Degranulation and shrinkage of dark cells in eccrine glands and elevated serum carcinoembryonic antigen in patients with acquired idiopathic generalized anhidrosis

Sakai, Kenji; Asahina, Masato; Uehara, Takeshi; Matsumoto, K; Araki, Nobuyuki; Okuyama, Ryuhei

doi:10.1111/jdv.14443

Cited by 15 publications

(14 citation statements)

References 25 publications

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“…Recently, elevated serum CEA has been reported in AIGA patients, 14,18 and our previous study confirmed the increase of serum CEA in more than 60% of AIGA patients (14/22 cases) 8 . Our AIGA patients showed low frequency of high serum CEA (3/8 CEA examined cases).…”

Section: Discussionsupporting

confidence: 86%

“…Previously, we reported dark cell changes such as shrinkage and degranulation at light microscopic level in AIGA patients 8 . In the current study, however, the clear cell damage revealed by electron microscopy was much more severe.…”

Section: Discussioncontrasting

confidence: 78%

“…suggested aberrantly high expression of CEA in eccrine glands of AIGA patients ( n = 10) based on the comparison with healthy controls, and other patients with atopic disease and urticaria. However, our previous data on CEA expression in the eccrine gland ( n = 12) was variable 8 . In addition, we found no significant tendency of high expression of CEA in non‐sweating skin in comparison with sweating skin in the same patient.…”

Section: Discussioncontrasting

confidence: 73%

“…Dermcidin, a dark cell‐specific marker, has been reported to be dramatically reduced in eccrine dark cells of AIGA patients 6,7 . We have also reported shrunken dark cells with a decrease of dermcidin in AIGA patients by comparing skin biopsies between non‐sweating and sweating‐preserved skin of the same patient 8 . Therefore, abnormal dark cells may contribute to anhidrosis caused by AIGA.…”

Section: Introductionmentioning

confidence: 59%

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Clear cell injury associated with reduced expression of carbonic anhydrase II in eccrine glands consistently occurs in patients with acquired idiopathic generalized anhidrosis

Sakai

Asahina

Uehara

et al. 2021

The Journal of Dermatology

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Acquired idiopathic generalized anhidrosis (AIGA) is characterized by anhidrosis/hypohidrosis without other autonomic and neurological dysfunctions. It has been believed that AIGA patients usually present no significant morphological alterations in the secretory portion of eccrine glands consisting of clear, dark and myoepithelial cells. However, we have recently revealed morphological damage of eccrine glands in AIGA patients by immunohistochemistry. Moreover, inhibitory side‐effects against carbonic anhydrase II (CA II) by the antiepileptic reagent topiramate have been reported to cause heat intolerance mimicking AIGA. To determine the precise morphological changes and CA II expression in eccrine glands of AIGA patients, electron microscopic observation and immunohistochemistry were applied to skin of both anhidrotic (non‐sweating) and normohidrotic (sweating‐preserved) sites, taken from each patient clinically diagnosed with AIGA. We found consistent clear cell injury in eccrine glands in anhidrotic skin samples of AIGA patients. Electron micrographs demonstrated edematous, swollen and destructive damage in clear cells of eccrine glands from non‐sweating areas of almost all AIGA patients. Immunohistochemically, clear cells showed reduced CA II expression that was heterogeneously distributed in non‐sweating skin. Some areas showed almost complete loss of CA II expression in spite of preserved dark cells, and others showed mild or moderate loss of it. Selective destruction of clear cells resulting in heterogenous atrophy in AIGA patients may be important to elucidate its etiology.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 78%

Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 59%

See 2 more Smart Citations

Clear cell injury associated with reduced expression of carbonic anhydrase II in eccrine glands consistently occurs in patients with acquired idiopathic generalized anhidrosis

Sakai

Asahina

Uehara

et al. 2021

The Journal of Dermatology

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“…A recent study proposed serum carcinoembryonic antigen (CEA) levels as a biomarker for the disease activity of acquired idiopathic generalized anhidrosis (AIGA) . One report showed that in AIGA patients, serum CEA is specifically elevated, relative to other adenocarcinoma tumor markers (CA19‐9 and CA125) .…”

Section: In This Study Elevated Serum Cea Has a Positive Predictive mentioning

confidence: 99%