Department of Dermatology, Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taipei, Taiwan.
Arch Dermatol Res. 2010 Sep;302(7):525-9. doi: 10.1007/s00403-010-1046-3. Epub 2010 Mar 25.
Ki-67 is an established marker of cell proliferation. It is highly expressed in psoriasis and correlated with the clinical severity of psoriasis. Higher number of Ki-67 positive keratinocytes has been observed in pustular psoriasis (PP) as compared with psoriasis vulgaris. As for Acute generalized exanthematous pustulosis (AGEP), a distinct disease entity but similar in many aspects of clinicopathologic features to PP, Ki-67 immunostaining presentation has never been investigated before. This study aimed to compare Ki-67 immunostaining presentation between PP and AGEP. By immunohistochemical staining, we compared Ki-67 immunostaining presentation on skin lesions of five patients of AGEP and five age-matched patients of PP. Ki-67 positive keratinocytes were counted and mean values were determined to compare between PP and AGEP. An augmented presence of Ki-67 positive keratinocytes was found in both AGEP and PP and they distributed not only in basal cell layer but in middle or even upper part of epidermis. Statistical analysis using Mann-Whitney U test showed no difference of epidermal proliferation rate between the two groups (P = 0.222). The results showed there was no difference of Ki-67 immunostaining presentation between AGEP and PP. Besides, we found marked increase of Ki-67-positive proliferating keratinocytes in AGEP and suggested that epidermal hyperproliferation may also play an important role in the formation of AGEP. We also discussed the possible pathophysiology of AGEP, possible epidermal architecture changes in AGEP and PP, and found the similarity in pathophysiology of AGEP and PP.
Ki-67 是细胞增殖的一个既定标志物。它在银屑病中高度表达，与银屑病的临床严重程度相关。与寻常型银屑病相比，脓疱型银屑病（PP）中观察到更多的 Ki-67 阳性角质形成细胞。对于急性泛发性发疹性脓疱病（AGEP），虽然是一种独特的疾病实体，但在临床病理特征的许多方面与 PP 相似，但之前从未研究过 Ki-67 免疫染色表现。本研究旨在比较 PP 和 AGEP 之间的 Ki-67 免疫染色表现。通过免疫组织化学染色，我们比较了 5 例 AGEP 患者和 5 例年龄匹配的 PP 患者的皮肤病变中的 Ki-67 免疫染色表现。计数 Ki-67 阳性角质形成细胞并确定平均值，以比较 PP 和 AGEP 之间的差异。在 AGEP 和 PP 中均发现 Ki-67 阳性角质形成细胞的存在增加，并且它们不仅分布在基底细胞层中，而且分布在表皮的中部甚至上部。使用 Mann-Whitney U 检验的统计学分析显示两组之间表皮增殖率无差异（P = 0.222）。结果表明，AGEP 和 PP 之间的 Ki-67 免疫染色表现无差异。此外，我们发现 AGEP 中 Ki-67 阳性增殖角质形成细胞明显增加，并提示表皮过度增殖可能在 AGEP 的形成中也发挥重要作用。我们还讨论了 AGEP 的可能发病机制、AGEP 和 PP 中可能的表皮结构变化，并发现 AGEP 和 PP 的发病机制具有相似性。
