Hong Duan

Interleukin-8-positive neutrophils in psoriasis

We performed an immunohistochemical study to try to determine the cellular source of interleukin-8 (IL-8) in psoriatic skin lesions. IL-8 was positively stained in the vast majority of neutrophils but not in the mononuclear cells, macrophages, or keratinocytes. IL-8-positive neutrophils were seen both in Munros microabcesses in cases of psoriasis vulgaris and in a small spongiform pustule and much larger macropustules of Kogoj in cases of pustular psoriasis. Some IL-8-positive neutrophils were observed in the upper dermis of pustular psoriasis. The staining was considered to be specific because it could be completely blocked by preabsorption with recombinant IL-8. In addition, stimulation of human neutrophils with lipopolysaccharide (LPS) or tumor necrosis factor-alpha (TNF-alpha) for 18 h induced IL-8 production in vitro. In our study, IL-8 was expressed in the neutrophils of psoriasis, suggesting that neutrophils are one of the sources of IL-8 in psoriasis. The expression of IL-8 and the influx of neutrophils led us to speculate that the IL-8 autocrine and/or paracrine system functions in the formation of the microabcesses and pustules in proriasis.

In situ localization of CD83-positive dendritic cells in psoriatic lesions.

Background: Dendritic cells (DC) are considered to be the most potent antigen-presenting cells, and CD83 is expressed at a high level on immune-competent, activated and mature DC. Although changes in the number or localization of mature and activated CD83+ DC could be expected in psoriasis, there is little information on such changes. Aim: Morphological identification of CD83+ DC in psoriatic skin lesions. Materials and Methods: Immunohistochemical staining was performed in 5 specimens of psoriasis vulgaris and 6 specimens of pustular psoriasis. Formalin-fixed, paraffin-embedded sections were used for examination in this study. The skin sections were pretreated with 0.1% trypsin for 60 min at 37°C prior to immunostaining for CD83. Results: A small but significant subpopulation of CD83+ DC was found in the upper dermis. In addition, CD83+ DC were occasionally scattered in the epidermis. The most common distribution pattern of CD83+ DC was as clusters with mononuclear lymphoid cells in the upper dermis. CD83+ DC were in close contact with lymphocytes. High-intensity staining of CD83 antigens was detected not only on the surface, but also in the cytoplasm of DC. Conclusion: These results indicate that activated and mature CD83+ DC may play a role in the immune response in psoriasis and provide in vivo support for the concept that CD83+ DC provide signals for direct intralesional T cell activation.

Basal Cell Carcinomas in Association with Basaloid Follicular Hamartoma

We describe a unique case of various types of basal cell carcinoma (BCC) associated with basaloid follicular hamartoma (BFH) in a 56-year-old female patient. The lesion consisted of a dark brown and elastic soft nodule and papules within the area of a birthmark on the neck. The lesion was surgically excised. Histological examination of the nodular region revealed aggregations of neoplastic basaloid cells. We diagnosed the nodule as BCC with a racemiform or reticular pattern. In addition, a specimen taken from brownish black papules within the birthmark was found to be composed of anastomosing cords of basaloid cells accompanied by infundibular cystic structures. These features were consistent with an infundibulocystic BCC. In contrast, specimens from a hamartomatous plaque showed distinctive branching strands of basaloid cells that are suggestive of BFH. Therefore, our findings indicate that several types of BCC may develop within a BFH.

Activated and mature CD83-positive dendritic cells and interferon-γ-positive cells in skin eruptions of secondary syphilis

Dendritic cells are considered to be the most potent antigen-presenting cells, and CD83 is expressed at a high level in immunocompetent, activated and mature dendritic cells. Various pathogens can activate and modulate the function of dendritic cells. The presence of activated and mature dendritic cells in skin lesions of secondary syphilis has never been reported. In the present study, an immunohistochemical technique was used to determine the exact tissue distributions of CD83+ dendritic cells and interferon-gamma+ cells in skin lesions of patients with secondary syphilis. Immunohistochemical staining was performed by using formalin-fixed, paraffin-embedded sections. A small but significant subpopulation of CD83+ dendritic cells was found in the dermis. CD83+ dendritic cells were in close contact with lymphocytes. High-intensity staining of CD83 antigens was detected not only on the surface but also in the cytoplasm of dendritic cells. Infiltrating mononuclear cells were stained positively for CD4 or CD8, with CD8+ cells always being in the majority. A small number of interferon-gamma+ cells resembling mononuclear lymphoid cells were detected in all samples. These results provide in vivo support for the hypothesis that dendritic cells are activated by Treponema pallidum and that thus activated and mature CD83+ dendritic cells may play a role in the Th1 response in secondary syphilis.

Spontaneous regression of multiple seborrheic keratoses associated with nasal carcinoma

Seborrheic keratoses are very common epidermal neoplasms. We describe a patient with seborrheic keratoses presenting multifocal spontaneous regression. The patient had a concurrent nasal adenoid cystic carcinoma. The simultaneous regression of seborrheic keratoses ceased after total resection of the nasal carcinoma. Histological examination revealed marked infiltration of mononuclear cells, including CD4+, CD8+, CD68+ and cutaneous lymphocyte‐associated antigen‐positive cells, with profound accumulation of CD1a+ dendritic cells. Although apoptotic keratinocytes were not found in the lesional epidermis by histology, the majority of keratinocytes in the regressing seborrheic keratosis were positively stained by the TUNEL method. We postulate that the internal malignancy may induce spontaneous regression of seborrheic keratoses.

CD1a+, CD3+, CD4+, CD8+, CD68+ and cutaneous lymphocyte-associated antigen-positive cells in Bowen's disease

Background Bowen’s disease (BD) is a squamous cell carcinoma in situ that rarely invades into the underlying dermis. However, little is known about its immunohistology.

The proliferative properties of tumor cells differentially correlate with the host immune responses in anogenital Bowen's disease.

Bowens disease is a squamous cell carcinoma in situ that rarely invades into the underlying dermis. In order to evaluate the relationship between the cytological properties of the tumor cells and the host immune response, we have examined the expression of p53 and proliferating cell nuclear antigen (PCNA), and the number of mitotic cells, clumping cells, koilocytes, Langerhans cells (LCs) and dermal lymphoid cell infiltration in 18 cases of anogenital Bowens disease. When compared with normal anogenital skins (n = 10), a statistically significant number of p53-positive cells, PCNA-positive cells, mitotic cells, clumping cells, koilocytes and dermal lymphoid cells was observed in the cases of Bowens disease. Importantly, there existed a very strong correlation between the number of PCNA-positive tumor cells and the number of infiltrated dermal lymphoid cells. Moreover, the number of mitotic cells significantly correlated with the number of intratumoral LCs. The in situ hybridization technique for human papilloma virus (HPV) demonstrated that the HPV-infected Bowens disease showed a similar histological and immunohistological pattern as the HPV-non-infected counterparts, except for increased koilocyte formation and decreased p53 positivity. The present data suggest that the proliferative activity of Bowens disease significantly correlates with the host immune reaction, and that the host immune system may differentially recognize the different cytological properties of tumor cells in the Bowens disease.

Interleukin-8 Expressed in the Granulocytes of the Eye in a Patient with Behcet's Disease Complicated by Lens-induced Endophthalmitis

BACKGROUND Interleukin-8 (IL-8) is believed to be involved in the progression of intraocular inflammation. We sought the source of IL-8 in the enucleated eye of the present patient. CASE A 40-year-old Japanese man was diagnosed as having Behçets disease. His vision deteriorated due to persistent uveitis and secondary glaucoma. His left eye had lens-induced endophthalmitis. OBSERVATIONS The left eye had to be enucleated, and it was investigated by an immunohistochemical analysis using antibodies for CD 1a (dendritic cells), CD 3 (T cells), CD 68 (monocytes/macrophages), interferon-gamma, or IL-8. Fibrovascular tissue had formed on and beneath the lens where inflammatory cells had infiltrated. Most of the mononuclear inflammatory cells were T cells. A large number of macrophages were observed especially around the lens. Interferon-gamma-positive cells were scattered, while IL-8 was observed only in the accumulated granulocytes, but not in either mononuclear cells or macrophages. CONCLUSION IL-8 is thus considered to play a role in the progression of intraocular inflammation, and granulocytes are thought to be a possible source of IL-8 in endophthalmitis.