ABSTRACT
BACKGROUND: Because antigen presenting is necessary for T-cell activation, antigen-presenting cells should be involved in the pathogenesis of psoriasis. In this study, our purpose was to evaluate and compare effects of PUVA, cyclosporine A and narrow-band UVB on dendritic cells and activated lymphocytes in the psoriatic lesions. METHODS: Forty-five volunteered patients (15 patients in each treatment group as PUVA, cyclosporin A and narrow-band UVB) were enrolled in this study. Lesional skin biopsies were taken from each patient before and after treatments. Fresh frozen biopsies were studied for the expressions of CD1a, CD68, CD86, CD4, CD8 and HLA-DR proteins by immunohistochemistry. RESULTS: There was no correlation between severity of the lesions and expressions of the antigens. Only PUVA significantly decreased CD1a+ epidermal Langerhans cells' (LCs) counts. Treatment modalities decreased expression of costimulator CD86, and most of them decrease antigen-presenting capacity of skin by decreasing HLA class-II expression. CONCLUSIONS: All treatment modalities equally reduce lymphocytes, macrophages and dendritic cells. PUVA is the only treatment that decreases epidermal LCs. All treatments effectively diminish expression of CD86 and inhibit this step of inflammation.
Subject(s)
Cyclosporine/therapeutic use , Immunosuppressive Agents/therapeutic use , PUVA Therapy , Psoriasis/therapy , Ultraviolet Therapy , Antigen-Presenting Cells/drug effects , Antigen-Presenting Cells/immunology , Antigen-Presenting Cells/radiation effects , Antigens, CD/metabolism , Cell Count , Dendritic Cells/drug effects , Dendritic Cells/immunology , Dendritic Cells/radiation effects , Fluorescent Antibody Technique, Direct , Humans , Keratinocytes/drug effects , Keratinocytes/immunology , Keratinocytes/radiation effects , Lymphocyte Subsets/drug effects , Lymphocyte Subsets/immunology , Lymphocyte Subsets/radiation effects , Macrophages/drug effects , Macrophages/immunology , Macrophages/radiation effects , Psoriasis/immunology , Psoriasis/pathology , Skin/drug effects , Skin/immunology , Skin/radiation effectsABSTRACT
BACKGROUND: Psoriasis is a common dermatological disease with erythematous plaques where articular and extra articular findings (tenosynovitis and enthesitis) may well accompany. The aim of this current study was to evaluate the Achilles' tendon of psoriasis patients with ultrasonography. METHODS: The study comprised 30 psoriasis patients and 20 healthy controls. Ankle ultrasonography was performed with posterior approach, the joint in neutral or in a little dorsiflexed position. The statistical analysis was carried out with a Student's t-test and Spearman correlation tests. RESULTS: The mean values of Achilles' tendon thickness of two groups were compared: the psoriatic group was found to have thicker tendon measurements (P = 0.00). The tendons of the patients with radiologically proven enthesopathy were found to be even thicker (P = 0.001). CONCLUSIONS: We encourage the use of diagnostic ultrasonography for evaluation of enthesopathy manifestations in psoriasis patients as an adjunct to conventional methods owing to its convenience and promising results.