Elevated B-lymphocyte levels in lesional tissue of non-arthritic psoriasis

Psoriasis is a chronic inflammatory skin disorder characterized clinically by maculopapular skin lesions and on the cellular level by increased T-lymphocyte activation in the peripheral blood and migration of activated T-lymphocyte into the lesions. The lymphocyte subpopulations in peripheral blood from 21 Kuwaiti patients showed elevated levels of the T-lymphocyte activation marker CD25, as well as increased expression of HLA-DR compared with a group of age and sex-matched controls, confirming published findings on psoriasis. In addition, there was a tendency towards a significant increase in the CD4+/CD45RO+ (memory cell) population that was also consistent with peripheral T-lymphocyte activation. Immunohistological studies showed a heavy infiltrate of all cell types into the lesional tissue including, as expected, activated T-lymphocytes. An unexpected finding was significantly higher levels of B-lymphocytes infiltrating the psoriatic lesions; they numerically exceeded the T-lymphocyte infiltrate. This has previously been reported only in cases of psoriasis with concurrent arthritis. None of the subjects had arthritis, suggesting an immunopathological variant of psoriasis possibly specific to this population group.