Heterozygous Arrhythmogenic Cardiomyopathy-desmoplakin Mutation Carriers Exhibit a Subclinical Cutaneous Phenotype with Cell Membrane Disruption and Lack of Intercellular Adhesion

Genetic variants that result in truncation in desmoplakin (DSP) are a known cause of arrhythmogenic cardiomyopathy (AC). In homozygous carriers, the combined involvement of skin and heart muscle is well defined, however, this is not the case in heterozygous carriers. The aim of this work is to describe cutaneous findings and analyze the molecular and ultrastructural cutaneous changes in this group of patients. Four women and eight men with a mean age of 48 ± 14 years were included. Eight met definitive criteria for AC, one was borderline and three were silent carriers. No relevant macroscopic changes in skin and hair were detected. However, significantly lower skin temperature (29.56 vs. 30.97 °C, p = 0.036) and higher transepidermal water loss (TEWL) (37.62 vs. 23.95 g m 2 h 1, p = 0.028) were observed compared to sex- and age-matched controls. Histopathology of the skin biopsy showed widening of intercellular spaces and acantholysis of keratinocytes in the spinous layer. Immunohistochemistry showed a strongly reduced expression of DSP in all samples. Trichogram showed regular nodules (thickening) compatible with pseudomonilethrix. Therefore, regardless of cardiac involvement, heterozygous patients with truncation-type variants in DSP have lower skin temperature and higher TEWL, constant microscopic skin involvement with specific patterns and pseudomonilethrix in the trichogram.

High S100A2 expression in keratinocytes in patients with drug eruption

Telaprevir used as a protease inhibitor against hepatitis C virus is frequently associated with cutaneous adverse reactions. To explore a histological biomarker of cutaneous adverse events induced by telaprevir, we systematically searched for genes that were dysregulated by telaprevir in normal human epidermal keratinocytes (NHEKs). Microarray analysis and real-time polymerase chain reaction (PCR) revealed the significant increase in the expression of S100 calcium-binding protein A2 (S100A2) gene following treatment of NHEKs with telaprevir. Immunohistochemical analysis demonstrated that the expression of S100A2 was dominant in the spinous layer of the epidermis in patients with telaprevir-mediated severe-type drug eruptions and limited to the basal layer of the epidermis in healthy subjects. Furthermore, S100A2 expression increased after treatment with trichloroethylene and other medications, and the degree of S100A2 expression correlated with the severity of cutaneous adverse events. S100A2 expression also significantly increased in the skin of patients with atopic dermatitis and psoriasis. Taken together, S100A2 is highly expressed in the epidermis under inflammatory conditions and drug eruptions and may serve as a marker for keratinocyte damage in response to any inflammatory or toxic condition.

FEATURES OF THE ULTRASTRUCTURE OF THE SKIN OF WHITE RATS 60 AND 90 DAYS AFTER MODELING OF PORTAL HYPERTENSION

The aim: The aim of the research was to study the features of the ultrastructure of the skin of white rats 60 and 90 days after modeling of portal hypertension. Materials and methods: The investigations were performed on male white nonlinear rats. The animals of the first (control) group underwent a sham operation. In rats of the second group, portal hypertension was simulated by applying a ligature to the portal vein. 60 and 90 days after the start of the experiment, a biopsy was taken from the anterior abdominal wall for electron microscopy research. Results: It was shown that skin in intact animals (control group) was of typical structure before beginning of experiment and 60 and 90 days after a sham operation. 60 days after the start of the experiment, we found severe edema of the basal and spinous layer of the epidermis, breakdown of intercellular contacts, edema of endotheliocytes, their perivascular edema, leukocytes infiltration, edema of mitochondria and lysosomes. 90 days after the start of the experiment, ultrastructural changes in the skin were more pronounced. Ultrastructural changes of microvessels were characterized by narrowed lumen. Endothelial cells had significant edema. Conclusions: Тhe data obtained should be taken into account when performing surgical interventions to prevent complications in the formation of the scar.

A Case of Pseudoepitheliomatous Keratotic and Micaceous Balanitis with Verrucous Carcinoma

Pseudoepitheliomatous Keratotic and Micaceous Balanitis (PKMB) is a rare chronic inflammatory disease characterised by hardened, hyperkeratotic plaques on the glans of the penis of older men. Although PKMB is described as benign, there is growing evidence that it has the potential to become cancerous. authors hereby report a case of 55 year old male who was initially characterised by white sclerosis and atrophy at the glans. Without treatment, verrucous keratinising organisms appeared after two years and were misdiagnosed as viral warts. The patient received four cryotherapy treatment with liquid nitrogen, which completely removed the warts, but the rash recurred about two months after cryotherapy. The patient received histopathological examinations which showed obvious hyperkeratosis with incomplete keratosis in the epidermis, papilloma-like and pseudoepithelioma-like hyperplasia appeared in the spinous layer, flattening of rete ridges, squeezing growth into the dermis, disordered arrangement of basal cells and frequent mitoses. A few squamous masses were seen in the dermis and the formation of squamous fossa could be seen.There were more lymphocyte infiltrations in the superficial layer of the dermis and around blood vessels. After being diagnosed with PKMB with verrucous carcinoma, the patient finally chose to undergo surgery in the Urology Department of another hospital. Unfortunately, we lost the follow-up. Our case supports the view that PKMB can develop into a malignant disease, which suggests that early detection, treatment and follow-up of the disease are essential.

Comparison analysis of Baso Cellular Carcinoma and Spino Cellular Carcinoma - Protein Kinase D1, Wnt/β-catenin and Epithelial to Mesenchimal Transition (markers)

Understanding cancer biology is crucial to the successful diagnosis and application of personalized therapies. Skin carcinogenesis is a multi-step process. The first step is the development of potentially malignant disorders (PMDs) known as leukoplakia, erytroplakia, lichen planus, probably trough mutation in the proteins regulated cell cycle (p16INK4A, p21Waf1/Cip1/Sdi1, p27 kip1, Cyclin D1) and, second in p53 (TP53), Ras, hTert, EGFR, will reverse benign phenotype of late precancer lesions (PMDs) into benign cancer lesion. Third mutation probably in PI3K, PKD1 or E-cadherin, will increase malignant potential of SCCs, activating EMTransition, invasion and metastasis, e.g. aggressive phenotype. In BCC mutations of p53 are known to be late events (UV signature), whereas silencing of 14-3-3 takes place early in tumor progression, concomitant with increased activity of Snail. Early increased expression of PKD1 and down-regulation of c-myc mRNA are also events in pathogenesis of BCC. There is no data for detected mutations in PKD1 gene in both cancers, although the kinases is with high expression in BCC and lack of expression in SCC. There is no data concerning PKD1 expression in the PMDs leading to SCCs, nor to BCCs, such data were recently published concerning PKD1 expression in pancreatic oncogenesis. Curently adequate question is whether lack of PKD1 expression in SCCs, despite its PMDs origin, is a consequence of its spinous layer origin, or is a consequense of PKD1 gene mutations (downregulation). Identification of mutations as markers for early malignant transformation could be useful for early diagnosis and treatment of skin head and neck cancers.

UV-Induced Keratin 1 Proteolysis Mediates UV-Induced Skin Damage

Keratins play critical roles in intermediate filament formation, inflammatory responses and cellular signaling in epithelium. While keratins is a major epidermal fluorophore, the mechanisms underlying the autofluorescence (AF) of keratins and its biomedical implications have remained unknown. Our study used mouse skin as a model to study these topics, showing that UV dose-dependently induced increases in green AF at the spinous layer of the epidermis of mouse within 6 hr of the UV exposures, which may be used for non-invasive prediction of UV-induced skin damage. The UV-induced AF appears to be induced by cysteine protease-mediated keratin 1 proteolysis: 1) UV rapidly induced significant keratin 1 degradation; 2) administration of keratin 1 siRNA largely decreased the UV-induced AF; and 3) administration of E-64, a cysteine protease inhibitor, significantly attenuated the UV-induced AF and keratin 1 degradation. Our study has also suggested that the UV-induced keratin 1 proteolysis may be a novel crucial pathological factor in UV-induced skin damage, which is supported by both the findings that indicate critical biological roles of keratin 1 in epithelium and our observation that prevention of UV-induced keratin 1 proteolysis can lead to decreased UV-induced skin damage. Collectively, our study has suggested that UV-induced keratin 1 proteolysis may be a novel and valuable target for diagnosis, prevention and treatment of UV-induced skin damage.

Immunohistochemical Analysis of GDNF and Its Cognate Receptor GFRα-1 Protein Expression in Vitiliginous Skin Lesions

Background: Vitiligo is an idiopathic skin disease, characterized by circumscribed white macules or patches on the skin due to loss of the functional melanocytes. Glial cell line–derived neurotrophic factor (GDNF) and its cognate receptor (GFRα-1) are distal members of the transforming growth factor-β superfamily. GDNF, produced by the basal cell keratinocytes, is involved in the migration and differentiation of the melanocytes from the neural crest to the epidermis. This study examines the hypothesis that expression of GDNF protein and its cognate receptor GFRα-1 protein is altered in vitiliginous skin. Patients and Methods: To test our hypothesis, we examined the expression patterns of these proteins in vitiliginous and corresponding healthy (control) skin biopsies (20 specimens each) using immunoperoxidase staining techniques. Results: We found variations between the vitiliginous skin and healthy skin. In healthy skin, the expression of GDNF and GFRα-1 proteins was strong (basal cell keratinocytes and melanocytes), moderate (spinous layer), and weak (granular cell layer). In contrast, weak expression of GDNF protein was observed in all epidermal layers of vitiliginous skin. GFRα-1 protein expression was strong (basal cell keratinocytes and melanocytes), moderate (spinous layer), and weak (granular cell layer). In both healthy skin and vitiliginous skin, the expression of GDNF and GFRα-1 proteins was strong in the adnexal structures. Conclusions: We report, for the first time, decreased expression of GDNF proteins in the epidermal keratinocytes of vitiliginous skin. Our findings suggest possible pathogenetic roles for these proteins in the development of vitiligo. The clinical ramifications of these observations mandate further investigations.

Canine papillomatosis: a retrospective study of 24 cases (2001-2011) and immunohistochemical characterization

A retrospective study of 24 cases of papillomas in dogs was performed from January 2001 to March 2011. Additionally, immunohistochemistry (IHC) was used to characterize and evaluate the samples. We found that disease was observed more in mixed breed dogs, ages ranging from 6 months to 10 years (mean 3.1 years), and there was no gender predilection. The main lesion sites were the skin (75%), lips (16.7%), and eyelids (8.3%). Upon histological evaluation, we observed papillary exophytic proliferation of squamous epithelium and papillary endophytic proliferation (inverted) in 87.5% and 12.5% of cases, respectively. The tumors were characterized by spinous layer hyperplasia (87.5%) with koilocytes (70.8%) and intranuclear pale basophilic inclusions bodies (8.3%), prominent granular layer with large amounts of keratohyalin granules (95.8%), and hyperkeratosis in the stratum corneum (100%). Positive immunostaining for Papillomavirus was found in 83.3% of cases, which were distributed between the granular layer and the stratum corneum. These findings indicate the following: that papillomas in dogs are caused by Papillomavirus, the viral cytopathic effect induces epithelial lesions, viral particles are found inside the cell nuclei, and inclusions bodies are rare.

Evidence that major 78-44-kD concanavalin A-binding glycopolypeptides in pig epidermis arise from the degradation of desmosomal glycoproteins during terminal differentiation.

The major concanavalin A (Con A)-binding component in urea/deoxycholate/mercaptoethanol extracts from pig ear epidermis had an apparent Mr of 78 kD. In indirect immunofluorescence affinity-purified polyclonal antibodies against this glycopolypeptide strongly stained the surface of suprabasal cells in the epidermis of pig and human skin. Immunocytochemical labeling with gold-labeled second antibody localized this staining to externally disposed, trypsin-sensitive components of desmosomes. Western blotting showed that the 78-kD glycopolypeptide was immunologically related to several other Con A-binding components in pig epidermis. Immunoreactive components with Mr of 115 and 100 kD were membrane-bound, appeared to be susceptible to trypsin in intact epidermis, and were absent from the stratum corneum. Immunoreactive components of lower Mr (78-44 kD) were not membrane-bound, were resistant to trypsin in intact tissue, and were present predominantly in the keratinized layers of pig epidermis. The 115-44-kD glycopolypeptides were also recognized by antisera raised against desmoglein II/desmocollin glycoproteins isolated from bovine spinous layer desmosomes. In addition, these antisera reacted with 120- and 105-kD bands that were apparently not recognized by the anti-78-kD glycopolypeptide antiserum in immunoblotting. In immune precipitation the anti-78-kD glycopolypeptide and antidesmoglein II/desmocollin antisera precipitated comparable amounts of the radioiodinated 78-44-kD components. Both antisera also precipitated the 120- and 105-kD components although the anti-78-kD glycopolypeptide serum was less effective. Little reaction with the 115- and 105-kD components was observed in immune precipitation with either serum. Proteolytic peptide mapping confirmed that the various immunoreactive glycopolypeptides were biochemically as well as immunologically related. The results suggest that terminal differentiation in pig epidermis is accompanied by the orderly degradation of desmoglein II/desmocollin glycoproteins resulting in the accumulation of 78-44-kD glycopolypeptides in the stratum corneum. These glycopolypeptides may represent functionally important nonmembranous domains of cell-adhesion molecules in desmosomes.