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Histological and immunofluorescence findings of non-follicular papulopustular lesions in patients with Behçet's disease.
J Eur Acad Dermatol Venereol. 2003 Sep; 17(5):521-4.JE

Abstract

BACKGROUND

Papulopustular lesions (PPL), the most common type of cutaneous lesions in Behçet's disease (BD), clinically may not be differentiated from ordinary acne. Disagreement exists as to the exact nature of these acneiform and folliculitis-like lesions and whether to include them as a major criterion.

OBJECTIVE

We investigated whether PPL can be a useful tool for the diagnosis of BD when non-follicular lesions over the trunk or extremities were selected, and were correlated with histological and/or immunofluorescence study.

METHODS

Seventeen patients with BD (five women, 12 men; mean +/- SEM age, 32 +/- 7.9 years), were enrolled in the study with blind histopathological and immunofluorescence studies. Biopsies of the PPL and adjacent (approximately 2 cm distant) normal-appearing skin were performed from the extremities and trunk. Follicle-based acneiform lesions and those lesions over face were excluded. Histological evaluation primarily included epidermal and dermal alterations, cellular infiltration and vascular changes. We also performed direct immunofluorescence studies, using polyclonal antibodies for IgA, IgG, IgM, C3 and fibrin.

RESULTS

Lesional specimens of the patients with BD revealed a significant leucocytoclastic vasculitis as compared with non-lesional skin (P<0.05). The vessels of the lesional skin showed a higher IgM deposition than non-lesional skin (52.9% and 17.6%) (P<0.05). IgG, C3 and fibrin deposits on the vessels of the lesional skin were also higher than non-lesional skin (35.3, 11.8%; 41.2, 17.6%; and 47.1, 17.6%, respectively), but the differences were not statistically significant.

CONCLUSIONS

Our findings indicate that non-follicular PPL over the trunk or extremities are more specific, and immune complex-mediated vasculitis is likely to be the main feature of these lesions, as they are in other cutaneous lesions of BD.

Authors+Show Affiliations

Department of Dermatology, Akdeniz University School of Medicine, Antalya, Turkey. ealpsoy@akdeniz.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12941085

Citation

Alpsoy, E, et al. "Histological and Immunofluorescence Findings of Non-follicular Papulopustular Lesions in Patients With Behçet's Disease." Journal of the European Academy of Dermatology and Venereology : JEADV, vol. 17, no. 5, 2003, pp. 521-4.
Alpsoy E, Uzun S, Akman A, et al. Histological and immunofluorescence findings of non-follicular papulopustular lesions in patients with Behçet's disease. J Eur Acad Dermatol Venereol. 2003;17(5):521-4.
Alpsoy, E., Uzun, S., Akman, A., Acar, M. A., Memişoglu, H. R., & Başaran, E. (2003). Histological and immunofluorescence findings of non-follicular papulopustular lesions in patients with Behçet's disease. Journal of the European Academy of Dermatology and Venereology : JEADV, 17(5), 521-4.
Alpsoy E, et al. Histological and Immunofluorescence Findings of Non-follicular Papulopustular Lesions in Patients With Behçet's Disease. J Eur Acad Dermatol Venereol. 2003;17(5):521-4. PubMed PMID: 12941085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histological and immunofluorescence findings of non-follicular papulopustular lesions in patients with Behçet's disease. AU - Alpsoy,E, AU - Uzun,S, AU - Akman,A, AU - Acar,M Alpaslan, AU - Memişoglu,H R, AU - Başaran,E, PY - 2003/8/28/pubmed PY - 2004/1/24/medline PY - 2003/8/28/entrez SP - 521 EP - 4 JF - Journal of the European Academy of Dermatology and Venereology : JEADV JO - J Eur Acad Dermatol Venereol VL - 17 IS - 5 N2 - BACKGROUND: Papulopustular lesions (PPL), the most common type of cutaneous lesions in Behçet's disease (BD), clinically may not be differentiated from ordinary acne. Disagreement exists as to the exact nature of these acneiform and folliculitis-like lesions and whether to include them as a major criterion. OBJECTIVE: We investigated whether PPL can be a useful tool for the diagnosis of BD when non-follicular lesions over the trunk or extremities were selected, and were correlated with histological and/or immunofluorescence study. METHODS: Seventeen patients with BD (five women, 12 men; mean +/- SEM age, 32 +/- 7.9 years), were enrolled in the study with blind histopathological and immunofluorescence studies. Biopsies of the PPL and adjacent (approximately 2 cm distant) normal-appearing skin were performed from the extremities and trunk. Follicle-based acneiform lesions and those lesions over face were excluded. Histological evaluation primarily included epidermal and dermal alterations, cellular infiltration and vascular changes. We also performed direct immunofluorescence studies, using polyclonal antibodies for IgA, IgG, IgM, C3 and fibrin. RESULTS: Lesional specimens of the patients with BD revealed a significant leucocytoclastic vasculitis as compared with non-lesional skin (P<0.05). The vessels of the lesional skin showed a higher IgM deposition than non-lesional skin (52.9% and 17.6%) (P<0.05). IgG, C3 and fibrin deposits on the vessels of the lesional skin were also higher than non-lesional skin (35.3, 11.8%; 41.2, 17.6%; and 47.1, 17.6%, respectively), but the differences were not statistically significant. CONCLUSIONS: Our findings indicate that non-follicular PPL over the trunk or extremities are more specific, and immune complex-mediated vasculitis is likely to be the main feature of these lesions, as they are in other cutaneous lesions of BD. SN - 0926-9959 UR - https://www.unboundmedicine.com/medline/citation/12941085/Histological_and_immunofluorescence_findings_of_non_follicular_papulopustular_lesions_in_patients_with_Behçet's_disease_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0926-9959&amp;date=2003&amp;volume=17&amp;issue=5&amp;spage=521 DB - PRIME DP - Unbound Medicine ER -