Immunofluorescence, Necrobiosis Lipoidica, and Blood Vessels

Abstract

New Haven, CT 06510 References 1. Braverman MS, Braverman IM: Three-dimensional reconstructions of objects from serial sections using a microcomputer graphics system. J Invest Dermatol 1986;86:290-294. 2. Perkins WJ, Green RJ: Three-dimensional reconstruction of biological sections. J Biomed Eng 1982;4:37-43. 3. Antunez J-CM, Galey FR, Linthicum FH, et al: Computer aided and graphic reconstruction of the human endolymphatic duct and sac. Ann Otol Rhinol Laryngol 1980;89(suppl 76):23-32. 4. Lindel\l=o"\fB, Forslind B, Hedblad M-A, et al: Morphology revealed by light and scanning electron microscopy and computer aided three-dimensional reconstruction. Arch Dermatol 1988; 124:1359-1363. 5. Braverman IM, Yen A: Microcirculation in psoriatic skin. J Invest Dermatol 1974;62:493-502. 6. Braverman IM, Keh-Yen A: Three-dimensional reconstruction of endothelial cell gaps in psoriatic vessels and their morphological identity with gaps produced by the intradermal injection of histamine. J Invest Dermatol 1986;86:577-581. 7. Majno G, Shea SM, Levinthal M: Endothelial contraction induced by histamine-like mediators: An electron microscopic study.

Diffuse necrobiosis lipoidica diabeticorum associated with non-insulin dependent diabetes mellitus

“…However, its precise pathogenesis remains unknown, some authors having considered it a cutaneous manifestation of diabetic microangiopathy and others an immune complex vasculitis. 1,2 In addition, some investigators have considered collagen abnormalities to be the initiating event; lysyl oxidase, which produces collagen cross-linking by the oxidation of lysine and hydroxylysine has been found to be significantly elevated in both NL and diabetes in one study, ,3 whereas in another, the overhydration of collagen was observed in diabetic skin. 4 Furthermore, recent studies have also successfully shown that glycation and oxidation -the age-dependent chemical modification of collagen -are accelerated in diabetes; 5,6 glycation (or nonenzymatic glycosylation) is a post-translational modification of protein, which results from chemical reactions between glucose and certain amino groups in proteins, 7 this reaction then forming fructoselysine and fructosehydroxylysine in collagen, 7 after which further oxidation results in the formation of glycoxidation products such as N(carboxymethyl)lysine and N(carboxymethyl)hydroxylysine.…”

Thalidomide for the Treatment of Refractory Necrobiosis Lipoidica

“…Some leading theories suggest that NL is a cutaneous manifestation of diabetic microangiopathy, an immune complex vasculitis, abnormal production of collagen, or impaired neutrophil migration, leading to increased numbers of macrophages and granuloma formation. 3,4 Most patients with NL present with asymptomatic shiny patches on the skin that slowly enlarge over time. In most patients, the lesions of NL are multiple and bilateral, maintain a chronic course, and are usually not painful.…”