title: Immunohistologic evaluation of the effect of cyclosporine treatment on the lichen planus immune infiltrate.
abstract: We have investigated immunohistologically the cutaneous immune infiltrate in the lesions of five patients with severe, extensive lichen planus of recent onset before and after 15 days of oral, low-dose cyclosporine therapy (3 mg/kg/day). Before therapy, we observed an abnormal bandlike cellular infiltrate localized in the papillary dermis, composed mostly of CD3+ cells, with a prevalence of CD4+ cells. Infiltrating lymphocytes showed markers of activation (HLA-DR antigens and interleukin 2 receptor), and there were many Langerhans (CD1+) cells in the dermal infiltrate. After 15 days of cyclosporine therapy, we observed a dramatic decrease in the total number of T cells and a corresponding decrease in interleukin 2 receptor-positive activated CD25+ cells and in antigen-presenting cells (CD1+ and CD14b+). These changes were concurrent with clinical improvement. Our results are compatible with the hypothesis that the inhibition of CD4 T cells by cyclosporine might explain the drug's therapeutic action and that the interaction between antigen-presenting cells and CD4 T cells is important in the pathogenesis of lichen planus.
authors.affiliation: Second Department of Dermatology, University of Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Mozzanica
authors.forename: A
authors.initials: A
authors.lastname: Cattaneo
authors.forename: A
authors.initials: A
authors.lastname: Legori
authors.forename: P
authors.initials: P
authors.lastname: Pigatto
authors.forename: A F
authors.initials: AF
authors.lastname: Finzi
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000032:analysis; D003524:Cyclosporins / Q000627:therapeutic use*; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D015603:Keratinocytes / Q000276:immunology; D007801:Langerhans Cells / Q000276:immunology; D008010:Lichen Planus / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000276:immunology* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D003524:Cyclosporins; D006684:HLA-DR Antigens