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Tseng HW, Liao JB, Wei YA. Adult-onset inflammatory linear verrucous epidermal nevus: Immunohistochemical studies and review of the literature. J Cutan Pathol 2020; 48:140-146. [PMID: 32954567 DOI: 10.1111/cup.13881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 11/28/2022]
Abstract
Adult-onset inflammatory linear verrucous epidermal nevus (ILVEN) is an uncommon cutaneous disease compared to childhood-onset ILVEN. The typical histopathologic features are alternating parakeratosis and orthokeratosis with an absent granular layer underneath parakeratosis, in contrast to a thickened granular layer below the foci of orthokeratosis in psoriasiform epidermal hyperplasia. Herein, we present a 49-year-old woman with typical clinical and histopathologic characteristics of adult-onset ILVEN, including linear arrangement of thick scaly papules and plaques localized on the medial side of her right leg, ankle, and foot. Immunohistochemical studies included involucrin, Ki-67, and keratin-10. Compared to the staining pattern in psoriasis, the expression of involucrin in this case was of lower intensity and localized to upper epidermal layers with relatively less extensive staining beneath regions of parakeratosis as compared to orthokeratosis; Ki-67 showed lower basal layer proliferative activity; and keratin-10 showed a greater intensity of staining within suprabasal epidermis.
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Affiliation(s)
- Hui-Wen Tseng
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Health and Beauty, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Jia-Bin Liao
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yu-An Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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2
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Cario M, Pain C, Kaulanjan-Checkmodine P, Masia D, Delia G, Casoli V, Costet P, Goussot JF, Guyonnet-Duperat V, Bibeyran A, Ezzedine K, Reymermier C, Andre-Frei V, Taieb A. Epidermal keratin 5 expression and distribution is under dermal influence. Pigment Cell Melanoma Res 2019; 33:435-445. [PMID: 31692218 DOI: 10.1111/pcmr.12844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/01/2019] [Accepted: 11/01/2019] [Indexed: 12/25/2022]
Abstract
Human skin melanin pigmentation is regulated by systemic and local factors. According to the type of melanin produced by melanocytes, the transfer and degradation of melanosomes differ, thus accounting for most variations between ethnicities. We made the surprising observation that in a drastically changed environment, white and black phenotypes are reversible since Caucasian skin grafted onto nude mice can become black with all black phenotypic characteristics. Black xenografts differed essentially from other grafts by the levels of epidermal FGF-2 and keratin 5. In vitro analysis confirmed that FGF-2 directly regulates keratin 5. Interestingly, this phenomenon may be involved in human pathology. Keratin 5 mutations in Dowling-Degos Disease (DDD) have already been associated with the pheomelanosome-eumelanosome transition. In a DDD patient, keratin 5 was expressed in the basal and spinous layers, as observed in black xenografts. Furthermore, in a common age-related hyperpigmentation disorder like senile lentigo (SL), keratin 5 distribution is also altered. In conclusion, modulation of keratin 5 expression and distribution either due to mutations or factors may account for the development of pigmentary disorders.
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Affiliation(s)
- Muriel Cario
- INSERM U1035, Bordeaux, France.,BMGIC, Universite de Bordeaux, Bordeaux, France.,National Reference Center for Rare skin Diseases, Bordeaux University Hospitals, Bordeaux, France.,AquiDerm, Bordeaux, France
| | - Catherine Pain
- INSERM U1035, Bordeaux, France.,BMGIC, Universite de Bordeaux, Bordeaux, France
| | | | - Daniela Masia
- Department of Plastic Surgery and Hand Surgery, Aurelia Hospital, Rome, Italy
| | - Gabriele Delia
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Vincent Casoli
- Department of Plastic Surgery, Bordeaux University Hospitals, Bordeaux, France
| | - Pierre Costet
- Animalerie Spécialisée, Bordeaux University, Bordeaux, France
| | | | | | - Alice Bibeyran
- Plateforme de Vectorologie VectUb, Bordeaux University, Bordeaux, France
| | - Khaled Ezzedine
- EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques), Service de Dermatologie, UPE-Université Paris-Est, Hôpital Henri Mondor, Créteil, France
| | | | | | - Alain Taieb
- INSERM U1035, Bordeaux, France.,BMGIC, Universite de Bordeaux, Bordeaux, France.,National Reference Center for Rare skin Diseases, Bordeaux University Hospitals, Bordeaux, France.,Department of Dermatology, Bordeaux University Hospitals, Bordeaux, France
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3
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Yang BY, Cheng YG, Liu Y, Liu Y, Tan JY, Guan W, Guo S, Kuang HX. Datura Metel L. Ameliorates Imiquimod-Induced Psoriasis-Like Dermatitis and Inhibits Inflammatory Cytokines Production through TLR7/8-MyD88-NF-κB-NLRP3 Inflammasome Pathway. Molecules 2019; 24:molecules24112157. [PMID: 31181689 PMCID: PMC6600670 DOI: 10.3390/molecules24112157] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/30/2019] [Accepted: 06/06/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Psoriasis is a chronic, immune-mediated inflammatory skin disease, and the inflammatory response plays an important role in its development and progression. Datura metel L. is a traditional Chinese medicine that exhibited a significant therapeutic effect on psoriasis in our previous study due to its remarkable anti-inflammatory effect. Meanwhile, the mechanism underlying its effects on psoriasis is still unclear. Methods: An imiquimod-induced psoriasis-like dermatitis mouse model was constructed to evaluate the protective effect of the effective part of Datura metel L. (EPD), which was verified by evaluations of the Psoriasis Area and Severity Index (PASI) score. Hematoxylin and eosin (H&E) staining, immunohistochemical examination, enzyme-linked immunosorbent assay (ELISA), and Western blot were used to measure the inflammatory cytokines and the protein expression associated with the Toll-like receptor 7– myeloid differentiation primary response gene 88–nuclear Factor-κB–nucleotide-binding oligomerization domain (Nod)-like receptor family pyrin domain-containing 3 (TLR7/8–MyD88–NF-κB–NLRP3) inflammasome pathway. Results: EPD significantly decreased the PASI, reduced epidermal thickness, and decreased the proliferation and differentiation of epidermal cells in psoriasis-like dermatitis C57BL/6 mice induced by imiquimod (IMQ). Furthermore, EPD reduced the infiltration of CD3+ cells to psoriatic lesions, as well as ameliorated the elevations of intercellular adhesion molecule 1 (ICAM-1) and inhibited the production of imiquimod-induced inflammatory cytokines, including IL-1β, IL-2, IL-6, IL-10, IL-12, IL-17, IL-22, IL-23, tumor necrosis factor-α (TNF-α), monocyte chemotactic protein 1 (MCP-1), and interferon-γ (IFN-γ). Besides, EPD decreased the imiquimod-induced expression levels of TLR7, TLR8, TRAF6, MyD88, p-IKKα, p-IKBα, p-NF-κB, NLRP3, apoptosis-associated speck-like protein contained a caspase recruitment domain (ASC), cysteinyl aspartate specific proteinase 1 (caspase-1), and IL-1β. Conclusion: This study demonstrated that EPD exhibited a protective effect on an imiquimod-induced psoriasis mice model by inhibiting the inflammatory response, which might be ascribed to the inhibition of the TLR7/8–MyD88–NF-κb–NLRP3 inflammasome pathway.
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Affiliation(s)
- Bing-You Yang
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Yan-Gang Cheng
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Yan Liu
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Yuan Liu
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Jin-Yan Tan
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Wei Guan
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Shuang Guo
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
| | - Hai-Xue Kuang
- Key Laboratory of Chinese Materia Medica, Ministry of Education of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
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Say M, Boralévi F, Lenormand C, Bursztejn AC, Estève E, Phan A, Bourrat E, Lacour JP, Richard MA, Acher A, Jullien D, Beneton N, Descamps V, Bodemer C, Lagaude M, Chiaverini C, Mahé E. Clinical and Therapeutic Aspects of Linear Psoriasis: A Study of 30 Cases. Am J Clin Dermatol 2018; 19:609-615. [PMID: 29594973 DOI: 10.1007/s40257-018-0354-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psoriasis affects 2-4% of the population, with the most common clinical type being plaque psoriasis. The linear form of psoriasis is very rare. The literature on linear psoriasis (LP) consists of only case reports, and data are few. OBJECTIVE This study aimed to better understand LP in a large-scale study. PATIENTS AND METHODS We retrospectively retrieved the medical records from 14 French medical centers of patients newly diagnosed clinically with LP, with or without the support of histology, between 1 February and 31 July 2015. For each case, we assessed the clinical features, treatments and treatment efficacy. RESULTS In total, 30 cases of LP (mean age 26.8 years, 13 males) were reported. Mean age at onset of LP was 20.0 years, with 18 developing LP in childhood. Ten patients had a family history of psoriasis, and two had psoriatic arthritis. A total of 19 cases were linear at onset, with concomitant classical psoriasis; these were termed "superimposed" LP. The remaining 11 cases were not associated with classical psoriasis and were termed "isolated" LP. In four of the superimposed cases, LP developed when the patient was receiving systemic treatment: methotrexate (n = 2), etanercept (n = 1) or infliximab (n = 1). Topical steroids were effective in 76% of cases in which they were used, and systemic treatment was effective in < 66%. Treatments were less effective in LP than in classical psoriasis. DISCUSSION We identified a wide range of LP, with two profiles: isolated LP and superimposed LP. Topical treatment usually evoked clinical response, with relative resistance to systemic therapy. Methotrexate and anti-tumor necrosis factor (TNF)-α therapies can possibly unmask LP.
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Affiliation(s)
- Matthieu Say
- Service de Dermatologie, Hôpital Victor Dupouy, 69 rue du Lieutenant-Colonel Prud'hon, 95100, Argenteuil, France
| | - Franck Boralévi
- Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France
| | - Cédric Lenormand
- Service de Dermatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Eric Estève
- Service de Dermatologie, Centre Hospitalier Régional d'Orléans, Orléans, France
| | - Alice Phan
- Service de Pédiatrie, Hôpital Femme-Mère-Enfant, Bron, France
| | - Emmanuelle Bourrat
- Service de Pédiatrie Générale, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Marie-Aleth Richard
- Service de Dermatologie, UMR 911 Inserm CRO2, Hôpital Timone, Assistance publique des Hôpitaux de Marseille, Centre de recherche en oncologie biologique et onco-pharmacologie, Université Aix-Marseille, Marseille, France
| | - Aurélie Acher
- Service de Dermatologie, Centre Hospitalier Universitaire de Caen, Université de Caen Basse-Normandie, UFR de Médecine, Caen, France
| | - Denis Jullien
- Service de Dermatologie, Hôpital Edouard Herriot, University Claude Bernard Lyon-1, Lyon, France
| | - Nathalie Beneton
- Service de Dermatologie, Centre Hospitalier du Mans, Le Mans, France
| | - Vincent Descamps
- Service de Dermatologie, Centre Hospitalier Universitaire Bichat-Claude Bernard, Assitance Publique-Hôpitaux de Paris, Paris 7 Diderot University, Paris, France
| | - Christine Bodemer
- Service de Dermatologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes Sorbonne Paris Cité, Paris, France
| | - Marion Lagaude
- Service de Dermatologie, Centre Hospitalier Universitaire de Caen, Université de Caen Basse-Normandie, UFR de Médecine, Caen, France
| | | | - Emmanuel Mahé
- Service de Dermatologie, Hôpital Victor Dupouy, 69 rue du Lieutenant-Colonel Prud'hon, 95100, Argenteuil, France.
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Saifaldeen RH, Fatani MI, Baltow B, Khan AS. Successful Treatment of Inflammatory Linear Verrucous Epidermal Nevus with Concomitant Psoriasis Using Etanercept. Case Rep Dermatol 2018; 10:29-34. [PMID: 29606943 PMCID: PMC5869485 DOI: 10.1159/000487001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/18/2018] [Indexed: 11/20/2022] Open
Abstract
Linear psoriasis is a rare form of the disease characterized by the linear distribution of lesions involving dermatome or along Blaschko's lines. Clinically, it may resemble inflammatory linear verrucous epidermal nevus; a combination of history, skin examination, and histopathology are required to ensure correct diagnosis and appropriate therapy. This paper describes a case of a 23-year-old male presenting with unilateral erythematous scaly plaques arranged in a linear path on the left leg. Etanercept was initiated after poor response to adalimumab. Improvement of his psoriasis was noted, with PASI 75 reduction after 24 weeks of treatment. Clinical studies have shown excellent efficacy of etanercept, and our patient well tolerated treatment with etanercept for 52 weeks without any adverse effects.
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Affiliation(s)
| | | | - Badee Baltow
- Consultant Pathologist, Hera General Hospital, Makkah, Saudi Arabia
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6
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Peng J, Sun SB, Yang PP, Fan YM. Is Ki-67, keratin 16, involucrin, and filaggrin immunostaining sufficient to diagnose inflammatory linear verrucous epidermal nevus? A report of eight cases and a comparison with psoriasis vulgaris. An Bras Dermatol 2018; 92:682-685. [PMID: 29166506 PMCID: PMC5674702 DOI: 10.1590/abd1806-4841.20176263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 12/24/2016] [Indexed: 01/06/2023] Open
Abstract
Inflammatory linear verrucous epidermal nevus and linear psoriasis are sometimes
hard to differentiate clinically and pathologically. Although
immunohistochemical expression of keratin 10 (K10), K16, Ki-67, and involucrin
may be useful for differentiating both entities, these results have been
reported in only a few cases. We collected data from 8 patients with
inflammatory linear verrucous epidermal nevus, 11 with psoriasis vulgaris, and 8
healthy controls and evaluated immunohistochemical expression of Ki-67, K16,
involucrin, and filaggrin among them. Ki-67 and K16 overexpression was similar
in inflammatory linear verrucous epidermal nevus and psoriasis vulgaris compared
with normal skin. Although staining for involucrin showed discontinuous
expression in parakeratotic regions in 4 inflammatory linear verrucous epidermal
nevus cases, it was continuous in the other 4 cases and in all psoriasis
vulgaris cases. Filaggrin expression was present in hyperkeratotic regions but
scarce in parakeratotic areas in both inflammatory linear verrucous epidermal
nevus and psoriasis vulgaris. The immunostaining pattern of Ki-67, K16,
involucrin, and filaggrin may be insufficient to discriminate inflammatory
linear verrucous epidermal nevus from psoriasis vulgaris.
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Affiliation(s)
- Jing Peng
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Shu-Bin Sun
- Department of Dermatology, Dongguan 3rd People's Hospital - Dongguan, Guangdong, China
| | - Pei-Pei Yang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Yi-Ming Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
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The Successful Treatment of a Case of Linear Psoriasis with Ixekizumab. Case Rep Dermatol Med 2017; 2017:3280215. [PMID: 29230331 PMCID: PMC5688342 DOI: 10.1155/2017/3280215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/10/2017] [Indexed: 11/18/2022] Open
Abstract
Linear psoriasis is an unusual clinical variation of psoriasis that manifests segmentally along the lines of Blaschko. A major differential diagnosis is inflammatory linear verrucous epidermal nevus (ILVEN). The treatment of linear psoriasis is often challenging, with inadequate response to biological agents reported in the literature. We report a case of a 25-year-old African-American female who presented with asymptomatic hyperkeratotic papules along the lines of Blaschko and was subsequently diagnosed with linear psoriasis. After failing conventional treatment regimens, the patient received a trial of ixekizumab with complete resolution of cutaneous lesions reported after 4 months and only 8 doses of the anti-IL-17 biologic agent.
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