Upregulation of epidermal surface molecule expression in primary and ultraviolet-induced lesions of lupus erythematosus tumidus.
BACKGROUND
Lupus erythematosus tumidus (LET), a photosensitive skin disorder with characteristic clinical and histological features, has not been generally accepted as a subset of cutaneous lupus erythematosus (CLE).


OBJECTIVE
To analyse the expression of epidermal surface molecules in skin biopsy specimens from patients with LET and to relate the results to other variants of CLE, such as discoid lupus erythematosus (DLE) and subacute CLE (SCLE).


METHODS
In total, 45 patients with different subtypes of CLE were included in the study, and cryostat sections from primary and ultraviolet (UV) A- and UVB-induced skin lesions were investigated using immunohistochemical methods.


RESULTS
In contrast to healthy controls, skin lesions of LET showed upregulation of intercellular adhesion molecule-1 (ICAM-1) and histocompatibility class II molecules (HLA-DR), with an expression pattern resembling that seen in DLE and SCLE. Furthermore, staining with a monoclonal antibody against 27E10, a distinct marker for cell activation and differentiation, revealed intense focal or band-like labelling of all epidermal layers independent of the type of lesion.


CONCLUSIONS
Expression of epidermal surface molecules such as ICAM-1, HLA-DR and 27E10 is equally upregulated in primary and UV-induced lesions of patients with LET, DLE and SCLE. These results support our recent clinical findings that LET represents a distinct subset of CLE with a similar immunopathomechanism rather than a different disease.
Kuhn
A
A
Department of Dermatology, University of Düsseldorf, Düsseldorf, Germany. kuhnan@uni-muenster.de
Sonntag
M
M
Sunderkötter
C
C
Lehmann
P
P
Vestweber
D
D
Ruzicka
T
T
D000328:Adult; D000368:Aged; D000954:Antigens, Surface / Q000378:metabolism*; D004817:Epidermis / Q000378:metabolism*; D005260:Female; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D039841:Leukocyte L1 Antigen Complex; D008178:Lupus Erythematosus, Cutaneous / Q000209:etiology / Q000378:metabolism*; D008179:Lupus Erythematosus, Discoid / Q000378:metabolism; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism; D008875:Middle Aged; D019006:Neural Cell Adhesion Molecules / Q000378:metabolism; D010787:Photosensitivity Disorders / Q000378:metabolism*; D014466:Ultraviolet Rays / Q000009:adverse effects*; D015854:Up-Regulation
D000954:Antigens, Surface; D006684:HLA-DR Antigens; D039841:Leukocyte L1 Antigen Complex; D008562:Membrane Glycoproteins; D019006:Neural Cell Adhesion Molecules; D018799:Intercellular Adhesion Molecule-1