We investigated the dermal inflammatory infiltrate and the expression of HLA-DR and beta 2-microglobulin on the tumour cells in 8 Bowen's disease (BD) using a series of monoclonal antibodies. The inflammatory infiltrate was classified as mild, moderate or heavy. The infiltrate in all cases consisted mainly of T cells (55 +/- 21%) and where the T helper (TH) subset predominated over the T suppressor/cytotoxic (TS/C) subset (TH/TS/C ratio of 2.4 +/- 1.0). The mean percentage of HLA-DR positive cells was 58 +/- 18%, Langerhans cells (LC) 4 +/- 1% and Leu-M5 positive cells (monocytes/macrophages) 9 +/- 2%. The mean percentage of B cells and natural killer (NK) cells was 4 +/- 5% and 1 +/- 2% respectively. B cells and NK cells did not invade any of the tumours. In the 5 BD with moderate or heavy infiltrate, TH cells, TS/C cells and Leu-M5 positive cells did invade the tumour. In the tumour area where there was invasion, the number of LC was increased and HLA-DR was expressed on the cells. beta 2-microglobulin was generally expressed on the tumour cells of BD. We concluded that there is evidence for a T cell-mediated anti-tumour immune response which may account for the infrequent invasive growth in BD.
The reliability of clinical signs to differentiate between autosomal dominant ichthyosis (ADI) or sex-linked ichthyosis (SLI) were assessed. SLI was defined as ichthyosis in combination with steroid sulphatase deficiency. Age of onset and format of the scales were found to be reliable signs to ascertain the diagnosis of ADI or SLI. The ADI-like appearance in histopathology seems to be of little diagnostic value.
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