Retinoids Strongly and Selectively Correlate With Keratin 13 and Not Keratin 19 Expression in Cutaneous Warts of Renal Transplant Recipients

Abstract

To compare the expression of keratin (K) 13 and K19 in cutaneous warts of renal transplant recipients (RTRs) and immunocompetent individuals (ICIs). Design: Retrospective, nonrandomized immunohistochemical study. Patients and Methods: Specimens from cutaneous warts of RTRs and ICIs were retrieved from the archives of the Department of Pathology, University Medical Center St Radboud, Nijmegen, the Netherlands. Twentyone warts from RTRs and 21 from ICIs were examined. Nine RTRs (10 specimens) received either systemic acitretin or topical all-trans retinoic acid, and their effect on both keratins was assessed. Main Outcome Measures: Frequency and expression patterns of K13 and K19 in warts of RTRs vs ICIs and the effect of retinoids. Results: A significantly higher percentage of warts of RTRs expressed K13 compared with warts of ICIs (86% vs 14%, 18 vs 3 cases, respectively; PϽ.001). In warts of RTRs, retinoid treatment correlated significantly with a particularly strong, segmental K13 expression pattern, which we termed zebroid. Without use of retinoids, K13 was mostly restricted to suprabasal single cells. Keratin 19 was absent in all warts of both patient groups.

Systemic treatment of psoriatic patients with bexarotene decreases epidermal proliferation and parameters for inflammation, and improves differentiation in lesional skin

“…It is known that RAR-selective retinoids can induce keratin 13 expression in doses sufficient for clinical and immunohistochemical improvement. [11][12][13] In this study efficacy has been demonstrated for several immunohistochemical parameters of proliferation, differentiation, and inflammation, as well as for clinical parameters, including a modified PASI score and the plaque elevation score. Typical retinoid-associated adverse events, such as cheilitis and hyperlipidaemia, which were observed in some patients, strengthen the conclusion that bexarotene at the doses tested has activity in psoriasis.…”

Topical vitamin A treatment of recalcitrant common warts

“…HPV cannot complete its replication cycle in cultured cells suggesting that differentiation of epithelia cells in tissues is important for HPV production [26]. HPV replication appears to be synchronized with epithelial cell differentiation [27,28]. Vitamin A may disrupt the interplay of HPV replication and epithelial cell differentiation, thereby allowing normal tissue to replace the warts.…”

The Risk of High-Grade Squamous Intraepithelial Lesions in Women with Low Serum Levels of Vitamin A

“…Samples were measured in duplicate. The results were classified as subnormal (deficient: <20 μg/dl, and low: 10-19.9 μg/dl) and normal (acceptable: 20-49.9 μg/dl, and high: ≥50 μg/dl) as defined by the International Defense Committee on Nutrition [15]. …”