Lim Hyun Jung, Han Man-Hoon, Lee Eun Hye, Eun Dong Hyuk, Kim Jun Young, Lee Weon Ju, Lee Seok-Jong, Kim Do Won, Park Tae-In, Kim Sang-Hyun, Jang Yong Hyun
Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Korea.
Ann Dermatol. 2020 Feb;32(1):31-37. doi: 10.5021/ad.2020.32.1.31. Epub 2019 Dec 27.
Based on clinical and genetic differences, atopic dermatitis (AD) and psoriasis have been classified in two different diseases, but recently, some authors regarded them as in one spectrum. The histological similarities including epidermal hyperplasia between chronic stages of AD and psoriasis supports the presence of two diseases in one spectrum.
We investigated clinical and immunohistopathological characteristics of adult Korean patients with AD showing psoriasiform chronic dermatitis on histopathology.
In total, 59 Korean patients with chronic AD were enrolled. Clinical, laboratory, and histopathological features were compared between AD patients with psoriasiform features and those with non-psoriasiform chronic dermatitis features on histology. In addition, immunohistopathological characteristics were analyzed using antibodies for key regulatory and effector cytokines in psoriasis.
Fifteen patients (25.4%) showed a more "psoriasiform" histological appearance. The lesions in patients with psoriasiform features often showed clearer boundaries and noticeable scaling. The interleukin (IL)-23 expression in the psoriasiform chronic dermatitis group was not different from that in the psoriasis group, but the IL-17 expression was less than that in the psoriasis group. In the case of IL-12, multiple dermal inflammatory cells with dendrites were stained in the psoriasiform chronic dermatitis group compared with the 2 other non-psoriasiform subgroups.
The results suggest that IL-12 secreted from dermal inflammatory cells might be one of the important factors associated with the formation of psoriasiform features in chronic AD. However, further studies are required to better define the specific role of IL-12.
基于临床和基因差异，特应性皮炎（AD）和银屑病已被归类为两种不同的疾病，但最近，一些作者认为它们属于同一谱系。AD和银屑病慢性期的组织学相似性，包括表皮增生，支持了这两种疾病属于同一谱系的观点。
我们调查了组织病理学表现为银屑病样慢性皮炎的成年韩国AD患者的临床和免疫组织病理学特征。
共纳入59例韩国慢性AD患者。比较了组织学上具有银屑病样特征的AD患者和具有非银屑病样慢性皮炎特征的AD患者的临床、实验室和组织病理学特征。此外，使用针对银屑病关键调节和效应细胞因子的抗体分析免疫组织病理学特征。
15例患者（25.4%）表现出更“银屑病样”的组织学外观。具有银屑病样特征的患者的皮损边界通常更清晰，鳞屑更明显。银屑病样慢性皮炎组中白细胞介素（IL）-23的表达与银屑病组无差异，但IL-17的表达低于银屑病组。在IL-12方面，与其他两个非银屑病样亚组相比，银屑病样慢性皮炎组中有多个带树突的真皮炎性细胞被染色。
结果表明，真皮炎性细胞分泌的IL-12可能是慢性AD中银屑病样特征形成的重要相关因素之一。然而，需要进一步研究以更好地确定IL-12的具体作用。
