Principal Component Analysis to Differentiate Patients with Palmoplantar Pustulosis from Those with Palmoplantar Pustular Psoriasis
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Background: Palmoplantar pustulosis (PPP) is initiated from the acrosyringium. However, it is unclear whether PPP should be considered a distinct entity or should be classified into the spectrum of pustular psoriasis, also known as palmoplantar pustular psoriasis (PPPP). Objective: We evaluated the differences in immunohistochemical staining in patients with PPP to determine whether they can be classified into two groups based on psoriatic proper- ties or acrosyringeal properties. Methods: Nineteen punch biopsy specimens diagnosed with PPP were collected. Antibod- ies were chosen for identifying the acrosyringeal properties of α-3-nicotine acetylcholine receptors (α-3-nAChR), psoriatic properties of interleukin (IL)-23 and IL-36R, inflamma- tory cell properties of human cathelicidin antimicrobial peptide 18/LL-37, IL-8, lipocalin-2 (LCN2), and CD3. The degree of staining of the epidermis was evaluated using the ordinal scale (0~3). The principal component analysis was used to derive principal components (PCs) of common variation between the stains, and the two groups were divided using PCs and cluster analysis. Results: Three main PCs explained 64% of the total variance in PPP. PC1 (pustular pso- riasis properties) showed a higher correlation with IL-36R. PC2 (acrosyringeal/inflamma- tory properties) showed a higher correlation with α-3-nAChR, IL-8, LCN2, and CD3. PC3 (psoriasis properties) showed a higher correlation with IL-23. PC1 showed a statistically significant difference ( =0.0284) between the two groups. We identified three PCs associ- ated with the pathomechanisms of PPP. Conclusion: Although PC1 showed a statistically significant difference between the two groups, we did not identify differential protein expression related to the pathogenesis be- tween PPP and PPPP
Abstract
Background: Palmoplantar pustulosis (PPP) is initiated from the acrosyringium. However, it is unclear whether PPP should be considered a distinct entity or should be classified into the spectrum of pustular psoriasis, also known as palmoplantar pustular psoriasis (PPPP). Objective: We evaluated the differences in immunohistochemical staining in patients with PPP to determine whether they can be classified into two groups based on psoriatic proper- ties or acrosyringeal properties. Methods: Nineteen punch biopsy specimens diagnosed with PPP were collected. Antibod- ies were chosen for identifying the acrosyringeal properties of α-3-nicotine acetylcholine receptors (α-3-nAChR), psoriatic properties of interleukin (IL)-23 and IL-36R, inflamma- tory cell properties of human cathelicidin antimicrobial peptide 18/LL-37, IL-8, lipocalin-2 (LCN2), and CD3. The degree of staining of the epidermis was evaluated using the ordinal scale (0~3). The principal component analysis was used to derive principal components (PCs) of common variation between the stains, and the two groups were divided using PCs and cluster analysis. Results: Three main PCs explained 64% of the total variance in PPP. PC1 (pustular pso- riasis properties) showed a higher correlation with IL-36R. PC2 (acrosyringeal/inflamma- tory properties) showed a higher correlation with α-3-nAChR, IL-8, LCN2, and CD3. PC3 (psoriasis properties) showed a higher correlation with IL-23. PC1 showed a statistically significant difference ( =0.0284) between the two groups. We identified three PCs associ- ated with the pathomechanisms of PPP. Conclusion: Although PC1 showed a statistically significant difference between the two groups, we did not identify differential protein expression related to the pathogenesis be- tween PPP and PPPP
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