Childhood Herpes Zoster-Triggered Guttate Psoriasis

in Open Dermatology Journal (The) (2012)

Psoriasis is commonly triggered or exacerbated by various stress factors, certain drugs, or streptococcal throat infections. Viral infections such as HIV, CMV, chikungunya, or herpes simplex virus are ... [more ▼]

Psoriasis is commonly triggered or exacerbated by various stress factors, certain drugs, or streptococcal throat infections. Viral infections such as HIV, CMV, chikungunya, or herpes simplex virus are very uncommon triggers for psoriasis. Cases of varicella-triggered psoriasis are exceptional. A 7-year-old boy with a previous history of guttate psoriasis presented with generalized acute guttate psoriasis shortly after an extensive herpes zoster infection affecting the first and second left lumbar dermatomes. INF-alpha and granulocyte monocyte colony stimulating factor influence peripheral monocytes to transform into INF-dendritic cells (DC's), similar to those involved in psoriasis. These INF-DC's express toll-like receptors 7 and 8, which are responsive to viral single stranded RNA. Hence, viral infections and interferon (INF)-alpha may play a role in triggering psoriasis. [less ▲]

Epidermal Calprotectin Expression in Lymphocyte-Depleted Cutaneous Graft-versus-Host Reaction

in Archivos Argentinos de Dermatologia (1998), 48

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates ... [more ▼]

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates the severity of cutaneous lesions to a peculiar lymphocyto-depleted GVHR (LD-GVHR) with scant recognizable inflammatory cells and almost absence of epidermal injury. The recently revisited histological criteria for cutaneous GVHR are of little help in diagnosing such LD-GVHR. As calprotectin (L1-protein) has been reported to be expressed in several types of stressed epithelia, we assessed the epidermal calprotectin expression during LD-GVHR. Calprotectin expression was studied by immuno-histochemistry using the Mac 287 moAb in 50 cases of LD-GVHR and 40 cases of toxic reactions due to the conditioning regimens or to post-transplant drugs. Calprotectin was evidenced in normal looking keratinocytes of all cutaneous LD-GVHR cases and in the vast majority of cytotoxic drug-induced dermatitis. It is concluded that calprotectin immunoreactivity appears to be a diagnostic clue in LD-GVHR. The epidermal calprotectin expression occurs early in GVHD, irrespective of the histological grading. However, it cannot be used alone to distinguish early LD-GVHR from drug-induced dermatitis. [less ▲]