Retinoids strongly and selectively correlate with keratin 13 and not keratin 19 expression in cutaneous warts of renal transplant recipients.
OBJECTIVE
To compare the expression of keratin (K) 13 and K19 in cutaneous warts of renal transplant recipients (RTRs) and immunocompetent individuals (ICIs).


METHODS
Retrospective, nonrandomized immunohistochemical study.


METHODS
Specimens from cutaneous warts of RTRs and ICIs were retrieved from the archives of the Department of Pathology, University Medical Center St Radboud, Nijmegen, the Netherlands. Twenty-one warts from RTRs and 21 from ICIs were examined. Nine RTRs (10 specimens) received either systemic acitretin or topical all-trans retinoic acid, and their effect on both keratins was assessed.


METHODS
Frequency and expression patterns of K13 and K19 in warts of RTRs vs ICIs and the effect of retinoids.


RESULTS
A significantly higher percentage of warts of RTRs expressed K13 compared with warts of ICIs (86% vs 14%, 18 vs 3 cases, respectively; P<.001). In warts of RTRs, retinoid treatment correlated significantly with a particularly strong, segmental K13 expression pattern, which we termed zebroid. Without use of retinoids, K13 was mostly restricted to suprabasal single cells. Keratin 19 was absent in all warts of both patient groups.


CONCLUSIONS
Retinoids strongly correlate with K13 in a characteristic zebroid pattern in warts of RTRs, making K13 a sensitive marker for retinoid bioactivity in skin (lesions) of RTRs. In non-retinoid-treated RTRs, K13 is also frequently found in warts but without the dramatic zebroid pattern noted in retinoid-treated warts.
Blokx
Willeke A M
WA
Department of Pathology, University Medical Center St Radboud, PO Box 9101, 6500 HB Nijmegen, the Netherlands. w.blokx@pathol.azn.nl
Smit
Jurgen V
JV
de Jong
Elke M G J
EM
Link
Monique M G M
MM
van de Kerkhof
Peter C M
PC
Ruiter
Dirk J
DJ
D017255:Acitretin / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D046508:Culture Techniques; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis* / Q000187:drug effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012871:Skin Diseases / Q000188:drug therapy* / Q000473:pathology*; D014860:Warts / Q000188:drug therapy* / Q000473:pathology*
D007633:Keratins; D017255:Acitretin