CD123 immunohistochemistry for plasmacytoid dendritic cells is useful in the diagnosis of scarring alopecia

Abstract

Our findings suggest that the presence and arrangement of CD123+ PDCs may assist in the diagnosis of scarring alopecia. We anticipate this will be of value in diagnosing challenging cases of highly inflammatory scarring alopecia.

Lupus erythematosus mimicking mycosis fungoides: CD123+ plasmacytoid dendritic cells as a useful diagnostic clue

“…In our case, the presence and distribution of CD123 + PDCs represented a helpful diagnostic tool. PDCs are bone‐marrow derived cells, typically absent in normal skin, that can be found in certain cutaneous lymphomas, such as blastic plasmocytoid dendritic cell neoplasm, and inflammatory dermatoses . PDCs are detected in skin biopsies by identifying immunohistochemically IL‐3 receptor α‐chain (CD123), which is a PDC surface receptor .…”

“…PDCs are detected in skin biopsies by identifying immunohistochemically IL‐3 receptor α‐chain (CD123), which is a PDC surface receptor . Recent studies have proposed the usefulness of CD123 immunohistochemistry in discriminating cutaneous lupus erythematosus (CLE) from other inflammatory dermatoses (Table ) . A high percentage of PDCs in the infiltrate, an arrangement in cell clusters and a perivascular, periadnexal or dermoepidermal junction (DEJ) distribution favor the former …”

“…PDCs are bone-marrow derived cells, typically absent in normal skin, that can be found in certain cutaneous lymphomas, such as blastic plasmocytoid dendritic cell neoplasm, and inflammatory dermatoses. 6 PDCs are detected in skin biopsies by identifying immunohistochemically IL-3 receptor α-chain (CD123), which is a PDC surface receptor. 7 In conclusion, the differentiation between MF and inflammatory skin diseases, such as CLE, may be a great diagnostic challenge in dermatology, requiring a skilled and trained dermatopathologist.…”

Cicatricial Alopecia Research Foundation meeting, May 2016: Progress towards the diagnosis, treatment and cure of primary cicatricial alopecias

“…Direct immunofluorescence labels linear and granular deposition of immun reactants (IgG, IgA, IgM, C3 and C1q) along the epidermal and follicular basement membranes. The presence and arrangement of CD123 + plasmacytoid dendritic cells may be useful to distinguish between forms of LE, LPP and CCCA …”

“…[16] Histologically, LE is very similar to LPP with a lymphocytic fol- plasmacytoid dendritic cells may be useful to distinguish between forms of LE, LPP and CCCA. [18] While the cause of LPP remains debated, bulge immune privilege collapse and inflammation-induced hair follicle stem cell death appear to be key components in the pathogenesis of LPP. [9,17] Transcriptome and immunohistochemical studies indicate a combination of processes may be involved including decreased expression of genes required for lipid metabolism and peroxisome biogenesis in LPP cases which was confirmed by progressive peroxisome loss, pro-inflammatory lipid accumulation and infiltration of inflammatory cells followed by destruction of the pilosebaceous unit.…”