Case Report OPEN ACCESS Overexpression of linker for activated T cells, cyclooxygenase-2, CD1a, CD68 and myeloid/histiocyte antigen in an inflamed seborrheic keratosis

Abstract Context: Inflamed seborrheic keratoses are generally associated with the accumulation of variable numbers of lymphocytes and histiocytes in the superficial dermis. The precise immunologic mechanism of this histologic phenomenon is not known Case Report: A 62-year-old male presented with a patch on the right neck with additional features of inflammation. Skin biopsies for hematoxylin and eosin examination, as well as for immunohistochemistry analysis were performed. Results: H&E staining demonstrated classic features of an inflamed seborrheic keratosis. Overexpression of LAT, COX-2, CD1a, and CD68 was noticed in the inflammatory infiltrate. A strong presence of CD1a was also seen in the epidermis suprajacent to the inflammation. Myeloid/histiocyte antigen was strongly expressed by the keratinocytes. Conclusion: A complex immune response seems to be involved in the pathophysiology of an inflamed seborrheic keratosis

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study.

OBJECTIVE: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. METHODS: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. RESULTS: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). CONCLUSIONS: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.info:eu-repo/semantics/publishedVersio

Immunologic findings in central centrifugal cicatricial alopecia

Introduction: Premature desquamation of the inner root sheath is described as a defining histologic feature of follicular degeneration syndrome/central centrifugal cicatricial alopecia; moreover, the immunological features of this disease are not well established.Case report: A 46-year-old African American female was evaluated for an asymptomatic scarring alopecia after using several chemicals on her hair. The clinical examination revealed visible, well defined patches of hair loss.Methods: Biopsies for hematoxylin and eosin examination, as well as for direct immunofluorescence and immunohistochemistry analysis were performed. We evaluated molecules involved in signaling of growth factor pathways (e.g. the Akts), specifically VEGF and Oct-4 to investigate involvement of these molecules in this disease. Hematoxylin and eosin staining demonstrated histopathologic findings of premature desquamation of the inner root sheath and eccentric thinning of the follicular epithelium, supporting the diagnosis of central centrifugal cicatricial alopecia. Direct immunofluorescence revealed strong depositions of IgG, Complement/C3 and fibrinogen around the multiple hair follicles and their supply vessels. Immunohistochemistry staining of the base of the hair follicle was seen with fibrinogen and Oct-4 antibodies. Immunohistochemistry also demonstrated increased expressions of VEGF around supply vessels of the hair follicle, as well as some overexpression of anti-human Akt-pS473 phosphorylation site specific antibody.Conclusions: Our immunologic findings suggest that the etiology of centrifugal cicatricial alopecia includes not only hair traction, but also a possible reactive immune response

LAT, EGFR -pY197, PCNL2, CDX2, HLA-DPDQDR, bromodeoxyuridine, JAM-A, and ezrin immunoreactants in a rubbed spongiotic dermatitis

Background: Acute and subacute spongiotic dermatitides are among the most commonly diagnosed types of dermatitis. Many patients rub their lesions, with the lesions becoming clinically thickened. The precise immunologic mechanisms within the thickening process are not well defined. Case report: An 85 year old male presented with the sudden clinical appearance of erythematous patches and small blisters on the back of his legs, with pruritis. Methods: Skin biopsies, one from a rubbed lesion and one from a non-rubbed lesion were submitted for hematoxylin and eosin (H&E), immunohistochemistry (IHC), and for direct immunofluorescence (DIF) analysis. Results: The H&E staining demonstrated classic features of a spongiotic dermatitis, but in the rubbed areas psoriasiform hyperplasia was also seen. The psoriasiform areas demonstrated positive, focal IHC staining with bromodeoxyuridine, LAT, EGFR-pY197, PCNL2, CDX2, and HLA-DPDQDR antibodies. DIF staining revealed positive staining of JAM-A and ezrin in the non-rubbed specimens in both the spongiotic epidermis and in the adjacent vessels; normal expression of these markers was appreciated in the rubbed biopsy. Conclusions: The immune response seems to be complex when a spongiotic dermatitis is converted from a non-rubbed to a rubbed lesion with histologic features of psoriasiform hyperplasia

Upregulation of anti-human ribosomal protein S6-p240, topoisomerase II ά, cyclin D1, Bcl-2 and anti-corneal antibodies in acute psoriasis

Background. The immunopathogenesis of psoriasis is complex, and involves alterations in the innate immunologic system Case Report: A 57-year-old female was evaluated for the presence of rapidly appearing plaques on the knees and elbows. Methods: Skin biopsies for hematoxylin and eosin examination, as well as for direct immunofluorescence and immunohistochemistry analysis were performed. Results: H&E examination demonstrated classic features of psoriasis. Direct immunofluorescence revealed positive anti-corneal antibodies with several immunoglobulins, as well as positivity to upper and deep small dermal blood vessels. Immunohistochemistry revealed an increased expression of survivin, anti-human-ribosomal protein S6-p240, Topoisomerase II ά, cyclin D1, and Bcl-2 in lesional plaques. Conclusions: The pathobiology of psoriasis seems to involve a series of molecules involved in a complex interaction between the inflammation itself, cell cycle regulation, and ectopic expression of selected molecules

Presence of neutrophil extracellular traps and antineutrophil cytoplasmic antibodies associated with vasculitides

Abstract Context: Anti-neutrophil p-ANCA antibodies are directed against antigens in the peripheral cytoplasm of both neutrophilic granulocytes and monocytes. They are detected in several autoimmune disorders and are particularly associated with systemic vasculitis. Case Report: We report a case of a 54-year-old female presenting with a pruritic rash, including purpura and diffuse erythema. A biopsy with hematoxylin and eosin (H & E) analysis, direct immunofluorescence (DIF), immunohistochemistry (IHC) and enzyme-linked immunosorbent assays for ANCAs were performed. The H & E staining demonstrated leukocytoclastic vasculitis, with focal vascular fibrinoid necrosis. The DIF revealed evidence of vasculitis, the presence of p-ANCAs and neutrophil extracellular traps (NETs). The IHC displayed autoreactivity to myeloperoxidase within the vessels. The IHC aided in ruling out any intrinsic autofluorescence of the vessels. Conclusions: By observing the deposition of neutrophil extracellular traps and myeloperoxidase in inflamed skin vessels, biopsy analysis may alert physicians for rapid therapeutic intervention in patients presenting with possible vasculitides

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study

Objective: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. Methods: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. Results: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). Conclusions: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.Merck Sharp & Dohme, Lda, Portugal provided financial support for the non-interventional study (Protocol Nr. MK0518-826 ).info:eu-repo/semantics/publishedVersio