Anand Shashi, Gupta Parikshaa, Bhardwaj Ranjeet, Narang Tarun, Dogra Sunil, Minz Ranjana W, Saikia Biman, Chhabra Seema
Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Cutan Pathol. 2017 Apr;44(4):346-351. doi: 10.1111/cup.12891. Epub 2017 Jan 30.
Psoriasis is a multisystem, immune-mediated inflammatory disease. Some authors have proposed an autoimmune basis for psoriasis; however, till date, it has not been definitely established. This study was conducted to explore the autoimmune nature of psoriasis.
This was a prospective study in which 43 psoriasis patients were assessed for detailed clinical, histopathological and immunopathological features to explore the diagnostic utility of subtypes, intensity and number of immunoreactants in lesional and non-lesional skin in these patients. In addition, the sera of these patients were analyzed for the presence of various autoantibodies.
The patients' age ranged from 14 to 75 years with a male-to-female ratio of 1.52:1. Nine patients (20.93%) were positive for antinuclear and 2 (4.65%) for antismooth muscle antibodies. Direct immunofluorescence (DIF) was positive in 31 (72%) biopsies from the lesional and 27 (63%) biopsies from non-lesional skin. In all these DIF positive cases, granular deposits of C5b-9 were detected at the dermoepidermal junction. No significant difference was observed on comparing the type and pattern of immunoreactant positivity, among lesional and non-lesional skin biopsies (P > .05).
No significant association between psoriasis and immunoreactant deposition as well as autoantibody seroprevalence was observed, thereby refuting a definite autoimmune basis for psoriasis.
银屑病是一种多系统、免疫介导的炎症性疾病。一些作者提出银屑病存在自身免疫基础；然而，迄今为止，尚未明确证实这一点。本研究旨在探讨银屑病的自身免疫性质。
这是一项前瞻性研究，对43例银屑病患者进行详细的临床、组织病理学和免疫病理学特征评估，以探讨皮损和非皮损皮肤中免疫反应物亚型、强度和数量的诊断效用。此外，分析这些患者血清中各种自身抗体的存在情况。
患者年龄在14至75岁之间，男女比例为1.52:1。9例患者（20.93%）抗核抗体阳性，2例（4.65%）抗平滑肌抗体阳性。直接免疫荧光（DIF）在31例（72%）皮损活检和27例（63%）非皮损活检中呈阳性。在所有这些DIF阳性病例中，在真皮表皮交界处检测到C5b-9颗粒状沉积。比较皮损和非皮损皮肤活检中免疫反应物阳性的类型和模式，未观察到显著差异（P>.05）。
未观察到银屑病与免疫反应物沉积以及自身抗体血清阳性率之间存在显著关联，从而反驳了银屑病存在明确自身免疫基础的观点。
