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Subacute cutaneous lupus erythematosus (SCLE) is a subtype of cutaneous lupus erythematosus characterized by high photosensitivity, the occurrence of annular or papulosquamous skin lesions located in body regions exposed to UV light, the presence of anti-Ro/SS‑A antibodies, and mild systemic involvement, such as arthralgia and myalgia. Similar to other subtypes of cutaneous lupus erythematosus, certain trigger factors exist for the development of SCLE, such as exposure to UV light, cigarette smoking and drugs. Rheumatic diseases, such as dermatomyositis, have been known as paraneoplastic syndromes for a long time. In recent years, there has been an accumulation of publications on the association of SCLE with malignant diseases. This article reports the case of a 78-year-old female patient who was diagnosed with the concomitant development of SCLE and gastric carcinoma. In all older patients with SCLE, patients with widespread skin affection outside the UV-exposed body areas or patients with B‑symptoms, the presence of a paraneoplastic SCLE should be considered and appropriate diagnostic steps should be initiated to screen for an associated neoplastic disease.Der subakut kutane Lupus erythematodes (SCLE) ist ein Subtyp des kutanen Lupus erythematodes, der sich durch hohe Photosensitivität, Auftreten von anulären oder papulosquamösen Hautveränderungen im Bereich der UV-exponierten Körperregionen, serologischen Nachweis von Anti-Ro/SS-A-Antikörpern und milde systemische Beteiligung wie Arthralgien und Myalgien auszeichnet. Wie bei anderen Formen des kutanen Lupus erythematodes kann auch der SCLE durch bestimmte Triggerfaktoren wie UV-Exposition, Zigarettenrauchen oder Medikamente ausgelöst werden. Rheumatische Erkrankungen wie die Dermatomyositis sind seit Langem als paraneoplastische Syndrome bekannt. In den letzten Jahren wird zunehmend über die Assoziation von SCLE und Tumorerkrankungen publiziert. Wir berichten den Fall einer 78-jährigen Patientin, bei der zeitgleich mit der Entwicklung eines SCLE ein Magenkarzinom diagnostiziert wurde. Bei SCLE-Patienten höheren Alters, ausgedehntem Befall außerhalb der UV-exponierten Körperpartien oder neu aufgetretener B‑Symptomatik sollte das Vorliegen eines paraneoplastischen SCLE in Erwägung gezogen und entsprechende diagnostische Schritte zur Abklärung einer Tumorerkrankung sollten eingeleitet werden.

ZusammenfassungBeim Lichen planus handelt es sich vermutlich um eine chronisch inflammatorische, immunologisch induzierte mukokutane Dermatose. Der Lichen planus mucosae manifestiert sich am häufigsten in der Mundhöhle. Diverse Triggerfaktoren wie bakterielle oder virale Infektionen, Medikamente oder physikalische Reize werden bei der Entstehung der Erkrankung diskutiert. Auch eine Assoziation mit Infektionen durch humane Papillomviren wurde beschrieben, ein kausaler Zusammenhang ist jedoch nicht hinreichend belegt. Als fakultative Präkanzerose kann sich auf dem Boden eines Lichen planus mucosae ein Plattenepithelkarzinom entwickeln, die maligne Transformationsrate ist aber gering. Das Risiko der malignen Transformation ist signifikant erhöht bei Patienten mit oralem Lichen planus, die rauchen, vermehrt Alkohol konsumieren oder an Hepatitis C erkrankt sind. Wir beschreiben 2 Patienten, bei denen sich lokal fortgeschrittene Plattenepithelkarzinome auf dem Boden eines langjährig bestehenden oralen Lichen planus entwickelten. Beide Fälle wurden erfolgreich durch radikale Tumorresektion mit anschließender Rekonstruktion und adjuvanter Radiatio/Radiochemotherapie behandelt.

ZusammenfassungBei einem Patienten mit diffusen Angiokeratomen im Bereich des unteren Abdomens und Genitalbereichs konnte mithilfe einer genetischen Untersuchung die Diagnose eines Morbus Fabry gestellt werden. Der Morbus Fabry ist eine X‑chromosomal vererbte Speicherkrankheit mit teilweise schwerwiegenden Multiorganbeteiligungen, unter anderem des Herzens und der Niere. Pathogenetisch liegt ein Mangel des lysosomalen Enzyms α‑Galaktosidase A (α-GAL A) vor. Unbehandelt ist die Lebenserwartung der Patienten besonders durch kardiale Komplikationen verkürzt. Aktuell zugelassene Therapieoptionen sind eine lebenslange Enzymersatztherapie und eine Chaperontherapie.

Die retikulare erythematose Muzinose (REM-Syndrom) ist eine seltene Hauterkrankung, die vorwiegend Frauen betrifft und sich durch flachige, zum Teil retikulare, unregelmasig konfigurierte blasse Erytheme im Bereich des Dekolletes und des Ruckens auszeichnet. Die Hautveranderungen sind oftmals symptomlos oder nur von geringem Juckreiz oder Brennen begleitet. Extrakutaner Befall oder Organbeteiligung kommt beim REM-Syndrom nicht vor. Histopathologisch imponieren in der Dermis lokalisierte, perivaskular und periadnexiell akzentuierte lymphozytare Entzundungsinfiltrate sowie eine vermehrte Ablagerung von Muzin. Aufgrund der ahnlichen Histologie zum Lupus erythematodes (LE) tumidus wird diskutiert, ob das REM-Syndrom dem Spektrum des kutanen LE zugeordnet bzw. als LE-artiges Krankheitsbild gewertet werden kann. Beide Krankheitsbilder zeigen zudem ein gutes Ansprechen auf eine Therapie mit Hydroxychloroquin.

Uber das Auftreten einer atypischen Variante der Hand-Fus-Mund-Krankheit (HFMK) wird erst seit wenigen Jahren berichtet. Dabei wurden Ausbruche in Europa, Asien, den USA und Sudamerika beschrieben. Die atypische HFMK wird durch eine neue Variante des zu den Enteroviren gehorenden Coxsackie-Virus A6 verursacht und uber Tropfcheninfektionen oder fakal-oral ubertragen. Mit einem oftmals vorausgehenden Prodromalstadium wird die Erkrankung haufig von hohem Fieber und einem deutlich reduzierten Allgemeinzustand begleitet. Klinisch zeigt sich ein papuloses oder vesikulobulloses Exanthem, das im weiteren Verlauf mit konfluierenden Bullae, Krustenbildung und Ulzerationen einhergehen kann. Zu den Pradilektionsstellen zahlen im Gegensatz zur „klassischen“ HFMK die Hand- und Fusrucken, Unterarme und Unterschenkel sowie Korperstamm und Nacken. Eine orale Beteiligung kann vorliegen, ist jedoch sehr selten. Die Therapie ist in der Regel rein symptomatisch, und meist kommt es innerhalb von 7 bis 14 Tagen zu einer folgenlosen Abheilung. Die Diagnosestellung kann Probleme bereiten, da das polymorphe klinische Bild der atypischen HFMK viele Differenzialdiagnosen zulasst. Anhand der vorliegenden Ubersicht soll ein bisher noch wenig beschriebenes, jedoch gehauft auftretendes Krankheitsbild naher dargestellt werden.

BACKGROUND In contrast to adults, only limited data are available on the human papillomavirus (HPV)-type spectrum in anogenital warts (AGW) of children. OBJECTIVE This study aimed to evaluate the HPV-type spectrum in AGW of prepubertal children. MATERIALS & METHODS In a retrospective German multicentre study, HPV genotyping was performed in AGW biopsies of 55 1- to 12-year-old children using HPV group-specific PCRs followed by hybridization with type-specific probes or sequence analysis. RESULTS Human papillomavirus-DNA was found in 53 of the 55 AGW. In 58.5% (31/53) of the HPV-positive AGW, mucosal HPV types were detected. HPV6 (27/53, 50.9%) was the predominant type. 43.4% (23/53) of the lesions were induced by cutaneous HPV types (HPV2, HPV27, HPV57). Mucosal HPV types were significantly more common in children under 5 years of age than in children 5 years of age and older (22/25, 88.0% [95% CI: 70.0-95.8] vs. 9/28, 32.1% [95% CI: 17.9-50.7], P

is missing (Short communication)

Diseases of the skin are the cause of approximately one fifth of outpatient visits to general practitioners (GPs) in Germany. GPs are expected to be competent in both knowledge and skills required to manage dermatological diseases, but making the correct diagnosis can be challenging facing the broad clinical spectrum of dermatological disorders. Knowledge of morphological characteristics is essential in the accurate diagnosis of a dermatological condition and to ensure optimal patient care. The objective of this dossier is to provide an overview of common dermatological diseases in daily routine, with a focus on acute and chronic-inflammatory dermatoses. The most important dermatological diseases were sorted by three anatomic regions (face, trunk and lower leg), and an overview on the respective differential diagnoses is provided.

An atypical variant of hand-foot-mouth disease (HFMD) has sporadically been reported in recent years, with outbreaks in Europe, Asia, the USA and South America. A new lineage of Coxsackie virus A6 has been identified as the causative agent, a virus-type belonging to the group of enteroviruses. HFMD is transmitted through droplet infection or through faecal-oral transmission. The disease may begin with a prodromal stage and is often accompanied by fever and malaise. Typical skin findings include a papular and vesiculobullous exanthema that might be accompanied by confluent blisters (bullae), crusting, and ulceration. In contrast to "classic" HFMD, predilection sites include the dorsal aspects of the hands and feet, forearms, lower legs, neck and trunk. Oral lesions may be present, but are less often seen compared to "classic" HFMD. The course of the disease is self-limiting, with complete resolution usually within 7-14 days after disease onset. The treatment of atypical HFMD is usually symptomatic. A diagnosis of atypical HFMD might be challenging due to the polymorphous presentation of the disease. This review describes a rarely reported but more frequently diagnosed viral condition.

Immune checkpoint inhibition with ipilimumab has revolutionized cancer immunotherapy and significantly improved outcomes of patients with advanced malignant melanoma. Local peripheral treatments (LPT), such as radiotherapy or electrochemotherapy, have been shown to modulate systemic immune responses, and preliminary data have raised the hypothesis that the combination of LPT with systemic immune checkpoint blockade might be beneficial. Clinical data from 127 consecutively treated melanoma patients at four cancer centers in Germany and Switzerland were analyzed. Patients received either ipilimumab (n = 82) or ipilimumab and additional LPT (n = 45) if indicated for local tumor control. The addition of LPT to ipilimumab significantly prolonged overall survival (OS; median OS 93 vs. 42 weeks, unadjusted HR, 0.46; P = 0.0028). Adverse immune-related events were not increased by the combination treatment, and LPT-induced local toxicities were in most cases mild. In a multivariable Cox regression analysis, we show that the effect of added LPT on OS remained statistically significant after adjusting for BRAF status, tumor stage, tumor burden, and central nervous system metastases (adjusted HR, 0.56; 95% confidence interval, 0.31–1.01, P = 0.05). Our data suggest that the addition of LPT to ipilimumab is safe and effective in patients with metastatic melanoma irrespective of clinical disease characteristics and known risk factors. Induction of antitumor immune responses is most likely the underlying mechanism and warrants prospective validation. Cancer Immunol Res; 4(9); 744–54. ©2016 AACR.

Diseases of the skin are the cause of approximately one fifth of outpatient visits to general practitioners (GPs) in Germany. GPs are expected to be competent in both knowledge and skills required to manage dermatological diseases, but making the correct diagnosis can be challenging facing the broad clinical spectrum of dermatological disorders. Knowledge of morphological characteristics is essential in the accurate diagnosis of a dermatological condition and to ensure optimal patient care. The objective of this dossier is to provide an overview of common dermatological diseases in daily routine, with a focus on acute and chronic-inflammatory dermatoses. The most important dermatological diseases were sorted by three anatomic regions (face, trunk and lower leg), and an overview on the respective differential diagnoses is provided.

This virological study examines the association of cutavirus DNA with different types of cutaneous B-cell lymphoma and cutaneous T-cell lymphoma in lesional skin samples.

Anamnese und klinischer Befund: Eine 83-jahrige Patientin mit einer „myelodysplastischen / myeloproliferativen Neoplasie“ vom Typ der chronischen myelomonozytaren Leukamie (CMML) stellte sich mit einem nach Sturzereignis aufgetretenen, intermittierend blutenden, grosenprogredienten Tumor im Bereich der Glabella unter der Verdachtsdiagnose eines Granuloma pyogenicums in unserer Klinik vor. Im Rahmen der ambulanten Wundversorgung kam es zu einer starken persistierenden Blutung, sodass die Patientin notfallmasig stationar aufgenommen wurde. Untersuchungen und Diagnosen: Die histopathologische Aufarbeitung des exzidierten Tumorknotens zeigte eine spezifische kutane Infiltration im Rahmen der Leukamie. In der Labordiagnostik fiel eine Thrombozytopenie mit Thrombozytopathie und Hypofibrinogenamie auf. Therapie und Verlauf: Trotz adaquater intraoperativer Blutstillung kam es zu fortwahrenden postoperativen Sickerblutungen, was die Gabe mehrerer Erythrozytenkonzentrate und die Substitution von Prothrombin, Fibrinogen und Faktor XIII notwendig machte. Nach Entlassung entwickelte die Patientin einen hochleukamischen Ubergang in eine akute myelomonozytare Leukamie und verstarb kurze Zeit spater. Folgerungen: Hautveranderungen sind haufig bei „myelodysplastischen / myeloproliferativen Neoplasien“ und myelodysplastischen Syndromen. Spezifische Hautinfiltrate im Rahmen einer CMML konnen einen klinischen Indikator fur einen Ubergang in eine akute Leukamie darstellen.

Objective.Vasculopathy is a key factor in the pathophysiology of systemic sclerosis (SSc) and the main cause for Raynaud phenomenon (RP), digital ulcers (DU), and/or pulmonary arterial hypertension (PAH). It is so far unknown how patients with SSc are treated with vasoactive agents in daily practice. To determine to which extent patients with SSc were treated with different vasoactive agents, we used data from the German Network for Systemic Scleroderma registry.Methods.The data of 3248 patients with SSc were analyzed.Results.Patients were treated with vasoactive drugs in 61.1% of cases (1984/3248). Of these, 47.6% received calcium channel inhibitors, followed by 34.2% treated with angiotensin-converting enzyme (ACE) inhibitors, 21.1% treated with intravenous (IV) prostanoids, 10.1% with pentoxifylline, 8.8% with angiotensin 1 receptor antagonists (AT1RA), 8.7% with endothelin 1 receptor antagonists (ET1RA), 4.1% with phosphodiesterase type 5 (PDE5) inhibitors, and 5.3% with others. Patients with RP received vasoactive therapy in 63.3% of cases, with DU in 70.1%, and with PAH in 78.2% of cases. Logistic regression analysis revealed that patients with PAH were significantly more often treated with PDE5 inhibitors and ET1RA, and those with DU with ET1RA and IV prostanoids. In addition, 41.8% of patients were treated with ACE inhibitors and/or AT1RA. Patients registered after 2009 received significantly more often ET1RA, AT1RA, and IV prostanoids compared with patients registered prior to 2005.Conclusion.These data clearly indicate that many patients with SSc do not yet receive sufficient vasoactive therapy. Further, in recent years, a marked change of treatment regimens can be observed.

CD30-positive primary cutaneous anaplastic large cell lymphoma (C-ALCL) is an indolent type of cutaneous lymphoma with favourable clinical prognosis. Pseudocarcinomatous hyperplasia (PCH) is a rare benign epithelial condition that can resemble invasive squamous cell carcinoma both clinically and histopathologically. PCH predominantly occurs in CD30-positive lymphoproliferative disorders. We report a 75-year-old woman with PCH in a multifocal C-ALCL located on the scalp and right retroauricular area, which rapidly responded to treatment with psoralen ultraviolet A photochemotherapy. Comprehensive virological analyses for potential oncogenic viruses, including Epstein-Barr virus, human herpesvirus-8, human papillomaviruses, the recently discovered cutavirus and nine different human polyomaviruses, were negative.

Glutathione S-transferases (GSTs) are involved in detoxification of xenobiotics such as fumaric acid esters (FAE).To perform GSTT1 geno- and phenotyping in psoriasis patients treated with FAE to find out whether the responder status and/or occurrence of side-effects are associated with allelic variants and enzymatic activity of GSTT1.We treated 106 psoriasis patients with FAE. GSTT1 genotyping was performed using PCR, phenotyping was carried out by means of a validated high performance liquid chromatography assay at baseline and under treatment.The distribution of GSTT1 genotypes was as follows: 31% *A/*A; 49% *A/*0; 20% *0/*0. GSTT1 phenotypes as expressed in enzyme activity significantly differed between conjugators classes. (P0.001). GSTT1 activity under treatment was significantly (P = 0.0001) increased when compared with baseline. There were no significant associations between the aforementioned GSTT1 pheno- and genotypes and clinical parameters such as psoriasis area and severity index (PASI)50, adverse effects and FAE dosage (P0.05), except for the frequent occurrence of reduction (50%) of circulating lymphocytes in patients with *0/*0 GSTT1 status (P = 0.036; odds ratio: 6, 95% CI: 1.1-32).GSTT1 geno- and phenotypes significantly correlate in psoriasis patients and do not substantially differ from healthy controls. Response to FAE does likely not depend on GSTT1. However, *0/*0 GSTT1 status is a predictor for the occurrence of marked reduction of lymphocyte counts under FAE therapy. Notably, FAE seem to enhance GSTT1 enzyme activity in high and low conjugators.

Background Antimicrobial peptides (AMPs) are small effector molecules of the innate immune system with well-known antimicrobial activity. Skin infections rarely occur in patients with cutaneous lupus erythematosus (CLE), and AMP expression in CLE has not been previously evaluated. Objectives We aimed to determine the expression of several important AMPs in 3 different subtypes of CLE. Methods Skin lesions were analyzed for the gene and protein expression of human β-defensin (hBD)-1, -2, and -3; RNase-7; the cathelicidin LL-37; and psoriasin (S100A7) using real-time reverse transcriptase polymerase chain reaction and immunohistochemistry. Results Skin biopsy specimens of 96 study participants including 47 patients with CLE (15 patients with discoid lupus erythematosus [LE], 11 patients with subacute CLE, and 21 patients with LE tumidus), 34 patients with psoriasis, and 15 healthy control subjects were evaluated in this study. HBD-2, hBD-3, LL-37, and psoriasin were significantly more highly expressed in CLE as compared with healthy controls, and most AMPs were significantly more highly induced in subacute CLE as compared with discoid LE and LE tumidus. AMP gene expression paralleled well with AMP protein expression in CLE and controls. Subacute CLE and discoid LE showed a similar correlation of AMP gene expression (significant correlations between hBD-1 and RNase-7, hBD-2 and hBD-3, hBD-2 and psoriasin, and hBD-3 and psoriasin). Limitations The relatively small number of samples and the lack of analysis of the lesional bacterial colonization are a limitation. Conclusions Several AMPs are increased in CLE at both gene and protein levels. This could explain the low prevalence of skin infections in CLE. It remains to be elucidated whether AMPs play a pathogenic role in CLE.

Summary Background A substantial portion of patients with psoriasis does not achieve a satisfactory response under antitumour necrosis factor (TNF)-α biological therapies. Objectives We aimed to evaluate whether etanercept plus narrowband ultraviolet B (NB-UVB) phototherapy is superior to etanercept monotherapy in the management of psoriasis. Methods In this prospective study, patients with psoriasis were treated with etanercept 25 mg twice weekly. Two marker lesions were selected for determination of the modified Psoriasis Area and Severity Index (M-PASI). NB-UVB was administered thrice weekly whereby one marker lesion was covered as nonirradiated control. Skin biopsies for histology and immunohistochemistry were performed in both marker lesions after a 6-week treatment course. Results After 6 weeks of therapy, the relative M-PASI reduction (mean ± SD) in etanercept-treated sites (53·7 ± 36·9%) was significantly lower than the reduction in etanercept plus NB-UVB-treated lesions (64 ± 27·8%; P = 0·011). At the end of treatment, histology scores of etanercept-treated psoriatic plaques were significantly higher than scores of etanercept plus NB-UVB-treated sites (4·6 ± 2·7 vs. 3·7 ± 2·4; P = 0·045). Epidermal immunoreactivity for CD1a, CD4 and CD8 was significantly lower in etanercept plus NB-UVB-treated lesions when compared with etanercept monotherapy. Conclusions Etanercept combined with NB-UVB is more effective than etanercept monotherapy at 6 weeks as demonstrated at a clinical, histological and immunohistological level. However, as there is an increased risk for malignancy by treatment with TNF-α blockers alone or in combination with phototherapy, we recommend to restrict this highly effective combination to short periods of time, for instance to obtain a quicker response, and to avoid long-term treatment.

Background The histopathology of lichen sclerosus (LS) suggests abnormalities in extracellular matrix (ECM) composition. Objectives We aimed to investigate the expression pattern of ECM proteins and related growths factors and Smad signal transducers in LS as compared with healthy skin. Methods To assess the expression of decorin, biglycan, versican, perlecan, fibronectin, dermatopontin, extracellular matrix protein 1 (ECM-1), matrix metalloproteinase 1, tissue inhibitor of metalloproteinase 1, connective tissue growth factor (CTGF), transforming growth factor β1, and Smad-3 protein, real-time RT-PCR and immunohistochemistry were performed on skin specimens obtained from the genital region of healthy subjects (n = 10) as well as LS patients (n = 26). Results Median mRNA as well as mean protein expression of biglycan, versican, fibronectin, and ECM-1 was significantly higher in LS when compared with healthy controls. Both mRNA and protein CTGF expression observed in LS was significantly higher than in controls. CTGF mRNA expression significantly correlated with mRNA expression of biglycan, versican and fibronectin. Conclusions Expression of ECM proteins (e.g. proteoglycans, ECM-1) and CTGF is altered in LS. TGF-s/Smad-3 independent up-regulation of CTGF may induce accumulation of ECM proteins and maintain fibrosis in chronic LS.

Summary Background Current studies indicate that treatment with tumour necrosis factor (TNF)-α blockers plus ultraviolet (UV) B phototherapy results in higher relative Psoriasis Area and Severity Index reduction as compared with TNF-α monotherapy. Objectives This study aimed to investigate the acute impact of etanercept on UVB-induced inflammation, cell cycle regulation and DNA damage. Methods Eleven subjects diagnosed with psoriasis who fulfilled the indication criteria for etanercept treatment were studied. A healthy skin site on the upper back was treated with UVB at 2 minimal erythema doses (MED). After 1, 24 and 72 h punch biopsies were taken from this site. Following the 72 h biopsy etanercept 50 mg was administered subcutaneously. After 48 h, 2 MED was given on healthy skin adjacent to previously treated skin sites. Again, after 1, 24 and 72 h punch biopsies were taken from this site. UVB- as well as UVB plus etanercept-treated skin was assessed by means of colorimetry and immunohistochemical studies for caspase 3, cyclin D1, interleukin-12, Ki-67, p16, p53, survivin, thymine dimers and TNF-α. Results Erythema formation did not differ significantly between UVB- and UVB plus etanercept-treated sites. Comparisons between UVB- and UVB plus etanercept-treated sites at a given time (1, 24, 72 h) did not result in significant differences in immunoreactivity of the markers investigated, except for cyclin D1, p53 and survivin. Immunoreactivity of cyclin D1 and p53 was significantly decreased in UVB plus etanercept-treated sites at 24 h. Survivin expression was significantly higher in UVB plus etanercept-treated skin as compared with UVB monotherapy. Conclusions Our data indicate that combined treatment with broadband UVB and TNF-α blockers might increase the risk of photocarcinogenesis by influencing apoptotic as well as antiapoptotic pathways.

Please cite this paper as: Upregulation of cathepsin S in psoriatic keratinocytes. Experimental Dermatology 2010; 19: e80–e88. Abstract: Cathepsin S (CATS) is a cysteine protease, well known for its role in MHC class II-mediated antigen presentation and extracellular matrix degradation. Disturbance of the expression or metabolism of this protease is a concomitant feature of several diseases. Given this importance we studied the localization and regulation of CATS expression in normal and pathological human/mouse skin. In normal human skin CATS-immunostaining is mainly present in the dermis and is localized in macrophages, Langerhans, T- and endothelial cells, but absent in keratinocytes. In all analyzed pathological skin biopsies, i.e. atopic dermatitis, actinic keratosis and psoriasis, CATS staining is strongly increased in the dermis. But only in psoriasis, CATS-immunostaining is also detectable in keratinocytes. We show that cocultivation with T-cells as well as treatment with cytokines can trigger expression and secretion of CATS, which is involved in MHC II processing in keratinocytes. Our data provide first evidence that CATS expression (i) is selectively induced in psoriatic keratinocytes, (ii) is triggered by T-cells and (iii) might be involved in keratinocytic MHC class II expression, the processing of the MHC class II-associated invariant chain and remodeling of the extracellular matrix. This paper expands our knowledge on the important role of keratinocytes in dermatological disease.

Aims/background: We aimed to investigate the impact of ultraviolet B (UVB) as well as UVA1 on the epidermal expression of specific markers of gap and adhesion junctions. Methods: Twelve healthy subjects were enrolled in the study. The back of the subjects was irradiated with three MED-UVB as well as three MED-UVA1. Twenty-four hours later, punch biopsies were taken from irradiated and non-irradiated skin. Immunohistochemical procedures were used for the detection of connexin 43, E-cadherin, involucrin, Ki-67 using specific antibodies. Results: Staining intensity of connexin 43 in UVB-exposed skin was significantly increased when compared with non-exposed and UVA1-exposed sites. By contrast, staining intensity of E-cadherin in UVB-exposed skin was significantly decreased when compared with non-exposed and UVA1-exposed sites. Involucrin and Ki-67 staining of keratinocytes was significantly increased in UVB-exposed sites as compared with non-exposed and UVA1-irradiated sites. Conclusions: UVB significantly alters the epidermal expression of gap and adhesion junction proteins possibly indicating a role of these proteins in the regulation of UV-induced inflammation and development and progression of skin cancer.