[Psoriasis in HTLV-III-induced immunologic defect--status of cellular immunity and immunohistologic findings]

Four patients suffering from immune deficiency related to HTLV III developed psoriasis vulgaris. All patients showed lymphadenopathy and cutaneous hypergy or anergy. In three of them, the count of peripheral helper cells was critically decreased (less than 400/microliter), and they showed oral candidosis. One patient suffered from disseminated Kaposi's sarcoma and developed pneumocystis carinii pneumonia. The psoriasis was extensive, exsudative, and almost refractory to therapeutical approaches. The bulk of dermal infiltrating mononuclear cells were T lymphocytes, mostly the T 8 positive phenotype. The majority of these cells were HLA-DR positive, so were many epidermal cells. OKT6 positive epidermal Langerhans' cells were not diminished. Thus we observed the development of psoriasis in spite of severe disturbances of cellular immunity. We suppose that immune mechanisms mediated by T cells--after having got out of control--might play some role in the pathogenesis of the disease.