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Int J Clin Exp Pathol. 2011 Jun 20;4(5):526-9. Epub 2011 Jun 3.

Subcorneal pustular dermatosis an immnohisto-pathological perspective.

Author information

1
Georgia Dermatopathology Associates, Atlanta, Georgia, USA; 2Diagnostic and Medical Clinic/Dermatology, Mobile,Alabama, USA. abreuvelez@yahoo.com

Abstract

Subcorneal pustular dermatosis (SPD) represents a chronic, relapsing sterile pustular eruption, involving the trunk and flexoral proximal extremities. A 54-year-old female presented with recurrent, flaccid pustules measuring several millimeters in diameter, on normal and mildly erythematous skin of the groin and submammary areas. Biopsies for hematoxylin and eosin (H&E) examination, direct immunofluorescence (DIF) and immunohistochemistry (IHC) analysis were performed. The H&E staining demonstrated typical features of SPD, including some damage within dermal pilosebaceous units subjacent to the subcorneal blistering process. DIF revealed strong deposits of immunoreactants IgG, IgM, fibrinogen and complement/C3, present in a shaggy pattern within the subcorneal disease areas; in focal, areas of the basement membrane junction and in focal pericytoplasmic areas of epidermal keratinocytes. IHC revealed strong positivity to HLA-DPDQDR, mast cell tryptase, CD68, and ZAP-70 in the subcorneal inflammatory infiltrate, and surrounding dermal blood vessels. Myeloperoxidase was also positive. Positive staining with the anti-ribosomal protein S6-pS240 at the edges of hair follicles and sebaceous glands subjacent to the subcorneal blisters was also noted.

CONCLUSIONS:

We conclude that this disorder may have several components in its etiopathology, including a possible restricted immune response and a possible genetic component; these possibilities warrant further investigation.

KEYWORDS:

HLA-DPDQDR; Subcorneal pustular dermatosis; ZAP-70; anti-ribosomal protein S6-pS240; mast cell tryptase

PMID:
21738824
PMCID:
PMC3127074
[Indexed for MEDLINE]
Free PMC Article

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