Diagnostic approach of eosinophilic spongiosis

Morais, Karina Lopes; Miyamoto, Denise; Maruta, Celina Wakisaka; Aoki, Valéria

doi:10.1016/j.abd.2019.02.002

Cited by 14 publications

(16 citation statements)

References 10 publications

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“…[1][2][3][4][5][6][7] This disorder is usually associated with marked pruritus and blood eosinophilia, [8][9][10][11] and eosinophilic spongiosis (ES), with or without mild acantholysis, which is invariably present in the classic subtypes of pemphigus. [12][13][14] There is no clear explanation for the mechanisms by which autoantibodies produce the distinct skin lesions of PH, or the pruritus. Although some hypotheses have been postulated, some features of PH are still inconclusive.…”

Section: Introductionmentioning

confidence: 99%

“…Pemphigus herpetiformis (PH) is a rare variant within the pemphigus group and differs from the classic forms due to specific clinical and histologic features 1–7 . This disorder is usually associated with marked pruritus and blood eosinophilia, 8–11 and eosinophilic spongiosis (ES), with or without mild acantholysis, which is invariably present in the classic subtypes of pemphigus 12–14 …”

Section: Introductionmentioning

confidence: 99%

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Increased expression of in situ IL‐31RA and circulating CXCL8 and CCL2 in pemphigus herpetiformis suggests participation of the IL‐31 family in the pathogenesis of the disease

Morais

Miyamoto

Orfali

et al. 2020

Acad Dermatol Venereol

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Background Pemphigus herpetiformis (PH) is a rare clinical subtype of pemphigus with the presence of urticarial plaques, severe pruritus, rare acantholysis and eosinophilic spongiosis. Objectives The aim of this study was to investigate the influence of IL-31 and pro-inflammatory cytokines/chemokines in the pathogenesis of PH. Methods Twenty-five patients with PH and three groups: pemphigus foliaceus (PF = 14), pemphigus vulgaris (PV = 15) and healthy controls (HC = 20) were selected for this study. The groups were analysed by immunohistochemistry utilizing IL-31, IL-31RA, IL-4, IL-17 and TNF-a antibodies. Serum levels of IL-4, IL-13, TNF, CXCL8, CCL5 and CCL2 were evaluated by cytometric bead array. Results Analysis of IL-31 family of PH patients revealed the following findings: (i) Enhanced in situ expression of IL-31 in PH samples, compared to PF and to PV (epidermis); (ii) Cutaneous IL-31RA expression in PH samples was higher than in PF, PV and HC groups (epidermis and dermis); (iii) PF patients that evolved to PH showed significant increased IL-31RA epidermal expression during the PH phase. Profile of pro-inflammatory cytokines (IL-4, IL-17 and TNF-a) in PH patients' skin exhibited: (i) Enhanced IL-4 expression, when compared to patients with PF (epidermis and dermis) and with PV (epidermis); (ii) Augmented IL-17 expression than PF and PV patients (epidermis); (iii) Augmented expression of TNF-a when compared to PF at the epidermal level. Evaluation of circulating cytokines and chemokines showed higher levels of CXCL8 and CCL2 in PH sera compared to HC group. Conclusions IL-31 and IL-31RA, cytokines related to pruritus, and pro-inflammatory chemokines (CXCL8 and CCL2) seem to exert a role in the pathogenesis of PH. These findings support future studies to clarify the role of IL-31 pathway as a potential therapeutic target for patients with PH.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased expression of in situ IL‐31RA and circulating CXCL8 and CCL2 in pemphigus herpetiformis suggests participation of the IL‐31 family in the pathogenesis of the disease

Morais

Miyamoto

Orfali

et al. 2020

Acad Dermatol Venereol

Self Cite

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“… 7 Other groups described patients with tense bullae, eosinophilic spongiosis, and negative immunofluorescence as having eczema. 8 Three of the patients in our series had a known history of atopy, which suggests the possibility of bullous eczema. Future studies are needed to clarify this entity.…”

Section: Discussionmentioning

confidence: 77%

Bullous eczema presenting as bullous pemphigoid-like eruption: A case series

et al. 2021

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“…The key histopathological feature of pemphigus group diseases is the intraepidermal bullae with acantholysis, which makes clinical correlations and immunofluorescence techniques mandatory for differential diagnosis with other intraepidermal bullous diseases ( 11 , 14 , 15 ). The bullae contain acantholytic cells with eosinophilic cytoplasm, pyknotic nuclei perinuclear halo, and serum.…”

Section: Spongiosis Patterns In Autoimmune Bullous Dermatosesmentioning

confidence: 99%

Spongiotic reaction patterns in autoimmune bullous dermatoses (Review)

et al. 2021

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Spongiosis or a spongiotic reaction pattern is the histological hallmark of intercellular epidermal edema, viewed as clear spaces within the epidermis. Although considered a histopathological term, spongiosis has clinical correlations, with the variable degrees of spongiotic reaction leading to different dermatological findings. This review aimed to highlight the spongiotic reactive patterns found in different autoimmune bullous dermatoses, considering the paucity of publications in this domain. The pathogenesis of spongiosis assumes the passage of extravasated edema fluid from the dermis into the epidermis, frequently accompanied by dermal inflammatory cells, and classification of the spongiotic reaction patterns, as well as their associated spongiotic dermatitis, take into consideration the type and distribution of these inflammatory cells. It is mandatory to consider different reactive processes, specific for other skin disorders, which act as simulants of different spongiotic patterns for the diagnosis. Considering the possible transient occurrence, the heterogeneity and non-specificity of the histopathological features of these diseases, the diagnosis is very complex, requiring clinicopathological correlations and additional analyses. A deep insight into spongiosis pathogeny may open the perspectives of a classification refinement of autoimmune bullous dermatoses.

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Diagnostic approach of eosinophilic spongiosis

Cited by 14 publications

References 10 publications

Increased expression of in situ IL‐31RA and circulating CXCL8 and CCL2 in pemphigus herpetiformis suggests participation of the IL‐31 family in the pathogenesis of the disease

Increased expression of in situ IL‐31RA and circulating CXCL8 and CCL2 in pemphigus herpetiformis suggests participation of the IL‐31 family in the pathogenesis of the disease

Bullous eczema presenting as bullous pemphigoid-like eruption: A case series

Spongiotic reaction patterns in autoimmune bullous dermatoses (Review)

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