Lobitz, Walter C.

Miura, Yusho

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Histochemical Studies in Atopic Dermatitis: Responses Following Controlled Strip Injury 

HISTOCHEMICAL STUDIES IN ATOPIC DERMATITIS: RESPONSES
FOLLOWING CONTROLLED STRIP INJURY*
YUSHO MIURA, M.D.t AND WALTER C. LOBITZ, Ja., M.D.
In previous studies we have shown that the
epidermis of normal human skin will produce
histochemical changes when the skin is injured
(1, 2, 3, 4). One of these injuries was the well-
established technic of removing the stratum
corneum with an adhesive tape. For this study
we applied this technic to the lichenified and
normal skin of patients with atopic dermatitis.
The stratum corneum was removed with cello-
phane adhesive tape from the lichenified atopic
dermatitis of the popliteal area and from the non-
lichenified, normal-appearing skin of the adjacent
flexural thigh of the same patient. With an electric-
driven, 5 mm diameter, high-speed, rotary punch,
two biopsy specimens were removed from each
of these injured areas before the injury and 4,
18, and 24 hours after the injury. As an addi-
tional control, the normal skin of the popliteal
area of a person who does not have atopic der-
matitis was removed for biopsy. Specimens were
examined for mitotic activity in the epidermis and
for histochemically demonstrable glycogen (5),
phosphorylase (6), glucose-6-phosphatase (7), suc-
cinic dehydrogenase (8) and cytochrome oxidase(9). The comparative results are recorded in table
1 through 6.
RESULTs
Glycogen and Mitotic A ctivity
The glycogen response and mitotic activity in
the non-lichenified skin of the atopic patient
followed the same pattern as previously de-
scribed for normal human skin (3). Glycogen ap-
* From the Division of Dermatology, Uni-
versity of Oregon Medical School, Portland,
Oregon.
t Dr. Miura is Professor and Head of the De-
partment of Dermatology, Hokkaido University,Sapporo, Japan. He was Visiting Research Pro-
fessor of Dermatology at the University of Oregon
Medical School under sponsorship and support
of the Rockefeller Foundation at the time of this
study.
This investigation was supported (in part) by
the U. S. Army Research and Development
Command under contract DA-49-193-MD-2184;
by a PHS training grant, 2A-5300, from theNational Institute of Arthritis and Metabolic
Diseases, Public Health Service; and by a PHS
research grant, E-3102 (C2), National Institute of
Allergy and Infectious Diseases, Public Health
Service.
Received for publication July 11, 1963.
115
peared in the stratum basale of the epidermis 18
hours after the injury. Mitotic activity in the
stratum basalc began to increase slowly 18 hours
after the injury (Table 1). The lichenified skin of
the atopic patient was different. Glycogen was
seen mainly in the stratum spinosum of the epi-
dermis before the injury. It was then definitely
decreased 4 hours after the injury, but at 18
hours there was a sharp increase in both the
stratum basale and in the stratum spinosum.
Twenty-four hours after the injury a sudden
decrease in the glyeogen content of all the epi-
dermal cells was observed. The mitotie activity
which was seen in the stratum basale before the
injury showed a slight increase afterwards
(Table 2).
Phosphorylase
There was no significant difference between
the phosphorylase activity of liehenified and
non-liehenified skin of the atopic patient. The
injury did not alter the activity in any instance
(Table 3).
Glucose-fl -phosphata.se
In the normal popliteal skin there was a
moderate degree of glueose-6-phosphatase ac-
tivity in the stratum basale, spinosum and granu-
losum. A similar distribution of the enzyme was
seen before injury in the lichenified and non-
liehenified skin of the atopic patient. The stratum
granulosum had a little more activity than normal
but of questionable importance. After the injury
there was a slight increase in the activity of the
enzyme in the stratum basale of liehenified skin.
Activity also appeared after the injury in the
stratum eorneum in both specimens taken
from the atopie person.
Succinic dehydrogenase
The activity of sueeinic dehydrogenase was
decreased in the liehenified skin after injury.
This was especially prominent in the outer
stratum spinosum and in the stratum granulosum
(Table 5).
116 THE JOURNAL OF INVESTIGATIVE DERMATOLOGY
TABLE 1
Response to strip. Non-lichenifled skin of the patient
with atopic dermatitis
Time in Hours 0 4 18 24
% basal cells with glycogen 0 3.4
Mitoses per 1,000 cells 0 0
53.5
1.8
14
5
TABLE 2
Response to strip. Lichenified skin of the patient
with atopic dermatitis
Time in Hours ..; 0 4 18 24
% basal cells with glycogen 12 2.4
Mitosesper1,000cells 0.5 1
17.7
1.8
1
2.8
TABLE 3
Degree of phosphor ylase activity in the skin of the
patient with atopic dermatitis (graded 0 to 4,
4 being the greatest activity)
Lichenified Non-lichenified
Stratum Normal
0 4 18 24 0 4 18 24
Basale 2 2 2 2 2 3 2 2 2
Inner spino-
sum 1 2 2 1 1 2 2 2 2
Outer spino-
sum 0 0 0 0 0 0 0 0 0
Granulosum.. 0 0 0 0 0 0 0 0 0
Corneum 00 0 0 0 0 0 0 0
Cytochrome oxidase
Although there was no activity of the enzyme
in the stratum granulosum before injury, it de-
veloped in both the lichenified and non-lichenified
skin on all post-injury specimens. This was more
marked in the lichenified skin (Table 6).
SUMMARY
The response of the various strata of human
epidermal cells in lichenified and non-lichenified
skin of patients with atopic dermatitis was
studied before and after an injury that was pro-
duced by removing the stratum corneum with
cellophane adhesive tape. Observations were
made for the presence or absence of glycogen and
other enzymes involved with glycogen metabo-
lism. Glycogen in the stratum basale increased
4 hours and again 18 hours after the injury.
Glucose-6-phosphatase activity appeared in the
stratum granulosum after injury. Succinic de-
hydrogenase activity decreased in all layers after
injury. The phosphorylase activity was not
altered.
TABLE 4
Degree of glucose-6-phosphatase activity in the skin
of the patient with atopic dermatitis (graded 0 to
4, 4 being the greatest activity)
Lichenified Non-lichenified
Stratum Normal
0 4 18 24 0 4 18 24
Basale 2 3 3 3 2 2 2 2 2
Inner spino-
sum 2 2 2 2 2 2 2 2 2
Outer spino-
sum 2 2 2 2 2 2 2 2 2
Granulosum. . 3 2 3 3 3 3 3 2 2
Corneum 0 0 2 3 0 2 2 2 0
TABLE 5
Degree of succinic dehydrogenase activity in the skin
of the patient with atopic dermatitis (graded 0 to
4, 4 being the greatest activity)
Lichenified Non-lichenified
Stratum Normal
0 4 18 24 0 4 18 24
Basale 3 2 2 2 3 3 4 3 3
Inner spmo-
sum 3 2 2 2 3 3 3 3 3
Outer spino-
sum 3 1 2 2 3 22 2 3
Granulosum.. 2 0 2 1 0 1 1 1 0
Corneum 0 00 0 0 0 0 0 0
TABLE 6
Degree of cytochrome oxidase activity in the skin of
the patient with atopic dermatitis (graded 0 to 4,
4 being the greatest activity)
Lichenified Non-lichenified
Stratum
,
Normal
0 4 18 24 0 4 18 24
Basale 2 2 2 2 2 3 3 3 2
Inner spino-
sum
Outer spino-
2 2 2 2 2 2 2 2 2
sum 1 2 2 2 2 2 2 2 2
Granulosum.. 0 2
Corneum 0 0
3
0
3 0
00
2
0
1
0
1 00 0
ATOPIC DERMATITIS: RESPONSES FOLLOWING STRIP INJURY 117
REFERENCES
1. LOBITZ, WALTER C., JR. AND HOLYORR, JOHN
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Histochemical Studies in Atopic Dermatitis: Responses Following Controlled Strip Injury

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