Dubertret L, Bertaux B, Fosse M, Touraine R
Br J Dermatol. 1984 Apr;110(4):405-10. doi: 10.1111/j.1365-2133.1984.tb04654.x.
The possible role of epidermal serine proteases in the genesis of psoriatic lesions was investigated by sequential biopsies of the epidermal damage induced by topical cantharidin. In the skin of normal subjects, epidermal damage was followed by the transient appearance of proteolytic activity in the upper epidermis accompanied by temporary hyperacanthosis and perivascular inflammatory cells in the superficial dermis. In the uninvolved skin of five patients with psoriasis this proteolysis persisted longer, for more than 7 days. Thereafter, in three of the patients, the proteolysis abated, and this was followed by disappearance of the hyperacanthosis and the dermal infiltrate; in the other two psoriatics the proteolysis and hyperacanthosis increased, and a typical Koebner phenomenon ensued. Migration of neutrophils into the epidermis occurred as a later event. Thus the abnormal persistence of proteolytic activity in the upper epidermis after cantharidin application distinguishes the normal from the psoriatic skin injury response and might initiate the psoriatic lesion.
通过对斑蝥素诱导的表皮损伤进行连续活检，研究了表皮丝氨酸蛋白酶在银屑病皮损发生中的可能作用。在正常受试者的皮肤中，表皮损伤后，表皮上层会短暂出现蛋白水解活性，同时伴有暂时性棘层肥厚和浅表真皮血管周围炎性细胞浸润。在5例银屑病患者未受累的皮肤中，这种蛋白水解持续时间更长，超过7天。此后，其中3例患者的蛋白水解减弱，随后棘层肥厚和真皮浸润消失；另外2例银屑病患者的蛋白水解和棘层肥厚加重，并出现典型的同形反应。中性粒细胞向表皮的迁移是后来发生的事件。因此，斑蝥素应用后表皮上层蛋白水解活性的异常持续，区分了正常皮肤与银屑病皮肤损伤反应，并可能引发银屑病皮损。
