Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Dermatology, Fukushima Medical University, Fukushima, Japan.
J Dermatol. 2019 Jan;46(1):43-47. doi: 10.1111/1346-8138.14694. Epub 2018 Oct 31.
Malnutrition-associated dermatoses including necrolytic migratory erythema (NME) and pellagra share common clinicopathological features; in particular, necrolytic changes in the upper epidermis. Here, we report the involvement of autophagy in the development of necrolysis in three patients with malnutrition-associated dermatoses. First, we examined an autophagy-specific molecule, microtubule-associated protein light chain 3 (LC3), using a monoclonal antibody. LC3 was strongly expressed in the granular layers of the active border, and less intensely observed in the perilesional areas. Little LC3 staining or only background levels were observed in control skin diseases including atopic dermatitis (n = 4), psoriasis vulgaris (n = 3), basal cell carcinoma with amyloid deposits (n = 3) and squamous cell carcinoma (n = 3). Electron microscopic observations revealed the presence of autophagosome-like structures in the necrolytic areas. No apoptotic signals were observed in the necrolytic lesion using the terminal deoxynucleotidyl transferase dUTP nick end labeling method. Epidermal Langerhans cells determined by anti-CD1a antibody were markedly decreased in number. Our observations suggest the possibility that malnutrition-associated necrolysis, as exemplified by NME and pellagra, may be induced by autophagy.
营养不良相关性皮肤病，包括坏死性游走性红斑（NME）和糙皮病，具有共同的临床病理特征；特别是在上表皮有坏死性改变。在这里，我们报告了在 3 例营养不良相关性皮肤病患者的坏死发展中自噬的参与。首先，我们使用单克隆抗体检测了一种自噬特异性分子微管相关蛋白轻链 3（LC3）。LC3 在活跃边界的颗粒层中强烈表达，在病变周围区域表达较弱。在包括特应性皮炎（n = 4）、寻常型银屑病（n = 3）、伴有淀粉样沉积物的基底细胞癌（n = 3）和鳞状细胞癌（n = 3）在内的对照皮肤病中，LC3 染色很少或只有背景水平。电子显微镜观察显示在坏死区存在自噬体样结构。使用末端脱氧核苷酸转移酶 dUTP 缺口末端标记法在坏死病变中未观察到凋亡信号。用抗 CD1a 抗体测定的表皮朗格汉斯细胞数量明显减少。我们的观察结果表明，以 NME 和糙皮病为代表的营养不良相关性坏死可能是由自噬引起的。
