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Erythema Toxicum Neonatorum: An Immunohistochemical Analysis
Author(s) -
Marchini Giovanna,
Ulfgren AnnKristin,
Loré Karin,
Ståbi Berit,
Berggren Veronica,
LonneRahm Solbritt
Publication year - 2001
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1046/j.1525-1470.2001.018003177.x
Subject(s) - medicine , erythema , chemokine , proinflammatory cytokine , skin biopsy , cell adhesion molecule , immunology , pathology , cd14 , dermis , immune system , inflammation , biopsy
Erythema toxicum neonatorum is a benign rash of unknown etiology, present to various degrees in most term newborns and characterized by an accumulation of eosinophils in dermal lesions. The recruitment of leukocytes to tissues implicates the involvement of adhesion molecules, cytokines, and chemokines. We therefore performed immunohistochemistry on punch biopsy specimens from cutaneous lesions of ten 1‐day‐old infants with erythema toxicum using specific monoclonal antibodies directed against a variety of adhesion molecules, cytokines, chemokines, and cell type‐specific membrane markers. Biopsy specimens of noninflamed skin from four matched newborns and four adults served as controls. The immunohistologic features of erythema toxicum in all 10 infants included a strong staining of the adhesion molecule E‐selectin in the vessel wall and the presence of numerous inflammatory cells that were identified as dendritic cells (CD1a, CD83, HLA‐DR, CD40, and ICAM‐1 positive), eosinophils (EG2 positive), neutrophils (CD15 positive), macrophages (CD14, CD68, and Mac387 positive), and E‐selectin‐expressing cells. Furthermore, the lesions showed a high incidence of the proinflammatory cytokines interleukin (IL)‐1α and IL‐1β and of the chemokines IL‐8 and eotaxin. This immunologic activity was reduced or absent in noninflamed skin from newborn controls and adults. We conclude that there is an accumulation and activation of immune cells in the lesions of erythema toxicum, also present in noninflamed skin of 1‐day‐old infants, but to a lower level. The physiologic significance of the rash remains to be elucidated.