Clinical and immunological features of psoriasis vulgaris in HIV-infected patients

Introduction. Psoriasis is an inflammatory dermatosis, which has characteristic clinical features and is closely associated with immunological changes in the skin. HIV-infected patients suffering from psoriasis have immunological features associated with the effect of HIV virus on CD4+T-lymphocytes.Aim. To identify clinical features of psoriasis in HIV-infected patients depending on the stage of HIV infection and immune status.Materials and methods. An open prospective study (2014–2018) included 143 patients with psoriasis vulgaris, of which 79 (55.2%) were infected with HIV and 64 (44.8%) were not infected with HIV. The groups were comparable in terms of age and gender. The diagnosis of psoriasis vulgaris was established with due account for its clinical presentation and histologically confirmed in 29 (20.3%) patients, of which 17 (58.6%) were infected with HIV and 12 (41.4%) were not infected with HIV. In a biopsy, tissue samples were taken from the areas of inflammatory and healthy skin in each patient. Numbers of CD4+ and CD8+T-lymphocytes in the biopsy samples obtained were calculated using immunohistochemical staining of biopsy. The severity of psoriasis progress was assessed using the psoriasis lesions severity index, taking into account the body surface area covered by lesions, the intensity of erythema, infiltration and sloughing of skin. In the course of the study, the patients had general clinical examinations performed, their HIV infection confirmed or denied, their immune status assessed, and their clinical stage of HIV infection determined.Results and discussion. Mild psoriasis was less often identified, and moderately severe and severe psoriasis was more often observed in HIV-infected patients as compared to HIV-negative patients. The psoriatic plaque CD8+T-lymphocyte counts in HIV-infected patients grew with increasing immunosuppression and clinical stage of HIV infection; these changes were not observed in HIV-negative patients.Сonclusion. HIV-infected patients often have moderately severe (39.2%) and severe (22.8%) psoriasis vulgaris. The psoriatic plaque CD8+T-lymphocyte counts in HIV-infected patients predominate over the CD4+T-lymphocyte counts, while the HIV-negative patients show the opposite test results.

Profiles of Innate Immune Cell Infiltration and Related Core Genes in Psoriasis

Psoriasis is an inflammatory skin disease with substantial morbidity. Numerous patients with psoriasis experience recurrence after therapy. The underlying mechanism about psoriasis is still not fully understood. Some evidences suggest that innate immunity may play an unexpected and important role in active severe psoriasis. In this work, the deconvolution algorithm CIBERSORT was conducted to identify the infiltration of innate immune cells and related core genes in psoriatic plaque. Datasets from the Gene Expression Omnibus, including skin samples from 405 psoriasis patients and 91 healthy donors, were downloaded for analysis. Considerable differences of the innate immune cell composition were uncovered between psoriatic plaque and control skin. Results revealed that γδ T cells, resting NK cells, M0 macrophages, M1 macrophages, activated dendritic cells, and neutrophils were significantly increased in psoriatic skin, while resting mast cells and active NK cells were significantly decreased. Moreover, the proportion of M0 macrophages or resting mast cells was found to be associated with disease severity. Spearman correlation analysis suggests that RORC and S100A12 genes were related to disease severity, while genes including S100A12, CLEC4C, IL-19, AIM2, IL-17F, and PPARGC1A were correlated with biologic treatment response. In conclusion, this work displays innate immune status in psoriatic skin and provides novel clues for clinical decisions and mechanism study.

An Unusual Presentation of Proliferating Trichilemmal Tumor Developing in Psoriatic Plaque: A Case Report

Proliferating trichilemmal tumor (PTT) is a rare, mostly benign neoplasm which stems from the follicular outer root sheath epithelium. PTT occurs as a subcutaneous cystic nodule slowly enlarging to a larger noduler mass, and is usually localized on the scalp of elderly women. To the best of our knowledge, PTT localized on a psoriatic plaque has not been reported previously. Herein, we report an unusual case of benign PTT arising from a psoriatic plaque on the knee of a 63-year-old male patient. Keywords: proliferating trichilemmal tumor, psoriasis, trichilemmal cyst

Profiles of Innate Immune Cell Infiltration and Related Core Genes in Psoriasis

Background: Psoriasis is an inflammatory skin disease with substantial morbidity. Numerous patients with psoriasis experience recurrence after therapy. The underlying mechanism about psoriasis is still not fully understood. Some evidences suggest that innate immunity may play an unexpected and important role in active severe psoriasis. In this work, the deconvolution algorithm CIBERSORT was conducted to identify the infiltration of innate immune cells and related core genes in psoriatic plaque.Results: Datasets from the Gene Expression Omnibus, including 407 psoriasis lesional, 373 non-lesional and 91 normal skin samples, were downloaded for analysis. Considerable differences of the innate immune cell composition were uncovered between psoriatic plaque and control skin. Results revealed that γδ T cells, resting NK cells, M0 macrophages, M1 macrophages, activated dendritic cells and neutrophils were significantly increased in psoriatic skin, while resting mast cells and active NK cells were significantly decreased. Moreover, the proportion of M0 macrophages or resting mast cells was found to be associated with disease severity. Spearman correlation analysis suggests that RORC and S100A12 genes were related to disease severity, while genes including S100A12, CLEC4C, IL-19, AIM2, IL-17F, PPARGC1A, were correlated with biologics treatment response.Conclusions: Collectively, this work displays innate immune status in psoriatic skin, and provides novel clues for clinical decisions and mechanism study.