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Evaluation of ICAM ‐1 expression and vascular changes in the skin of patients with plaque, pustular, and erythrodermic psoriasis
Author(s) -
Bressan Aline L.,
Picciani Bruna L. S.,
AzulayAbulafia Luna,
FaustoSilva Anna K.,
Almeida Paula N.,
Cunha Karin S. G.,
Dias Eliane P.,
Carneiro Sueli
Publication year - 2018
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.13883
Subject(s) - psoriasis , medicine , skin biopsy , immunohistochemistry , pathology , dermis , immunostaining , pustular psoriasis , erythroderma , dermatology , biopsy
Background Psoriasis is a chronic inflammatory disease. Pustular, erythrodermic, and extensive plaque psoriasis are responsible for systemic complications. Systemic capillary leak syndrome is the complication with greater progression to death and occurs due to vascular changes. Purpose The aim of this study was to evaluate vascular changes through the expression of CD 34 and ICAM ‐1 in plaque, pustular, and erythrodermic psoriasis. Methods The sample consisted of seven patients with erythrodermic psoriasis, 24 with moderate‐severe plaque psoriasis, 14 with mild plaque psoriasis and 13 with pustular psoriasis. Patients were submitted to physical examination and skin biopsy for histopathological examination and immunohistochemical analysis with anti‐ CD 34 and anti‐ ICAM ‐1 antibodies. Subsequently, tissue fragments were organized by groups using the Tissue Macroarray (TMA) technique to perform immunohistochemistry. Results In 58 patients, analysis of vessels using anti‐ CD 34 demonstrated vascular immunostaining in superficial dermis and between dermal papillae. There were more blood vessels in erythrodermic psoriasis, followed by plaque psoriasis. In erythrodermic psoriasis, there were small and few tortuous blood vessels with great dilatation, while plaque psoriasis presented larger vessels that were less dilated and more tortuous. There was an intense and localized expression of ICAM ‐1 in endothelial and lymphocytic cells in all groups, with significant differences. Conclusions Vascular alterations are important in psoriasis, with an increase in the number of blood vessels and ICAM ‐1 overexpression, especially in erythrodermic form. Therefore, vascular changes and the expression of intercellular adhesion molecules could help to diagnose the erythrodermic form of psoriasis.