title: α-Synuclein inclusions in the skin of Parkinson's disease and parkinsonism.
abstract: OBJECTIVE
  The presence in the brain of α-synuclein containing Lewy neurites, or bodies, is the histological hallmark of Parkinson's disease (PD). The discovery of α-synuclein aggregates in nerve endings of the heart, digestive tract, and skin has lent support to the concept of PD as a systemic disease. Our goals were, first, to demonstrate the presence of α-synuclein inclusions in the skin and, second, to detect quantitative differences between patients with PD and atypical parkinsonism (AP).
  
  
  METHODS
  Skin biopsies were taken from 67 patients and 20 controls. The biopsies underwent immunohistochemistry (IHC) and immunofluorescence (IF) testing for α-synuclein, whereupon its presence was quantified as the percentage of positive cells. Patients were divided into those with PD and those with AP. AP patients included AP with neurodegenerative disease (proteinopathies) and secondary AP.
  
  
  RESULTS
  Sixty-seven patients (34 with PD) and 20 controls were recruited. In the PD group, α-synuclein was detected in 58% of the cells in the spinous cell layer (SCL), 62% in the pilosebaceous unit (PSU), and 58% in the eccrine glands (EG). The AP-proteinopathies group showed 7%, 7%, and 0% expression of α-synuclein, respectively. No expression was found in the skin of the control group.
  
  
  CONCLUSIONS
  The expression of α-synuclein in the skin was relatively high in the PD group, scarce in AP, and null for the individuals in the control group. While these findings require further confirmation, this minimally invasive technique may aid in the improvement of the accuracy of PD diagnoses.
authors.affiliation: Neurology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Rodríguez-Leyva
authors.affiliation: Instituto de Medicina Forense, Universidad Veracruzana Boca del Río, México.
authors.forename: Ana Laura
authors.initials: AL
authors.lastname: Calderón-Garcidueñas
authors.affiliation: Biochemistry Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: María E
authors.initials: ME
authors.lastname: Jiménez-Capdeville
authors.affiliation: Neurology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Ana Arely
authors.initials: AA
authors.lastname: Rentería-Palomo
authors.affiliation: Neurology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Héctor Gerardo
authors.initials: HG
authors.lastname: Hernandez-Rodriguez
authors.affiliation: Dermatology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Valdés-Rodríguez
authors.affiliation: Dermatology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Fuentes-Ahumada
authors.affiliation: Dermatology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Bertha
authors.initials: B
authors.lastname: Torres-Álvarez
authors.affiliation: Histology Deparment, Medicine Faculty, Universidad Autónoma de Nuevo León Nuevo León, México.
authors.forename: Julio
authors.initials: J
authors.lastname: Sepúlveda-Saavedra
authors.affiliation: Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León Nuevo León, Mexico.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Soto-Domínguez
authors.affiliation: Biochemistry Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Santoyo
authors.affiliation: Neurology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: José Ildefonso
authors.initials: JI
authors.lastname: Rodriguez-Moreno
authors.affiliation: Dermatology Department, Hospital Central "Dr. Ignacio Morones Prieto", Universidad Autónoma de San Luis Potosí San Luis Potosí, México.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Castanedo-Cázares