[Immunologic reactivity of the skin in chronic hepatitis]

The aim of the study was to evaluate the practical usefulness of immunological examination of the skin in chronic liver diseases, especially chronic active hepatitis (CAH) HBsAg (+). Fifty-four patients were examined. DNCB and tuberculin skin tests as well as direct immunofluorescence method for clinically normal skin specimens were used to estimate some of the immunological processes in the skin. Results of immunopathological examinations of the skin in a group of patients with CAH HBsAg (+) were compared with some clinical, biochemical and serological data. The skin delayed hypersensitivity tests with DNCB and tuberculin were negative in the majority of persons having CAH HBsAg (+), which provided support for the cellular immunity discrimination in these cases. It was demonstrated that serum HBsAg titer in patients with CAH HBsAg (+) and positive tuberculin test was significantly lower as compared to the group with negative tuberculin test. Deposits of immunoglobulins, particularly IgM, and C3-component of complement in vessel walls were stated in clinically normal skin in patients with CAH HBsAg (+) and other liver diseases. They were found in about 3/4 of the examined cases of CAH HBsAg (+). C3-deposits were recorded significantly more frequently in superficial skin vessel walls in patients with histologically diagnosed liver cirrhosis. It seems that homogenous deposits of IgM or C3 in skin vessel walls may indicate early and granular--later stage of CAH HBsAg (+). Immunological examinations of the skin may be useful for better evaluating the cases of chronic liver diseases, particularly in chronic active hepatitis with HBs-antigenaemia.