Keloid is an aberrant scarring process of the skin, characterized by excessive extracellular matrix synthesis and deposition. The pathogenesis of this prevalent cutaneous disorder is not fully understood; however, a persistent inflammatory process is observed. To obtain more insight into this process, we analyzed lesional, perilesional and healthy tissue using multi-antigen-analysis (MAA) in conjunction with a data mining approach. Here, we demonstrate that monocyte-derived inflammatory dendritic cells (CD1a+, CD11c+, CD14+) and activated CD4+ T lymphocytes (CD45 RO+) dominated the immune infiltration in keloids while associating with fibroblasts. In perilesional tissue, precursor immune cells were dominant in the perivascular area, suggesting that they were attracted by an immune process, potentially in the lesional area. Supporting this hypothesis, only in keloid lesions, high levels of ADAM10/17 and Neprilysin (CD10) were observed in both fibroblasts and leukocytes. The spatial proximity of these two cell types, which could be confirmed by image analysis only in lesional tissue, could be a potential factor leading to the activation of fibroblasts. Our findings provide new insight into the pathogenesis of keloid formation and reveal metalloproteinases as a target for therapeutical intervention.
ADAM17 Protein/metabolism , Dendritic Cells/immunology , Fibroblasts/pathology , Inflammation/pathology , Keloid/pathology , Neprilysin/metabolism , Adolescent , Adult , Case-Control Studies , Cells, Cultured , Fibroblasts/immunology , Fibroblasts/metabolism , Humans , Inflammation/immunology , Inflammation/metabolism , Keloid/immunology , Keloid/metabolism , Middle Aged , Young Adult
We report a case of severe "bodybuilding acne" in a 22-year-old patient. Treatment with isotretinoin paradoxically led to exaceibation and occurrence of pyogenic granuloma-like lesions.
Acne Vulgaris , Anabolic Agents/adverse effects , Androgens/adverse effects , Dermatologic Agents/adverse effects , Granuloma, Pyogenic/chemically induced , Isotretinoin/adverse effects , Testosterone/adverse effects , Acne Vulgaris/chemically induced , Acne Vulgaris/drug therapy , Acne Vulgaris/pathology , Adult , Anti-Bacterial Agents/therapeutic use , Causality , Cefotiam/therapeutic use , Granulation Tissue/drug effects , Humans , Inflammation , Male , Necrosis , Suppuration , Weight Lifting
Multifocal disseminated lesions of circumscribed lipoatrophy have not been described as an adverse reaction of intravenously applied drugs. A unique patient with adrenal insufficiency is reported who received corticosteroids intravenously and then had multiple lesions develop that were similar to focal lipoatrophy as known to occur secondary to faulty intradermal injections of corticosteroids.
Adrenal Insufficiency/drug therapy , Lipodystrophy/chemically induced , Prednisolone/adverse effects , Adrenal Insufficiency/diagnosis , Female , Follow-Up Studies , Humans , Infusions, Intravenous , Middle Aged , Prednisolone/administration & dosage , Risk Assessment , Severity of Illness Index