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Mast cell degranulation in the evolution of acute eruptive guttate psoriasis vulgaris
Abstract:
Clinically normal psoriatic skin (CNPS) and psoriatic lesions (PLs) were studied for mast cell degranulation (MCD) in patients with acute eruptive guttate psoriasis vulgaris (AEGP) following penicillin-treated acute streptococcal throat infection. The clinically manifest duration of psoriasis at the time of the biopsies was 2, 5, 10, 14, or 21 days. Two types of MCD were distinguished. Type I was characteristic for those portions of the CNPS in which vascular and epidermal changes were detected, while the PLs showed both Type I and Type II MCD. In Type I MCD the extruded granules (MCGs) in the immediate vicinity of the mast cells appeared as intact bodies encased in a distinctly trilaminar membrane. Around subepidermal and subpapillary blood vessels, in stratum papillare without proximity of blood vessels, beneath the epidermal-dermal junction, in lamina lucida, and in intercellular space of strata basale and spinosum the MCGs appeared partly as intact structures and partly in more or less disintegrated form. In Type II MCD the MCGs were extruded without perigranular membranes. The data here presented showed that MCD is an early and constant feature in the evolution of AEGP.
Insights
Mast cell degranulation (MCD) is an early and constant feature in acute eruptive guttate psoriasis vulgaris (AEGP) following streptococcal infection. Both clinically normal and lesional psoriatic skin show distinct types of MCD during psoriasis evolution.
Area of Science:
- Dermatology
- Immunology
- Pathology
Background:
- Psoriasis vulgaris is a chronic inflammatory skin condition.
- Acute eruptive guttate psoriasis vulgaris (AEGP) can be triggered by streptococcal infections.
- Mast cells play a role in inflammatory skin diseases.
Purpose of the Study:
- To investigate mast cell degranulation (MCD) in clinically normal psoriatic skin (CNPS) and psoriatic lesions (PLs) in patients with AEGP.
- To characterize the types and temporal evolution of MCD in AEGP.
Main Methods:
- Biopsies were taken from CNPS and PLs of AEGP patients at 2, 5, 10, 14, and 21 days after penicillin treatment for streptococcal throat infection.
- Two types of mast cell degranulation (Type I and Type II) were distinguished based on the morphology of extruded granules (MCGs).
Main Results:
- Mast cell degranulation (MCD) was observed in both CNPS and PLs.
- Type I MCD was found in CNPS with vascular and epidermal changes, and in PLs.
- PLs exhibited both Type I and Type II MCD, with Type II characterized by MCGs lacking perigranular membranes.
Conclusions:
- Mast cell degranulation (MCD) is an early and constant feature in the evolution of acute eruptive guttate psoriasis vulgaris (AEGP).
- Distinct types of MCD occur in clinically normal and lesional psoriatic skin, suggesting different mechanisms or stages of mast cell involvement.