Psoriasis confined strictly to vitiligo areas--a Koebner-like phenomenon?
Vitiligo and psoriasis are both common skin disorders. However, psoriasis strictly confined to pre-existing vitiligo areas is rare and suggests a causal relationship. We report here on two patients with a strict anatomical colocalization of vitiligo and psoriasis. The histopathological examinations showed typical changes for both diseases together with a dense infiltrate of CD4+ and CD8+ T cells. By immunohistochemistry, intracytoplasmatic granzyme B and tumour necrosis factor alpha (TNF-alpha) were detected within the T-cell population, suggesting the functional activity of these cells and the creation of a local T helper 1 (Th1)-cytokine milieu. Additionally, in one patient we could identify anti-melanocytic T cells by tetramer staining and enzyme-linked immunospot (ELISPOT) analysis. These skin-infiltrating lymphocytes might trigger, by the local production of Th-1 cytokines such as TNF-alpha and interferon-gamma (IFN-gamma), the eruption of psoriatic plaques in patients with a genetic predisposition for psoriasis.
Berger
T G
TG
Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany. bergerts@web.de
Kiesewetter
F
F
Maczek
C
C
Bauer
N
N
Lueftl
M
M
Schuler
G
G
Simon
M
M
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D020022:Genetic Predisposition to Disease; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D013601:T-Lymphocytes / Q000166:cytology / Q000378:metabolism; D014820:Vitiligo / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology