Morphological and immunological changes in the skin of autopsied women with AIDS.
Acquired immunodeficiency syndrome (AIDS) is characterized by decreased immunity, making a patient more susceptible to opportunistic infections which can have cutaneous manifestations. The aim of this study was to evaluate the local immunity of the skin through morphological and immunohistochemical analysis. Skin samples of 52 women, 27 without AIDS and 25 with AIDS, autopsied in an academic referral hospital in Brazil were evaluated. The autopsy reports and medical records were reviewed, and histochemical Hematoxylin-eosin, Picrosirius red, and Verhoeff stains as well as morphometric (Image J and KS-300 Kontron-Zeiss) and immunohistochemical (S-100 and anti-IgA) analyses of the skin were performed. Women with AIDS presented a thinner epidermis than women without AIDS (33.33 [12.00-317.66] vs 67.42 [12.00-530.02] μm; p < 0.001), with a lower number of epithelial cell layers (4.00 [2.00-11.00] vs 4.00 [2.00-16.00]; p < 0.001), a smaller cell diameter (12.92 [6.00-28.87] vs 24.32 [6.00-33.12] μm; p < 0.001), and a lower number of Langerhans cells (LC) (12.58 [0.00-81.74] vs 31.44 [0.00-169.77] LC/mm(2); p < 0.001). The dermis contained more collagen fibers (8.20 % [2.40-19.40] vs 6.30 % [0.40-13.90]; p < 0.001). Some of these parameters were negatively correlated with viral load and positively correlated with the number of CD4+ T-lymphocytes. We conclude that a decrease of the local skin immunity in women with AIDS may contribute to the development of skin lesions.
General Pathology Division, Triangulo Mineiro Federal University, Rua Frei Paulino 30, Bairro Abadia, CEP: 38025-180, Uberaba, Minas Gerais, Brazil.
Renata Beatriz
RB
Silva
Laura Penna
LP
Rocha
Laís Resende Cardoso
LR
de Souza
Humberto Aparecido
HA
Faria
Janaínna Grazielle Pacheco
JG
Olegário
Maria Helena
MH
Soares
Mara Lúcia Fonseca
ML
Ferraz
Rosana Rosa Miranda
RR
Corrêa
Vicente de Paula Antunes
Vde P
Teixeira
Camila Lourencini
CL
Cavellani
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology* / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D001344:Autopsy; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D002452:Cell Count; D004817:Epidermis / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006678:HIV / Q000302:isolation & purification; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000276:immunology* / Q000473:pathology*; D019562:Viral Load; D055815:Young Adult