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Clinicopathologic overlap of psoriasis, eczema, and psoriasiform dermatoses: A retrospective study of T helper type 2 and 17 subsets, interleukin 36, and β-defensin 2 in spongiotic psoriasiform dermatitis, sebopsoriasis, and tumor necrosis factor α inhibitor-associated dermatitis.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2020 Feb; Vol. 82 (2), pp. 430-439. Date of Electronic Publication: 2019 Dec 16. - Publication Year :
- 2020
-
Abstract
- Background: T helper (Th) type 17 and Th2 cells mediate psoriasis and eczema, respectively. Some dermatoses exhibit overlapping clinicopathologic features, and their immunopathology is relatively unexplored.<br />Objective: To determine whether Th17 and Th2 subsets and interleukin (IL) 36 and β-defensin 2 (BD-2) markers of IL-17 signaling expression can discriminate between biopsy samples of psoriasis and eczematous/spongiotic dermatitis and to use those markers to immunophenotype cases with clinicopathologic overlap.<br />Methods: A retrospective study was performed on biopsy samples of psoriasis, eczema/spongiotic dermatitis, sebopsoriasis, tumor necrosis factor α inhibitor-associated psoriasiform dermatitis, and ambiguous cases diagnosed as spongiotic psoriasiform dermatitis. Dual CD4/GATA3 and CD4/RORC, IL-36, and BD-2 immunohistochemistry was performed.<br />Results: IL-36 and BD-2 were strongly expressed in biopsy samples of psoriasis compared with eczema/spongiotic dermatitis. No significant differences were observed in the percentages of Th2 and Th17 cells between disease types. Strong expression of IL-36 and BD-2 was observed in a subset of spongiotic psoriasiform dermatitis, sebopsoriasis, and tumor necrosis factor α inhibitor-associated psoriasiform dermatitis biopsy samples.<br />Limitations: This was an exploratory study with a small sample size. No multiple testing adjustment was done. Clinical follow-up was limited.<br />Conclusions: In cases with clinicopathologic overlap between psoriasis and spongiotic dermatitis, IL-36, and to a lesser extent BD-2, may be used to assess for a psoriasis-like/IL-17 phenotype, which could inform therapeutic clinical decisions.<br /> (Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Biopsy
Child
Drug Eruptions etiology
Drug Eruptions pathology
Eczema immunology
Eczema pathology
Female
Humans
Male
Middle Aged
Psoriasis immunology
Psoriasis pathology
Retrospective Studies
Young Adult
Drug Eruptions blood
Drug Eruptions complications
Eczema blood
Eczema complications
Interleukin-1 blood
Interleukin-17 blood
Psoriasis blood
Psoriasis complications
Th17 Cells
Th2 Cells
Tumor Necrosis Factor-alpha antagonists & inhibitors
beta-Defensins blood
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 82
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 31859047
- Full Text :
- https://doi.org/10.1016/j.jaad.2019.08.023