherche Scientifique, UMR 5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Lyon, France
| | - Peter Wolf
- Research Unit for Photodermatology, Medical University of Graz, Graz, Austria
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Lee CN, Chen TY, Wong TW. The Immunogenetics of Photodermatoses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:369-381. [DOI: 10.1007/978-3-030-92616-8_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kadurina M, Kazandjieva J, Bocheva G. Immunopathogenesis and management of polymorphic light eruption. Dermatol Ther 2021; 34:e15167. [PMID: 34676645 DOI: 10.1111/dth.15167] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022]
Abstract
Polymorphic light eruption (PLE) is the most common immunologically mediated photodermatosis, demonstrating many abnormalities caused by critical failure of ultraviolet (UV)-induced immunosuppression. The unique expression of antimicrobial peptides in PLE, which is most likely determined by alteration of microbiome components upon UV exposure, implicates their possible triggering role and pathogenic significance in the eruption. The review aims to clarify current knowledge regarding the immunological disturbances correlated with PLE that serve a base for better understanding of molecular pathogenesis of the disease and the development of new therapeutic strategies. Preventive treatment with broad-spectrum suncreens and sunscreens containing DNA repair enzymes, as well as natural photohardening with graduate exposure to sunlight in early spring could be sufficient in milder cases. Antioxidants and topical calcipotriol are promising approach for adjuvant prevention. Phototherapy, mainly with narrow band UVB rays, is more appropriate method in severe cases of the disease. The established treatment options for PLE include local and systemic glucocorticoids, systemic nonsedative antihistamines for itch relief, and rarely, immunosuppressive drugs in the refractory cases. Like medical photohardening, afamelanotide has the potential of photoprotection by inducing a melanization of the skin. Afamelanotide is believed to be a possible new treatment option for very severe and refractory cases of PLE. Targeting the main pruritogenic cytokine, IL-31, opens a new road for the development of novel therapeutic approaches to combat moderate and severe itching in cases of PLE with intense pruritus.
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Affiliation(s)
- Miroslava Kadurina
- Department of Dermatology, University Acibadem City Clinic, Sofia, Bulgaria
| | - Jana Kazandjieva
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - Georgeta Bocheva
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
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Gruber-Wackernagel A, Schug T, Graier T, Legat FJ, Rinner H, Hofer A, Quehenberger F, Wolf P. Long-Term Course of Polymorphic Light Eruption: A Registry Analysis. Front Med (Lausanne) 2021; 8:694281. [PMID: 34336899 PMCID: PMC8323194 DOI: 10.3389/fmed.2021.694281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/11/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Little is known about the long-term course of polymorphic light eruption (PLE). Objective: To predict disease course, a questionnaire was sent to patients whose PLE had been diagnosed between March 1990 and December 2018 and documented in the Austrian Cooperative Registry for Photodermatoses. Methods: In January 2019, 205 PLE patients were contacted by mail and asked to complete a questionnaire on their disease course, including whether the skin's sun sensitivity had normalized (i.e., PLE symptoms had disappeared), improved, stayed the same, or worsened over time. Patients who reported normalization of sun sensitivity were asked to report when it had occurred. Results: Ninety-seven patients (79 females, 18 males) returned a completed questionnaire. The mean (range) duration of follow-up from PLE onset was 29.6 (17–54) years for females and 29.4 (16–47) years for males. The disease disappeared in 32 (41%) females after 17.4 (2–41) years and in 4 (24%) males after 11.8 (5–26) years. Twenty-nine (37%) females and 6 (35%) males reported improvement of symptoms over time; 15 females (19%) and 7 males (41%) reported no change; and 3 females (4%) and no males reported worsening of symptoms. Kaplan-Meier analysis revealed that after 20 years 74% (95%CI, 64–82%) of patients still suffered from PLE. PLE lesion persistence (>1 week) tended to predict a prolonged course of PLE. Conclusions: PLE usually takes a long-term course over many years though in most patients its symptoms improve or disappear over time. How improvement relates to the pathophysiology of the disease remains to be determined.
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Affiliation(s)
| | - Tanja Schug
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Thomas Graier
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Franz J Legat
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Hanna Rinner
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Angelika Hofer
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria
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10
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Lembo S, Raimondo A. Polymorphic Light Eruption: What's New in Pathogenesis and Management. Front Med (Lausanne) 2018; 5:252. [PMID: 30250845 PMCID: PMC6139322 DOI: 10.3389/fmed.2018.00252] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/22/2018] [Indexed: 01/25/2023] Open
Abstract
Polymorphic light eruption is the commonest photosensitive disorder, characterized by an intermittent eruption of non-scarring erythematous papules, vesicles or plaques that develop within hours of ultraviolet radiation exposure of patient skin. Together with the lesions, a terrible itch starts and increases with the spreading of the disease, sometimes aggravated by a sort of burning sensation. Clinical picture and symptoms can improve during the rest of the summer with further solar exposures. In the last years many advances have been performed in the knowledge of its pathogenesis and some news have been proposed as preventive, as well as therapeutic options. All this has been discussed in the current mini review.
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Affiliation(s)
- Serena Lembo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Annunziata Raimondo
- Department of Clinical Medicine and Surgery, University of Naples, Federico II, Naples, Italy
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Lembo S, Caiazzo G, Balato N, Monfrecola G, Patra V, Wolf P, Balato A. Polymorphic light eruption and IL-1 family members: any difference with allergic contact dermatitis? Photochem Photobiol Sci 2018; 16:1471-1479. [PMID: 28812775 DOI: 10.1039/c7pp00142h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Polymorphic light eruption (PLE) is described as a delayed-type hypersensitivity reaction (DTHR) toward a de novo light-induced antigen, yet to be identified. In effect, the inflammatory pathways of PLE and allergic contact dermatitis (ACD) share common patterns in terms of the mediators involved from the innate and adaptive immune system participating in the DTHR. As we have previously highlighted the role of interleukin (IL)-1 family members in ACD, we hypothesised that the same mediators could have similar functions in PLE. Our research aimed to assess the expression of certain IL-1family members in PLE patients vs. controls, and to compare it with ACD. The study population comprised 17 patients with PLE, 5 affected by ACD and 10 healthy controls in the same age range. Lesional and healthy skin samples were collected respectively from patients and donors. IL-36α, IL-36β, IL-36γ, IL-36 receptor antagonist (Ra), IL-1β, IL-33 gene and protein expressions were evaluated through RT-PCR and immunohistochemistry. Circulating proteins in the PLE patients were analysed by using western blot. The IL-36γ gene expression was significantly increased in PLE lesions compared to that in healthy controls and ACD lesions (***p < 0.001; ##p < 0.01 respectively), whereas the other analyzed ILs were more expressed in ACD. Immunohistochemical analysis revealed that IL-36α and IL-36γ protein levels were increased in PLE lesions compared to those of the healthy samples (***p < 0.001). Furthermore the IL-36γ plasma level was increased in PLE patients vs. controls (*p < 0.05). Our findings indicate that the IL-1 family pro-inflammatory members are increased in PLE with distinct differences from those in ACD, in particular with regard to IL-36γ mRNA regulation. Their role as activators of the local, and perhaps systemic, immune response, or as inhibitors of the immune tolerance machinery, needs further investigation.
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Affiliation(s)
- S Lembo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Italy.
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Rossi MT, Arisi M, Lonardi S, Lorenzi L, Ungari M, Serana F, Fusano M, Moggio E, Calzavara-Pinton PG, Venturini M. Cutaneous infiltration of plasmacytoid dendritic cells and T regulatory cells in skin lesions of polymorphic light eruption. J Eur Acad Dermatol Venereol 2018; 32:985-991. [PMID: 29430717 DOI: 10.1111/jdv.14866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 01/25/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Polymorphic light eruption (PLE) is the most common autoimmune photodermatosis. Plasmacytoid dendritic cells (PDCs) are important mediators of innate antimicrobial immunity involved in the pathogenesis of many inflammatory skin diseases. In addition to PDCs, regulatory T cells (Tregs) are involved in controlling inflammation and adaptive immunity in skin by their immunosuppressive capacity. OBJECTIVE The aim of this study was to investigate the presence of PDCs and Tregs in photoexposed skin from PLE compared to healthy skin. METHODS Patients with PLE diagnosis and healthy controls were recruited and underwent a photoprovocative test. A 4-mm punch biopsy was taken from the site of positive photoprovocation test reaction, and immunohistochemistry for BDCA2 as marker for PDCs, CD4 and FOXP3 as markers for Tregs was performed. Double immunostain for FOXP3 and CD4 was performed as well. Absolute counts for CD4, BDCA2 and FOXP3 were performed in at least 5 High Power Fields (HPF). Percentage of CD4-, BDCA2- and CD4FOXP3-positive cells over the total inflammatory infiltrate was assessed for each case. RESULTS We enrolled 23 patients and controls. BDCA2+ cells were present in 91.3% of PLE skin samples and 100% of healthy volunteer. Both in PLE patients and healthy controls, PDCs distribution was mainly dermic (P < 0.05). Compared to healthy controls, both epidermic and dermic BDCA2+ cells count were significantly higher in PLE patients (P < 0.05). Both in PLE patients and healthy controls, Tregs distribution was mainly dermic (P < 0.05). The presence of both CD4+ cells and FOXP3+ cells was significantly higher in the dermis of PLE patients compared to controls (P < 0.05). Relative percentages of cellular infiltrations confirmed these results. CONCLUSIONS D-PDCS and Tregs may play a significant role in the development of PLE, and dermal distribution of PDCs in PLE skin biopsies seems to confirm a possible overlap with cutaneous lupus erythematosus (CLE).
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Affiliation(s)
- M T Rossi
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - M Arisi
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - S Lonardi
- Department of Pathology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - L Lorenzi
- Department of Pathology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - M Ungari
- Department of Pathology, Ospedale Maggiore di Cremona, Cremona, Italy
| | - F Serana
- CREA, Diagnostics Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - M Fusano
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - E Moggio
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - P G Calzavara-Pinton
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - M Venturini
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
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Patra V, Mayer G, Gruber-Wackernagel A, Horn M, Lembo S, Wolf P. Unique profile of antimicrobial peptide expression in polymorphic light eruption lesions compared to healthy skin, atopic dermatitis, and psoriasis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:137-144. [PMID: 29044786 PMCID: PMC5888155 DOI: 10.1111/phpp.12355] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 12/01/2022]
Abstract
Background Polymorphic light eruption (PLE) has been attributed to type IV, most likely delayed‐type hypersensitivity response (adaptive immunity) but little is known on innate immunity, especially antimicrobial peptides (AMPs) in the disease. Abnormalities in AMP expression have been linked to pathological skin conditions such as atopic dermatitis (AD) and psoriasis. Methods Antimicrobial peptide profiling was carried out in PLE skin samples (n,12) compared with that of healthy (n,13), atopic (n,6), and psoriatic skin (n,6). Results Compared to healthy skin, we observed increased expression of psoriasin and RNAse7 (both mostly in stratum granulosum of the epidermis), HBD‐2 (in the cellular infiltrate of the dermis), and LL37 (mostly in and around blood vessels and glands) in PLE lesional skin, a similar expression profile as present in psoriatic skin and different to that of AD (with little or no expression of psoriasin, RNAse7, HBD‐2, and LL37). HBD‐3 was downregulated in PLE compared to its high expression in the epidermis and dermis of healthy skin, AD, and psoriasis. Conclusion The unique profile of differentially expressed AMPs in PLE implies a role in the pathophysiology of the disease, possibly directly or indirectly linked to the microbiome of the skin.
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Affiliation(s)
- VijayKumar Patra
- Research Unit for Photodermatology, Medical University of Graz, Graz, Austria.,Center for Medical Research, Medical University of Graz, Graz, Austria
| | - Gerlinde Mayer
- Research Unit for Photodermatology, Medical University of Graz, Graz, Austria.,Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Alexandra Gruber-Wackernagel
- Research Unit for Photodermatology, Medical University of Graz, Graz, Austria.,Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Michael Horn
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Serena Lembo
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Fisciano, Italy
| | - Peter Wolf
- Research Unit for Photodermatology, Medical University of Graz, Graz, Austria.,Department of Dermatology, Medical University of Graz, Graz, Austria
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