title: A case of pretibial myxedema associated with Graves' disease: an immunohistochemical study of serum-derived hyaluronan-associated protein.
abstract: The myxomatous materials in cutis from a patient with pretibial myxedema (PTM) with Graves' disease were found to be mainly hyaluronic acid (HA), which had accumulated extensively in the upper dermis. Fibroblasts were increased in number in the mid to lower dermis. To clarify the mechanism of the deposition of HA in the dermis, we employed an antibody against serum-derived hyaluronan-associated protein (SHAP). This immunohistochemical study disclosed that the greater part of the fibroblasts in the mid to lower dermis stained positively, while the fibroblasts surrounded by fairly large amounts of HA in the upper dermis stained faintly or not at all. From these results, we suspect that the accumulation of HA progresses from the upper to the low dermis and that the interaction of fibroblasts and SHAP leads to development of the physiophathological cutaneous changes seen in our case.
authors.affiliation: Department of Dermatology, School of Medicine, Chiba University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Shishido
authors.forename: K
authors.initials: K
authors.lastname: Kuroda
authors.forename: R
authors.initials: R
authors.lastname: Tsukifuji
authors.forename: M
authors.initials: M
authors.lastname: Fujita
authors.forename: H
authors.initials: H
authors.lastname: Shinkai
mesh_terms: D005347:Fibroblasts / Q000737:chemistry / Q000473:pathology; D006111:Graves Disease / Q000150:complications / Q000276:immunology*; D006801:Humans; D018960:Hyaluronan Receptors / Q000276:immunology*; D006820:Hyaluronic Acid / Q000032:analysis; D007124:Immunoenzyme Techniques; D007868:Leg Dermatoses / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009230:Myxedema / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D012867:Skin / Q000737:chemistry / Q000473:pathology
chemical_list: D018960:Hyaluronan Receptors; D006820:Hyaluronic Acid