Skin barrier in atopic dermatitis: beyond filaggrin

Abstract: Atopic dermatitis is a chronic inflammatory skin disease with a complex pathogenesis, where changes in skin barrier and imbalance of the immune system are relevant factors. The skin forms a mechanic and immune barrier, regulating water loss from the internal to the external environment, and protecting the individual from external aggressions, such as microorganisms, ultraviolet radiation and physical trauma. Main components of the skin barrier are located in the outer layers of the epidermis (such as filaggrin), the proteins that form the tight junction (TJ) and components of the innate immune system. Recent data involving skin barrier reveal new information regarding its structure and its role in the mechanic-immunological defense; atopic dermatitis (AD) is an example of a disease related to dysfunctions associated with this complex.

Comparative histological and immunohistochemical changes of dry type cutaneous leishmaniasis after administration of meglumine antimoniate, imiquimod or combination therapy

This study compared histological and immunohistochemical changes of cutaneous leishmaniasis treated with meglumine antimoniate, imiquimod, and the combination of both therapies. Single blind clinicopathological studies of fifteen patients with old world cutaneous leishmaniasis in Kerman, Iran were included. A total of four patients received a combination of imiquimod [5% cream] and intra-lesional meglumine antimoniate weekly for four weeks. Monotherapy with imiquimod was given to seven patients and four patients were treated with meglumine antimoniate intralesionally. Histological confirmation was performed before and during therapy. Semi-quantitative histological parameters such as numbers of mixed inflammatory cells [cells/mm[2]] and percentages of Langerhans cells [CD1a+], T-cells [CD3+], B-cells [CD20+], and macrophages [CD68+] were calculated immunohistochemically in the dermis and adjacent epidermis. Topical imiquimod significantly reduced mean histiocytic cellular aggregation size [P<0.05]. Meglumine antimoniate reduced parasite load and infected activated histiocytes in the dermis [P<0.05]. Meglumine antimoniate therapy decreased epidermal CD3+ lymphocytes but increased them in the dermis, within the granulomas [P<0.05]. During topical application of imiquimod a depletion of CD1a+ dendritic cells in the epidermis [P<0.05] and slight predominance of dendritic cells in the dermis were observed. Combined therapy and imiquimod monotherapy decreased CD68+ macrophages in the dermis [P<0.05]. Meglumine antimoniate decreases parasite load with considerable effect on up-regulation of T-cells, which demonstrates that meglumine antimoniate works as parasitocidal and immunomodulator, which could be as the first line of treatment. Imiquimod, accentuates the host immune response and reduces granuloma size which could be effective immunomodulator for combination therapy. Monotherapy of imiquimod is less effective than the two other regimens in decreasing parasite load, inflammation and congestion at the inoculated site

An approach to the diagnosis of neutrophilic dermatoses: A histopathological perspective.

Neutrophilic dermatoses comprises of non-infective dermatoses which are histopathologically characterized by neutrophil predominant infiltrate and clinically, respond promptly to corticsteroids. Conditions primarily with vasculitis though neutrophilic are excluded from this group. In this article we intend to briefly outline the approach to diagnose these conditions with histological perspective. The ambiguity regarding few recent dermatosis viz, rheumatoid neutrophilic dermatosis, bowel associated-dermatosis-arthritis syndrome etc. with regard to their inclusion in this group has also been highlighted.

Moléculas de adhesión celular y piel / Adhesion molecules and skin

Las moléculas de adhesión celular tienen un papel importante en múltiples fenómenos biológicos, tanto normales (generación de la respuesta inmune, coagulación, cicatrización, órgano-génesis) como patológicos (inflamación, trombosis, metástasis de células tumorales). En el presente trabajo se revisan los aspectos básicos de las moléculas de adhesión celular y su papel en diversas condiciones patológicas que afectan a la piel

Epidermolysis bullosa aquisita with basal epidermal cytoplasmic antibodies

A 45-year-old woman with epidermolysis bullosa aquisita is presented. The clinical, histological, and immunopathological features were in keeping with the previous reports of this disease. The patient also had anti-basal cell cytoplasmic antibodies at a significant titer, which is considered an unusual finding associated with this disorder. Treatment with a moderate dose of corticosteroid was effective in controlling the bullous lesions

Estudo sobre a atividade imunológica natural contra auto-antígenos epidérmicos: frequência e padrão de reatividade em mulheres saudáveis e seus recém-nascidos / Study on the natural immunological activity against epidermal autoantigens: frequency and pattern of reactivity in healthy women and their newborns

O encontro de anticorpos contra diversas estruturas antigênicas da epiderme humana tem sido interpretado na maior parte das vezes como reatividade contra auto-antígenos alterados, decorrentes de traumas teciduais, agressoes por produtos tóxicos ou ainda como resultante de reaçao cruzada com antígenos exógenos. Desde o início do século XX, no entanto, foi demonstrada a presença de anticorpos no soro normal capazes de reagir com antígenos próprios do organismo, an ausência de doença auto-imune. Os anticorpos que reagiam contra a epiderme humana foram, entao, denominados anticorpos naturais antiepidérmicos e sua frequência na populaçao geral e a idade em que surgem ainda nao estao definidas