Psoriasis confined strictly to vitiligo areas – a Koebner‐like phenomenon? |
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Authors: | TG Berger F Kiesewetter C Maczek N Bauer M Lueftl G Schuler M Simon Jr |
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Affiliation: | Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany. bergerts@web.de |
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Abstract: | Vitiligo and psoriasis are both common skin disorders. However, psoriasis strictly confined to pre-existing vitiligo areas is rare and suggests a causal relationship. We report here on two patients with a strict anatomical colocalization of vitiligo and psoriasis. The histopathological examinations showed typical changes for both diseases together with a dense infiltrate of CD4+ and CD8+ T cells. By immunohistochemistry, intracytoplasmatic granzyme B and tumour necrosis factor alpha (TNF-alpha) were detected within the T-cell population, suggesting the functional activity of these cells and the creation of a local T helper 1 (Th1)-cytokine milieu. Additionally, in one patient we could identify anti-melanocytic T cells by tetramer staining and enzyme-linked immunospot (ELISPOT) analysis. These skin-infiltrating lymphocytes might trigger, by the local production of Th-1 cytokines such as TNF-alpha and interferon-gamma (IFN-gamma), the eruption of psoriatic plaques in patients with a genetic predisposition for psoriasis. |
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Keywords: | antigen-specific T cells autoimmunity tetramer Th1 |
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