Immunohistochemical Analysis of Prurigo Nodularis in 209 Patients: Clinicopathological Analysis between Atopic and Non-Atopic Patients and between Treatment Response Groups
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: Prurigo nodularis (PN) is a highly pruritic disease that significantly impairs patient quality of life. Although the mechanism that causes pruritus is not clear, one hypothesis argues that neural hyperplasia, mast cell, and Merkel cell neurite complexes may be associated with PN pathogenesis. Objective: The objective of this study was to analyze whether special staining outcomes differed depending on the presence of atopic dermatitis (AD) and treatment response. Methods: A total of 209 patients diagnosed with PN was analyzed retrospectively. Patients were divided into two groups according to presence or past history of AD and by treatment response. Histopathologic features were obtained using the following stains: Giemsa, S-100, neuron-specific enolase, cytokeratin (CK)-20, CAM5.2, and CK8/CK18. Results: A total of 126 patients (60.29%) had AD, and 68 (32.54%) showed clinical improvement. There were no statistically significant differences in the staining results between the PN groups with AD (PN c̅ AD) and without AD (PN s̅ AD). Additionally, there were no statistically significant differences in staining results between the improved and non-improved groups. Conclusion: Implementing the special stains helped to identify PN pathogenesis. Because there were no statistically significant differences in the special stain results between the improved and non-improved groups, we conclude that mast cell proliferation, neural hyperplasia, and Merkel cell hyperplasia may not have a significant effect on treatment response.
Abstract
Background: Prurigo nodularis (PN) is a highly pruritic disease that significantly impairs patient quality of life. Although the mechanism that causes pruritus is not clear, one hypothesis argues that neural hyperplasia, mast cell, and Merkel cell neurite complexes may be associated with PN pathogenesis. Objective: The objective of this study was to analyze whether special staining outcomes differed depending on the presence of atopic dermatitis (AD) and treatment response. Methods: A total of 209 patients diagnosed with PN was analyzed retrospectively. Patients were divided into two groups according to presence or past history of AD and by treatment response. Histopathologic features were obtained using the following stains: Giemsa, S-100, neuron-specific enolase, cytokeratin (CK)-20, CAM5.2, and CK8/CK18. Results: A total of 126 patients (60.29%) had AD, and 68 (32.54%) showed clinical improvement. There were no statistically significant differences in the staining results between the PN groups with AD (PN c̅ AD) and without AD (PN s̅ AD). Additionally, there were no statistically significant differences in staining results between the improved and non-improved groups. Conclusion: Implementing the special stains helped to identify PN pathogenesis. Because there were no statistically significant differences in the special stain results between the improved and non-improved groups, we conclude that mast cell proliferation, neural hyperplasia, and Merkel cell hyperplasia may not have a significant effect on treatment response.
참고문헌 (25)
- Kowalski EH, "Treatment-resistant prurigo nodularis : challenges and solutions", Clin Cosmet Investig Dermatol, 12, pp.163~172 (2019)
- Tan WS, "Extensive prurigo nodularis : characterization and etiology", Dermatology, 228, pp.276~280 (2014)
- Weisshaar E, "European guideline on chronic pruritus", Acta Derm Venereol, 92, pp.563~581 (2012)
- Tessari G, "The impact of pruritus on the quality of life of patients undergoing dialysis : a single centre cohort study", J Nephrol, 22, pp.241~248 (2009)
- Vaidya DC, "Prurigo nodularis : a benign dermatosis derived from a persistent pruritus", Acta Dermatovenerol Croat, 16, pp.38~44 (2008)
- Iking A, "Prurigo as a symptom of atopic and non-atopic diseases : aetiological survey in a consecutive cohort of 108 patients", J Eur Acad Dermatol Venereol, 27, pp.550~557 (2013)
- Saporito L, "Prurigo nodularis due to Mycobacterium tuberculosis", J Med Microbiol, 58(Pt 12), pp.1649~1651 (2009)
- Hayani K, "Clinical findings and provision of care in haemodialysis patients with chronic itch : new results from the German Epidemiological Haemodialysis Itch Study", Acta Derm Venereol, 96, pp.361~366 (2016)
- Kestner RI, "Acquired reactive perforating dermatosis is a variant of prurigo nodularis", Acta Derm Venereol, 97, pp.249~254 (2017)
- Khaled A, "Chronic prurigo revealing an angioimmunoblastic T cell lymphoma", Tunis Med, 87, pp.534~537 (2009)
- Seshadri P, "A sinister itch : prurigo nodularis in Hodgkin lymphoma", J Assoc Physicians India, 57, pp.715~716 (2009)
- Weigelt N, "Prurigo nodularis : systematic analysis of 58 histological criteria in 136 patients", J Cutan Pathol, 37, pp.578~586 (2010)
- Silverberg JI, "Fitzpatrick’s dermatology", pp.385~394 (2019), McGraw Hill Education
- Fernandez-Flores A, "CD10 immunohistochemistry in prurigo nodularis", Histopathology, 52, pp.642~643 (2008)
- Johansson O, "Increased nerve growth factor-and tyrosine kinase A-like immunoreactivities in prurigo nodularis skin--an exploration of the cause of neurohyperplasia", Arch Dermatol Res, 293, pp.614~619 (2002)
- Johansson O, "Eosinophil cationic protein-and eosinophil-derived neurotoxin", eosinophil protein X-immunoreactive eosinophils in prurigo nodularis, 2000, pp.292, 371~378
- Liang Y, "CGRP-immunoreactive nerves in prurigo nodularis--an exploration of neurogenic inflammation", J Cutan Pathol, 27, pp.359~366 (2000)
- Nahass GT, "Merkel cells and prurigo nodularis", J Am Acad Dermatol, 31, pp.86~88 (1994)
- Harris B, "Demonstration by S-100protein staining of increased numbers of nerves in the papillary dermis of patients with prurigo nodularis", J Am Acad Dermatol, 26, pp.56~58 (1992)
- Liang Y, "Histamine-containing mast cells and their relationship to NGFr-immunoreactive nerves in prurigo nodularis : a reappraisal", J Cutan Pathol, 25, pp.189~198 (1998)
- Groneberg DA, "Gene expression and regulation of nerve growth factor in atopic dermatitis mast cells and the human mast cell line-1", J Neuroimmunol, 161, pp.87~92 (2005)
- Ikoma A, "The neurobiology of itch", Nat Rev Neurosci, 7, pp.535~547 (2006)
- Garbuzenko E, "Human mast cells stimulate fibroblast proliferation, collagen synthesis and lattice contraction: a direct role for mast cells in skin fibrosis", Clin Exp Allergy, 32, pp.237~246 (2002)
- Kawakami T, "Mast cells in atopic dermatitis", Curr Opin Immunol, 21, pp.666~678 (2009)
- Youngblood B, "Atopic dermatitis skin biopsies have high numbers of activated mast cells that are inhibited by AK002 after stimulation ex vivo", J Allergy Clin Immunol, 145, pp.AB198~ (2020)