Segmental immune disorders resulting from neurologic injuries

The immunocompromised cutaneous district (ICD) is a novel pathogenic concept that refers to the occurrence of opportunistic skin disorders (such as infections, malignancies, and immune diseases) at a cutaneous site previously marked by a damaging event, usually involving the local lymph network or peripheral sensory nerves. In addition to herpetic infections, which are notoriously harmful for sensory nerve fibers and therefore already included among the potential causes of ICD, there are a large and variegate group of further neurologic diseases, both peripheral (carpal tunnel syndrome, facial nerve palsy, and trigeminal trophic syndrome) and central (poliomyelitis and brain stroke), which may be added to the wide and expanding spectrum of injuring events resulting in an ICD. The neural compartment of skin immunity plays a key role in immune homeostasis, and this assertion is confirmed by the fact that any neurologic injury, whatever the origin (peripheral or central) or the cause (infection, trauma, ischemia), can give rise to immune destabilization of the innervated area, which becomes a site prone to the occurrence of opportunistic skin disorders. A neural-driven process may be responsible for the cutaneous immune dysregulation ensuing from some neurologic diseases.