Skin nerve fibres and their contacts with mast cells in patients with palmoplantar pustulosis.
Patients with palmoplantar pustulosis (PPP) frequently report that stress worsens their condition. A study was therefore made of the distribution and number of nerve fibres positive for protein gene product (PGP) 9.5 (a general nerve marker) and nerve fibres with substance P- and calcitonin gene-related peptide-like immunoreactivity in involved skin from patients with PPP and in skin from healthy controls. The number of mast cells in the papillary dermis was larger (P = 0.0003) in lesional palmar PPP skin than in control skin, and the number of contacts between mast cells and nerve fibres was significantly larger (P = 0.02) in PPP skin than in control skin. Image analysis of the nerve fibres around the sweat glands showed that the positively stained area as a percentage of the total area of the sweat gland (coil + surrounding nerves) was significantly lower in PPP skin (P = 0.0006). Furthermore, the nerves seemed to be fragmented. Neutrophils within and below the pustules and in the papillary dermis showed positive substance P staining. The increased number of contacts between nerves and mast cells in PPP skin and the intense substance P-like immunoreactivity of the neutrophils indicate that neuromediation may influence the inflammation in PPP, whereas the destruction of the nerve fibres around the sweat glands might be a result of the inflammation.
Department of Medical Sciences, Dermatology and Venereology, University Hospital, Uppsala, Sweden.
E
E
Hagforsen
K
K
Nordlind
G
G
Michaëlsson
D000328:Adult; D000368:Aged; D000943:Antigens, Differentiation / Q000032:analysis; D015740:Calcitonin Gene-Related Peptide / Q000032:analysis; D002452:Cell Count; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008407:Mast Cells / Q000166:cytology / Q000378:metabolism*; D008875:Middle Aged; D009412:Nerve Fibers / Q000378:metabolism*; D009504:Neutrophils / Q000378:metabolism; D011565:Psoriasis / Q000378:metabolism*; D012867:Skin / Q000294:innervation* / Q000378:metabolism; D013373:Substance P / Q000032:analysis; D013545:Sweat Glands / Q000294:innervation; D043222:Ubiquitin Thiolesterase
D000943:Antigens, Differentiation; D013373:Substance P; D043222:Ubiquitin Thiolesterase; D015740:Calcitonin Gene-Related Peptide