In situ characterization of cellular infiltrates in lupus vulgaris indicates lesional T-cell activation.
Skin biopsy specimens from nine patients with lupus vulgaris were examined in situ by means of monoclonal antibodies directed against phenotypes of lymphocyte subsets, Langerhans cells, HLA-DR antigens, and interleukin 2 receptor. The epidermis showed prominent changes, including intense expression of HLA-DR on keratinocytes, increase in epidermal cell layers, moderate to high Langerhans cell hyperplasia, and infiltration by CD3+ pan-T cells as well as CD8+ (cytotoxic/suppressor) and CD4+ (helper/inducer) T cells. The predominant lymphocyte in the dermal granulomas was the activated CD3+ T cell, expressing major histocompatibility complex class II antigens and interleukin 2 receptor. CD4+ and CD8+ cells were randomly distributed among the epithelioid cells, which showed intense staining for major histocompatibility complex class II antigens. In all except two patients, the CD4+ population was greater than that of the CD8+ cells. CD1+ Langerhans cells were scattered in moderate numbers in the dermal granulomas. Acid-fast bacilli were conspicuously absent in the biopsy specimens. These features suggest that T-cell activation and Langerhans cell hyperplasia are prominent features of dermal tuberculosis.
Department of Dermatology, Safdarjang Hospital, New Delhi, India.
V
V
Ramesh
B
B
Samuel
R S
RS
Misra
I
I
Nath
D000328:Adult; D000911:Antibodies, Monoclonal; D002648:Child; D004817:Epidermis / Q000473:pathology; D000939:Epitopes / Q000235:genetics; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D015603:Keratinocytes / Q000276:immunology / Q000473:pathology; D007801:Langerhans Cells / Q000473:pathology; D008177:Lupus Vulgaris / Q000473:pathology*; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015375:Receptors, Interleukin-2 / Q000032:analysis; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology*
D000911:Antibodies, Monoclonal; D000939:Epitopes; D006684:HLA-DR Antigens; D015375:Receptors, Interleukin-2