Unexpected diminished innervation of epidermis and dermoepidermal junction in lichen amyloidosus

Summary Background Lichen amyloidosus is a localized, chronic, pruritic skin disease characterized by deposition of amyloid in the papillary dermis. The pathogenesis of the pruritus of lichen amyloidosus is largely unknown. Objectives To determine any change in the nerve fibre density in lichen am...

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Published in:	British journal of dermatology (1951) Vol. 159; no. 2; pp. 403 - 406
Main Authors:	Maddison, B., Namazi, M.R., Samuel, L.S., Sanchez, J., Pichardo, R., Stocks, J., Maruziva, D., Yosipovitch, G.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-08-2008 Blackwell
Subjects:	Adolescent Adult Aged Aging - metabolism Amyloidosis Amyloidosis - metabolism Amyloidosis - pathology Biological and medical sciences Biomarkers - metabolism Dermatology Epidermis - innervation Epidermis - metabolism Female Humans lichen amyloidosus Male Medical sciences Metabolic diseases Middle Aged Nerve Fibers - pathology nerve fibre density Neurodermatitis - metabolism Neurodermatitis - pathology Other metabolic disorders pruritus Psoriasis. Parapsoriasis. Lichen Skin - innervation Skin - metabolism Ubiquitin Thiolesterase - metabolism Skin disease Dermoepidermal junction Dermatology Innervation lichen amyloidosus Metabolic diseases Epidermis Pruritus Enzymopathy Density skin innervation Lichen amyloidis Protein nerve fibre density Amyloidosis Skin Nerve fiber
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Summary:	Summary Background Lichen amyloidosus is a localized, chronic, pruritic skin disease characterized by deposition of amyloid in the papillary dermis. The pathogenesis of the pruritus of lichen amyloidosus is largely unknown. Objectives To determine any change in the nerve fibre density in lichen amyloidosus lesions as an explanation for itch. Methods Using an antibody to protein gene product (PGP) 9.5, the immunohistochemical analysis of the skin biopsies of 30 Hispanic patients with clinicopathologically proven lichen amyloidosus and of 11 healthy Hispanic controls matched for age, sex and site was performed. Results Unexpectedly, the mean amount of PGP9.5 stain, a measure for nerve fibre amount, for the healthy controls was higher than the lichen amyloidosus group both in the epidermis (P < 0·0019) and dermoepidermal junction (P < 0·0064). No change was observed in the papillary dermis. Furthermore, the proportion of area covered by PGP9.5 showed a significant decrease in the epidermis (P < 0·0024) and dermoepidermal junction (P < 0·0075) in lichen amyloidosus compared with healthy controls. Age, gender and body site were found not to be influencing factors in nerve fibre amounts in lichen amyloidosus samples. Conclusions We speculate that the severe pruritus observed in lichen amyloidosus might be the result of the hypersensitivity of the remaining nerve fibres as a response to an unexplained neurodegeneration of the absent nerve fibres.
Bibliography:	ArticleID:BJD8685 istex:08E717E34C8407C7045B3AA455176C08A14ED6F9 ark:/67375/WNG-3S4S37BX-0 Conflicts of interest None declared. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0007-0963 1365-2133
DOI:	10.1111/j.1365-2133.2008.08685.x