PMID- 14616369
OWN - NLM
STAT- MEDLINE
DCOM- 20031218
LR  - 20190704
IS  - 0007-0963 (Print)
IS  - 0007-0963 (Linking)
VI  - 149
IP  - 4
DP  - 2003 Oct
TI  - Histopathological and immunohistochemical assessment of acquired ichthyosis in 
      patients with human T-cell lymphotropic virus type I-associated myelopathy.
PG  - 776-81
AB  - BACKGROUND: Patients with human T-cell lymphotropic virus type I 
      (HTLV-I)-associated myelopathy frequently display cutaneous alterations such as 
      acquired ichthyosis. OBJECTIVES: Elucidation of the pattern of acquired 
      ichthyosis in HTLV-I-associated myelopathy. METHODS: Skin fragments from 10 
      patients with HTLV-I-associated myelopathy presenting with acquired ichthyosis 
      were assessed by histopathological and immunohistochemical tests. We used 
      anticytokeratin antibodies related to normal keratinization (K1/K10), and others 
      related to cutaneous conditions such as activation, migration and 
      hyperproliferation of keratinocytes (K6/K16), and involucrin, a precursor protein 
      in the formation of the protein envelope in keratinocytes. For quantification of 
      the proliferating basal and parabasal cells the anti-Ki-67 antibody was employed. 
      RESULTS: On light microscopy, all skin specimens displayed orthokeratotic 
      hyperkeratosis and hypogranulosis. Three of them presented focal parakeratosis. A 
      slight to moderate perivascular infiltrate of mononuclear lymphocytes was 
      observed in seven cases, three of which showed discrete spongiosis with 
      epidermotropism of lymphocytes. All fragments displayed coexpression of K1, K10 
      and K16 in the suprabasal layers. Expression of involucrin was also observed in 
      all cases, in the upper spinous and granular layers. Focal expression of K6 was 
      observed in three cases, under a parakeratotic area. The mean number of Ki-67+ 
      basal and parabasal cells was 3.5 cells per mm, similar to that in control skin. 
      CONCLUSIONS: In acquired ichthyosis related to HTLV-I-associated myelopathy, 
      histopathology revealed orthokeratotic hyperkeratosis and a perivascular 
      inflammatory infiltrate of mononuclear lymphocytes, with areas of parakeratosis 
      and foci of epidermotropism in rare cases. The expression profiles of K1, K10 and 
      involucrin were similar to those in normal skin. The diffuse coexpression of K16 
      with K1 and K10 throughout the analysed epidermis, as well as the occurrence of 
      restricted areas of parakeratosis expressing K6, indicate the presence of 
      keratinocyte activation with induction of the alternative keratinization pathway, 
      probably dependent on the cytokines liberated by the mononuclear cells of the 
      dermal inflammatory infiltrate infected with HTLV-I. The absence of acanthosis 
      and of increased cellular kinetics, as shown by the low rate of Ki-67 antigen 
      expression, allow the inference that the pattern of acquired ichthyosis related 
      to HTLV-I-associated myelopathy may be retentional. The observation of foci of 
      parakeratosis expressing K6 in three specimens suggests that, at least in certain 
      areas and in some cases, interference with epidermal differentiation and 
      maturation occurs.
FAU - Milagres, S P
AU  - Milagres SP
AD  - Department of Dermatology, Outpatient Clinic of Neurology, School of Medicine, 
      University of Sao Paulo, Sao Paulo, SP, Brazil.
FAU - Sanches, J A Jr
AU  - Sanches JA Jr
FAU - Milagres, A C P
AU  - Milagres AC
FAU - Valente, N Y S
AU  - Valente NY
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Dermatol
JT  - The British journal of dermatology
JID - 0004041
RN  - 0 (Ki-67 Antigen)
SB  - IM
MH  - Cell Division
MH  - Humans
MH  - Ichthyosis/pathology/*virology
MH  - Keratosis/pathology/virology
MH  - Ki-67 Antigen/metabolism
MH  - Leg Dermatoses/pathology/virology
MH  - Paraparesis, Tropical Spastic/*complications
EDAT- 2003/11/18 05:00
MHDA- 2003/12/19 05:00
CRDT- 2003/11/18 05:00
PHST- 2003/11/18 05:00 [pubmed]
PHST- 2003/12/19 05:00 [medline]
PHST- 2003/11/18 05:00 [entrez]
AID - 5567 [pii]
AID - 10.1046/j.1365-2133.2003.05567.x [doi]
PST - ppublish
SO  - Br J Dermatol. 2003 Oct;149(4):776-81. doi: 10.1046/j.1365-2133.2003.05567.x.