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Biomedical subjects

G Kolde

Publications and source records attributed to G Kolde.

At least 19 recordsLinked to original sources

[Pseudoxanthoma elasticum. Clinically typical but frequently overlooked].

A 52-year-old man had small yellowish, striated or reticular papules since the age of 5 years. These appeared first on the large flexures, and later on the neck, abdomen, penis and the mucosa of the lips. He developed angina at the age of 47 years. A bypass operation, however, did not lead to complete regression of cardiac symptoms. Four years later, the vision in his right eye deteriorated because of arterial occlusion, and the patient was treated with laser coagulation; he was started on long-term treatment with acetylsalicylic acid (250 mg/d) and calcium dobesilate (1,500 mg/d). Despite this, the vision in his left eye also deteriorated progressively. Fundoscopy revealed bilateral pigmentary changes in the macular region, variations in the retinal arterial diameters and "angioid streaks". Pulses were absent in the right radial artery, the left posterior tibial artery and both dorsalis pedis arteries, but there were no trophic changes or symptoms. The serum total cholesterol (246 mg/dl), triglycerides (177 mg/dl) and LDL-cholesterol (193 mg/dl) were only slightly elevated. The diagnosis of pseudoxanthoma elasticum with typical changes in the elastic fibres was confirmed by elastin staining in a biopsy from one of the lesions.

Biopsy

Epidermal expression of the calcium binding surface antigen 27E10 in inflammatory skin diseases.

The expression of the heterodimeric complex of the calcium-binding proteins MRP-8 and MRP-14 was investigated in various inflammatory dermatoses using immunohistochemical staining with the monoclonal antibody 27E10. In addition to the inflammatory infiltrate, a positive staining was repeatedly found in the involved epidermis from patients with lichen planus, lupus erythematosus and psoriasis vulgaris, but not in normal skin epidermis and/or in epidermis from leucocytoclastic vasculitis patients. The keratinocytic expression of the 27E10 antigen was dissimilar to that of the MHC class-II molecules and the adhesion molecule ICAM-1. These data indicate that the 27E10 antigen is a distinct activation marker of inflammatory keratinocytes and may have proinflammatory properties.

Antigens, Surface

Immunohistological and immunoelectron microscopic identification of TNF alpha in normal human and murine epidermis.

The presence, distribution and cellular localization of tumour necrosis factor-alpha (TNF alpha) were investigated in normal human and murine epidermis using immunohistological and immunoelectron microscopic methods with monoclonal and polyclonal antibodies. The immunostaining revealed an intercellular plasma membrane and cytoplasmic labelling of the epidermal keratinocytes, but no labelling of Langerhans cells, melanocytes and Merkel cells. Large amounts of TNF alpha were regularly found in the sebaceous glands. These findings demonstrate that epidermal keratinocytes and especially sebocytes produce and release TNF alpha and that this keratinocyte-derived cytokine may be important for the structural and functional homeostasis of normal epidermis.

Adult

A novel monoclonal antibody to a distinct subset of cutaneous dendritic cells.

A monoclonal antibody was generated by immunizing rats with Langerhans cell (LC)-enriched epidermal cells obtained from BALB/c mouse earskin after epicutaneous application of the contact sensitizer 2,4-dinitrofluorobenzene (DNFB). The antibody 4F7 detects in normal mouse skin, few dermal cells showing the morphologic, phenotypic, and functional properties of accessory dendritic cells, but lacking Birbeck granules. The capacity to stimulate allogenic T cells in the mixed leucocyte reaction resembles that of freshly isolated LCs. After DNFB application, an increased number of 4F7+ dendritic cells are found in the dermis and, in addition, some labeled dendritic cells occur in the epidermis. Some of the latter cells exhibit cytoplasmic Birbeck granules. Remarkably, there is no increase of the 4F7+ cells in the regional lymph nodes after DNFB treatment. These data suggest that the 4F7 antibody labels distinct dendritic cells of the mouse skin that are involved in the mediation of contact sensitization and probably represent immature LCs.

Animals

Generalized lichenoid juvenile xanthogranuloma.

A generalized eruption of small, flat and shiny papules was observed in an otherwise healthy 6-month-old baby. The light and electron microscopical and immunohistological features of the self-healing lesions were consistent with juvenile xanthogranuloma and suggested an atypical lichenoid variant of this non-Langerhans cell histiocytosis.

Female

Induction of inflammatory cytokines in murine keratinocytes upon in vivo stimulation with contact sensitizers and tolerizing analogues.

In order to elucidate the role of keratinocytes (KCs) in the induction of contact sensitivity, we applied various contact sensitizers [2,4-dinitrofluorobenzene (DNFB), urushiol, 3-n-pentadecylcatechol (PDC), 4-ethoxymethylene-2-phenyloxazol-5-one (oxazolone)] and tolerizing compounds [2,4-dinitrothiocyanobenzene (DNTB), 5-methyl-3-n-pentadecyl-catechol (5-Me-PDC)] onto the earskin of non-sensitized Balb/c mice. In addition, we applied croton oil as a non-sensitizing, but stimulatory agent. Cytokine production was demonstrated by Northern blot hybridization of the total cellular RNA extracted from epidermal cells depleted by Langerhans cells and Thy 1+ dendritic cells using radiolabeled DNA probes encoding for the murine cytokines IL-1 alpha, -2, -3, -4, TNF alpha, IFN tau, GM-CSF and G-CSF. From all cytokines tested, TNF alpha and IL-1 alpha were markedly increased upon in vivo stimulation with contact sensitizers and also after application of croton oil. Both light and electron microscopic immunostaining with a polyclonal and monoclonal antibody demonstrated the presence of TNF alpha in the epidermis. This staining was most pronounced in KCs of the suprabasal epidermis upon application of contact sensitizers or croton oil, but not with tolerizing analogues. Using a functional assay significantly more TNF alpha was found in the supernatants of KCs treated in vitro with DNFB or LPS than with DNTB. GM-CSF was found in untreated epidermis as well as in stimulated cells. The results suggest that the sensitizing properties of contact sensitizers may partly be dependent on their ability to induce proinflammatory mediators. The induction and release of TNF alpha and IL-1 alpha in KCs by contact sensitizers may play an important role in the early response to immunogenic or inflammatory signals in vivo, whereby tolerance induction seems to be less dependent on these cytokines.

Animals

Dermal, serological and CSF changes in amyotrophic lateral sclerosis with and without intrathecal interferon beta treatment.

In 12 patients with amyotrophic lateral sclerosis (ALS) participating in a therapeutic trial with intrathecally applied human fibroblast interferon-beta (IFN-beta) and in 9 untreated ALS patients, we found significantly elevated circulating serum IgG immune complexes (CIC), quantitative immunoglobulin changes, and creatine kinase (CK) elevation; CK reached significantly more often pathological levels in non-bulbar disease. Dermal ultrastructural changes were equally present in all treated as well as untreated ALS patients. Some time ago IL-6 was quantitatively cleaned out of the Fiblaferon-preparation. Erythrocyte sedimentation rate (ESR) rose during intrathecal IFN therapy in 9/10 ALS patients. In 4/4 adequately monitored motoneuron patients, this elevation coincided with a decrease of serum CK, while ESR and CK did not correlate in 60 non-ALS non-IFN neurological controls. Collagen ultrastructure, CSF total protein or barrier function, immune complexes, immunoglobulin quantitation and serum CK may contribute to differentiated diagnosis and should be included in future study protocols.

Adolescent

Metastasizing eccrine porocarcinoma. Report of two cases with fatal outcome.

The clinical, histopathological and ultrastructural features of a metastasizing eccrine porocarcinoma are described in a 75-year-old woman and a 82-year-old woman. The previously not recognized tumors were identified by its distinct pattern of metastasis. Metastatic spreading was restricted for years to a circumscribed region of the skin. Histology and electron microscopy disclosed pronounced epidermotropism of the PAS-positive tumor cells. The characteristic pattern of dissemination obviously represents a homing phenomenon of the tumor cells derived from the intraepidermal sweat gland duct.

Adenoma, Sweat Gland

Autosomal dominant ichthyosis exfoliativa.

An unusual ichthyosiform dermatosis with circumscribed areas of blistering hyperkeratoses as well as scaly areas was observed in five consecutive generations of a German family. Light and electron microscopical studies revealed oedema of the keratinocytes in the upper epidermis but no defects of tonofilaments and keratohyalin granules. We suggest that this type of ichthyosis exfoliativa inherited as an autosomal dominant trait represents a new and distinct entity.

Adult

[Systemic proliferating angioendotheliomatosis].

A 75-year-old female patient with neurological disturbances and numerous erythematous skin infiltrates is presented. Angioendotheliomatosis proliferans systematisata was diagnosed on histological detection of intravascular tumour cells in the cutaneous blood vessels. On immunohistochemistry and electron microscopy, the mononuclear tumour cells were identified as atypical B-lymphocytes. Our results provide further evidence that angioendotheliomatosis proliferans systematisata is a malignant angiotropic lymphoma with neurocutaneous manifestation.

Aged

[Squamous epithelial carcinoma at the site of lichen ruber hypertrophicus of the glans penis].

Reports of cancer development in lichen planus mostly concern the oral erosive form. The reported frequency of malignant transformation ranges between less than 1% and 10%. There have been a few isolated observations of malignant transformation of cutaneous lichen planus. In these cases, the hypertrophic type located on the lower limbs predominated. We report an unusual case of squamous cell carcinoma developing on the glans penis in the presence of hypertrophic lichen planus. Systemic treatment of the lichen planus with dapsone, retinoids, corticosteroids and topical cyclosporin A failed to prevent this development.

Carcinoma, Squamous Cell

Naevus corniculatus: a new acantholytic disorder.

We describe a 33-year-old man with an unusual epidermal naevus that followed the lines of Blaschko. There were filiform hyperkeratoses, large cutaneous horns and lesions that resembled giant comedones and linear hyperkeratotic plaques. All of these lesions showed acantholysis without dyskeratosis. As the disorder is characterized by multiple small or large horn-like processes, we propose the term 'naevus corniculatus'.

Acantholysis

[Urticaria and mast cells in adolescence].

Adolescent patients are often affected by dermographic, cholinergic, cold or solar urticaria brought about by distinct physical stimulation. These physical forms of urticaria as well as cutaneous and systemic mastocytosis are due to the release of inflammatory mediators from the mast cells. As these diseases usually show characteristic cutaneous symptoms, they can easily be distinguished from other subtypes of urticarial reaction. In order to make the reader familiar with physical urticaria and mastocytosis, we describe the clinical features, pathogenic factors, and therapeutic possibilities of these disorders in adolescence.

Adolescent

Kaposi-like acroangiodermatitis in an above-knee amputation stump.

The clinical, histological and immunohistological features of a Kaposi-like acroangiodermatitis in an above-knee amputation stump are reported. There was no evidence for an underlying arteriovenous malformation and the irregular purple-blue skin lesions resulted from chronic circulatory disturbance of the distal stump caused by a poorly fitting suction-type prosthesis.

Acrodermatitis

Ultrastructural cytochemical visualization of chromium in the skin of sensitized guinea pigs.

Using a modified sulfide silver method for electron microscopy, the intraepidermal and intracellular localization of epicutaneously applied potassium dichromate was investigated at varying times in sensitized and nonsensitized guinea pigs. The hapten penetrated rapidly into the epidermis. There was a homogeneous extra- and intracellular staining of the keratinocytes in the upper epidermis. The basal and suprabasal cells, by contrast, exhibited a predominant extracellular and plasma membrane localization of the silver grains. This membrane staining pattern was also observed in the Langerhans cells showing cellular and endocytotic activation in the sensitized animals. No specific cellular uptake of the hapten by the Langerhans cells was found. These results demonstrate that the epicutaneous application of chromate resulted in a characteristic intraepidermal distribution which may be related to the epidermal conversion of the hexavalent chromate to the immunogenic trivalent form. Moreover, the absent intracellular localization of the hapten in the activated Langerhans cells supports the notion that contact allergens can be presented to T cells without prior intracellular processing.

Animals

Bone marrow findings in adult patients with urticaria pigmentosa.

In order to better assess the prognosis of adult patients with urticaria pigmentosa, 35 patients with generalized maculopapular skin lesions and biopsy-proved cutaneous mast cell increase had light and electron microscopic examinations of their bone marrow; 46% had an increased mast cell content that was focal in all but four patients. Additional frequent findings in this group were an increased cellularity, nuclear-cytoplasmic dissociation of maturation, eosinophilia, and macrophages that contained ingested nuclei. Similar changes were found in far fewer patients without increased marrow mast cells. Only one patient with massive cutaneous mastocytosis had mast cells with relatively large nuclei and immature granules in the extensively involved marrow. Repeated biopsies in this and in six other patients over 3 years showed no worsening of the marrow findings, and the clinical course of all patients was stable over up to 10 years of follow-up. The variable findings in the patients suggest that mastocytosis with cutaneous involvement is a heterogeneous disease where diverse stimuli may cause an increase of mast cells. The clinical course is, however, relatively stable.

Adult

Ultrastructural localization of 2,4-dinitrophenyl groups in mouse epidermis following skin painting with 2,4-dinitrofluorobenzene and 2,4-dinitrothiocyanatebenzene: an immunoelectron microscopical study.

The ultrastructural localization of 2,4-dinitrophenyl (DNP) groups in mouse epidermis after epicutaneous application of the contact sensitizer 2,4-dinitrofluorobenzene (DNFB) and the tolerogen 2,4-dinitrothiocyanatebenzene (DNTB) was investigated at varying times using immunoelectron microscopy with the protein A - gold technique. After application of DNFB, there was a homogenous cytoplasmic labeling of all epidermal cells. The intracellular localization of the DNP groups was not restricted to cytoplasmic organelles belonging to the endocytotic - lysosomal system. The numerous endocytotic organelles, Birbeck granules, and lysosomes of the Langerhans cells (LCs) typically observed after application of contact sensitizers also did not show an increased number of gold particles. Skin painting with DNTB resulted in a similar distribution and time-course of immunolabeling, but this compound did not induce cellular and the endocytotic activation of LCs as seen after DNFB application. These results demonstrate that contact sensitizers do not require specific cellular uptake and intracellular processing by the endocytotic - lysosomal compartment of the LCs before membrane presentation. However, a cellular and endocytotic activation of the LCs by haptens may be an important mechanism for T effector cell activation.

Animals

Interferon gamma is a marker for histiocytosis X cells in the skin.

In histiocytosis X (HX), which is regarded as a proliferative disease of Langerhans cells (LCs), the tumor cells share characteristic membrane antigens and ultrastructural features with normal LCs. To the present no markers have been described which distinguish HX cells from normal epidermal LCs. Here we report on the selective reactivity of HX cells with a monoclonal antibody against interferon gamma (IFNg). Our results show that HX cells share an epitope with human IFNg while normal LCs do not. It remains to be established whether the expression of IFNg is specific for HX cells or rather characterizes a certain activation state of LCs.

Antigens, Surface