title: Allergic contact dermatitis in psoriasis patients: typical, delayed, and non-interacting.
abstract: Psoriasis is characterized by an apoptosis-resistant and metabolic active epidermis, while a hallmark for allergic contact dermatitis (ACD) is T cell-induced keratinocyte apoptosis. Here, we induced ACD reactions in psoriasis patients sensitized to nickel (n = 14) to investigate underlying mechanisms of psoriasis and ACD simultaneously. All patients developed a clinically and histologically typical dermatitis upon nickel challenge even in close proximity to pre-existing psoriasis plaques. However, the ACD reaction was delayed as compared to non-psoriatic patients, with a maximum intensity after 7 days. Whole genome expression analysis revealed alterations in numerous pathways related to metabolism and proliferation in non-involved skin of psoriasis patients as compared to non-psoriatic individuals, indicating that even in clinically non-involved skin of psoriasis patients molecular events opposing contact dermatitis may occur. Immunohistochemical comparison of ACD reactions as well as in vitro secretion analysis of lesional T cells showed a higher Th17 and neutrophilic migration as well as epidermal proliferation in psoriasis, while ACD reactions were dominated by cytotoxic CD8+ T cells and a Th2 signature. Based on these findings, we hypothesized an ACD reaction directly on top of a pre-existing psoriasis plaque might influence the clinical course of psoriasis. We observed a strong clinical inflammation with a mixed psoriasis and eczema phenotype in histology. Surprisingly, the initial psoriasis plaque was unaltered after self-limitation of the ACD reaction. We conclude that sensitized psoriasis patients develop a typical, but delayed ACD reaction which might be relevant for patch test evaluation in clinical practice. Psoriasis and ACD are driven by distinct and independent immune mechanisms.
authors: ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
authors: Maria
authors: M
authors: Quaranta
authors: ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
authors: Stefanie
authors: S
authors: Eyerich
authors: Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany.
authors: Bettina
authors: B
authors: Knapp
authors: Laboratory of experimental immunology, IDI-IRCCS, Rome, Italy.
authors: Francesca
authors: F
authors: Nasorri
authors: Laboratory of experimental immunology, IDI-IRCCS, Rome, Italy.
authors: Claudia
authors: C
authors: Scarponi
authors: ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
authors: Martina
authors: M
authors: Mattii
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Natalie
authors: N
authors: Garzorz
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Anna T
authors: AT
authors: Harlfinger
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Teresa
authors: T
authors: Jaeger
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Martine
authors: M
authors: Grosber
authors: ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
authors: Davide
authors: D
authors: Pennino
authors: Department of Dermatology, Venereology, and Allergology, University Medicine Goettingen, Goettingen, Germany.
authors: Martin
authors: M
authors: Mempel
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Christina
authors: C
authors: Schnopp
authors: Institute of Computational Biology, Helmholtz Center Munich, Neuherberg, Germany; Department of Mathematics, Technische Universität Munich, Garching, Germany.
authors: Fabian J
authors: FJ
authors: Theis
authors: Laboratory of experimental immunology, IDI-IRCCS, Rome, Italy.
authors: Cristina
authors: C
authors: Albanesi
authors: Laboratory of experimental immunology, IDI-IRCCS, Rome, Italy.
authors: Andrea
authors: A
authors: Cavani
authors: ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany.
authors: Carsten B
authors: CB
authors: Schmidt-Weber
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Johannes
authors: J
authors: Ring
authors: Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany.
authors: Kilian
authors: K
authors: Eyerich
mesh_terms: D000328:Adult; D000368:Aged; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D002465:Cell Movement; D049109:Cell Proliferation; D017449:Dermatitis, Allergic Contact / Q000235:genetics* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D004817:Epidermis / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005786:Gene Expression Regulation / Q000276:immunology*; D015894:Genome, Human / Q000276:immunology*; D055106:Genome-Wide Association Study; D006801:Humans; D007114:Immunization; D015603:Keratinocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D009532:Nickel / Q000276:immunology; D011565:Psoriasis / Q000235:genetics* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D058504:Th17 Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology
chemical_list: D009532:Nickel