Actinic Reticuloid: An Immunohistochemical Study

Takigawa, Masaharu; Tokura, Y.; Shirahama, Shigeho; Sugimoto, Higashi; Yamada, Miki

doi:10.1001/archderm.1987.01660270028006

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…This phenomenon highlights their role as antigen-presenting cells and might indicate that cell-mediated immunologic processes play a role in the pathogenesis in AR. A prominence of CD8 + T cells in the peripheral blood mononuclear cells was described by Chu et al 39 and Takigawa et al 15 Similarly, we noted an inverse CD4:CD8 ratio commonly in our cases (36%). 36 The Langerhans cells were particularly present in the upper dermis as single cells, or more often in small or large clusters.…”

Section: Discussionsupporting

confidence: 87%

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Chronic Actinic Dermatitis/Actinic Reticuloid

Sidiropoulos

Deonizio

Martínez-Escala³

et al. 2014

The American Journal of Dermatopathology

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Chronic actinic dermatitis/actinic reticuloid (CAD/AR) is an eczematous hypersensitivity reaction to ultraviolet rays that can vary from mild eczematous cases to AR, the most severe cases which may resemble cutaneous T-cell lymphoma. Diagnosis is based on clinical, histopathologic, and photobiologic features. In this study, we characterize the histopathologic and immunohistochemical features of 40 biopsies from 37 patients with established CAD. The cohort included 30 men and 7 women, ranging in age from 38 to 84 years (median, 62 years) and with a median duration of symptoms at presentation of 3 years (range, 1 to 40 years). All patients presented with erythematous lichenified plaques on sun-exposed areas. Severe cases (12/37) had extension to non-exposed areas. Positive photo-testing (20/20) and patch-testing (10/10) results, and cases with a high peripheral blood eosinophila (7/24) and HIV positivity (4/37) were noted. Skin biopsies demonstrated eczematous features including parakeratosis, acanthosis, spongiosis, and prominent dermal fibroplasia. Dermal dendrocytes were prominent in all cases with frequent multinucleated giant cells positive for factor XIIIa and S100 protein. Most cases displayed a brisk lymphocytic infiltrate with subtle exocytosis, atypical lymphocytes, and increased numbers of Langerhans cells, eosinophils, and plasma cells. There was a predominance of CD8 T cells within the epidermis (20/25) and a low CD4:CD8 ratio was noted in 20 of 25 cases. T-cell clonality studies were negative in 10 of 10 cases. CAD/AR may be difficult to distinguish from eczematous variants of cutaneous T-cell lymphoma. Important clues to differentiate both conditions include the identification of prominent dermal dendrocytes with multinucleated giant cells, eosinophils, plasma cells, and a low CD4:CD8 ratio.

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Section: Discussionsupporting

confidence: 87%

“…1,4,5,13,[15][16][17][18][19][20] In this study, we describe our experience with 37 patients with CAD/AR. It was described as a severe photodermatitis, which clinically and pathologically can mimic CTCL.…”

Section: Discussionmentioning

confidence: 99%