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Preliminary findings on the histopathology of chronic hand dermatitis
Author(s) -
Willis Carolyn,
Britton L,
Orton D
Publication year - 2004
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/j.0105-1873.2004.00309hj.x
Subject(s) - atopy , medicine , dermatology , atopic dermatitis , immunology , contact dermatitis , etiology , irritant contact dermatitis , allergy , physical examination , pathology , surgery
Chronic hand dermatitis is a common and distressing condition with a complex, multifactorial aetiology. In order to better understand its pathophysiology and hopefully improve diagnosis, we have begun a systematic histopathological study of various forms of hand dermatitis, with a particular emphasis on those in which exposure to irritants and allergens is strongly implicated. Suitable patients were recruited from amongst those presenting at the contact dermatitis clinic. Detailed past and present medical and personal histories, clinical examination, patch testing and prick testing were conducted in order to classify the eczema into one of several broad entities e.g. chronic irritant contact dermatitis (CICD), with or without atopy. After performing a range of bio‐engineering measurements on a pre‐selected affected area of the hand, biopsies were removed and processed for high resolution light microscopy and immunocytochemistry. Age/sex matched, healthy, non‐atopic individuals provided control skin from similar sites of the hand. Using a range of antibodies and quantification techniques, we examined the status and expression of certain immune‐associated cells and receptor/adhesion molecules. Of note amongst these, were the differences in epidermal CD1a+ cell density between groups. Non‐atopics with CICD, for example, had significantly fewer CD1a+ cells than both atopics with CICD and those with normal skin. CD54 (ICAM‐1) and several cytokine/chemokine receptors were more widely and strongly expressed by keratinocytes in those with an atopic diathesis. Although preliminary in nature at this stage, our results suggest that different forms of hand dermatitis display characteristic immunopathological features which may possibly be of diagnostic value.