Ann Dermatol.  2020 Feb;32(1):31-37. 10.5021/ad.2020.32.1.31.

Increased Expression of Interleukin-12 in Lesional Skin of Atopic Dermatitis Patients with Psoriasiform Features on Histopathology: An Immunohistochemical Study

• Lim HJ
• Han MH
• Lee EH
• Eun DH
• Kim JY
• Lee WJ
• Lee SJ
• Kim DW
• Park TI
• Kim SH
• Jang YH

• KMID: 2467198
• DOI: http://doi.org/10.5021/ad.2020.32.1.31

Abstract

BACKGROUND
Based on clinical and genetic differences, atopic dermatitis (AD) and psoriasis have been classified in two different diseases, but recently, some authors regarded them as in one spectrum. The histological similarities including epidermal hyperplasia between chronic stages of AD and psoriasis supports the presence of two diseases in one spectrum.
OBJECTIVE
We investigated clinical and immunohistopathological characteristics of adult Korean patients with AD showing psoriasiform chronic dermatitis on histopathology.
METHODS
In total, 59 Korean patients with chronic AD were enrolled. Clinical, laboratory, and histopathological features were compared between AD patients with psoriasiform features and those with non-psoriasiform chronic dermatitis features on histology. In addition, immunohistopathological characteristics were analyzed using antibodies for key regulatory and effector cytokines in psoriasis.
RESULTS
Fifteen patients (25.4%) showed a more "psoriasiform" histological appearance. The lesions in patients with psoriasiform features often showed clearer boundaries and noticeable scaling. The interleukin (IL)-23 expression in the psoriasiform chronic dermatitis group was not different from that in the psoriasis group, but the IL-17 expression was less than that in the psoriasis group. In the case of IL-12, multiple dermal inflammatory cells with dendrites were stained in the psoriasiform chronic dermatitis group compared with the 2 other non-psoriasiform subgroups.
CONCLUSION
The results suggest that IL-12 secreted from dermal inflammatory cells might be one of the important factors associated with the formation of psoriasiform features in chronic AD. However, further studies are required to better define the specific role of IL-12.

Keyword

Atopic dermatitis; Cytokines; Endophenotype; Psoriasis

MeSH Terms

Adult
Antibodies
Cytokines
Dendrites
Dermatitis
Dermatitis, Atopic*
Endophenotypes
Humans
Hyperplasia
Interleukin-12*
Interleukin-17
Interleukins
Psoriasis
Skin*
Antibodies
Cytokines
Interleukin-12
Interleukin-17
Interleukins

Figure

• 

  Fig. 1 (A) Representative case of atopic dermatitis showing “psoriasiform” features on histopathology. Hematoxylin-eosin staining shows typical histopathological findings of psoriasis including parakeratosis (black arrows), thinning of the suprapapillary epidermis (white arrowheads), diminished to absent granular layer (white arrows), dilated capillaries (black arrowheads), elongation and edema of the dermal papillae (black double arrowheads), acanthosis with regular elongation (white double arrowheads). (B) Representative cases showing Munro's microabscesses-like findings on histopathology (black arrows). Scale bar: 500 µm.

• 

  Fig. 2 No significant differences in laboratory values were found between the psoriasiform chronic dermatitis group and the 2 other atopic dermatitis (AD) subgroups. IgE: immunoglobulin.

• 

  Fig. 3 Interleukin (IL)-23, IL-17, IL-22, IL-12, and interferon (IFN)-γ expression in each of the four groups. In the psoriasiform chronic dermatitis group, there was significantly increased expression of IL-12 observed in the lesional dermis (2.40±1.07) compared with the group showing non-psoriasiform dermatitis with moderate to severe epidermal hyperplasia (1.40±0.52) and the group with non-psoriasiform dermatitis with mild epidermal hyperplasia (1.60±0.52) (p<0.05). However, the IL-23, IL-17, IL-22, and IFN-γ expression in the epidermis of the psoriasiform chronic dermatitis group showed no statistically significant differences compared with the other 2 atopic dermatitis (AD) groups (×200, scale bar: 500 µm).

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