HLA Antigens in Lichen Sclerosus et Atrophicus

Purcell, Karla G.; Spencer, Linda V.; Simpson, Pippa; Helman, Sandra W.; Oldfather, John W.; Fowler, Joseph F.

doi:10.1001/archderm.1990.01670320067010

Cited by 44 publications

(16 citation statements)

References 12 publications

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“…The pathogeny of LSA is completely unknown. Genetic, hormonal and autoimmune factors [2, 3, 10, 11, 12, 13, 14]have been advocated. Pathological examination at early lesions of LSA shows hyperkeratosis, follicular plugging of the epidermis and vacuolar alteration of the basal layer.…”

Section: Discussionmentioning

confidence: 99%

Identification of TIA-1+ and Granzyme B+ Cytotoxic T Cells in Lichen sclerosus et atrophicus

Gross¹,

Wagner²,

Ugurel³

et al. 2001

Dermatology

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Background: The onset and persistence of cutaneous lichen sclerosus et atrophicus (LSA) are linked to the presence of an inflammatory infiltrate of CD3+ T cells that includes CD4+ and CD8+ cells. The functional relevance of the presence of these cells is unknown. Objective: The study intended to quantify resting and activated cytotoxic T cells in LSA lesions. Methods: Twenty patients with active LSA were studied. Skin-infiltrating T cells were immunohistologically characterized with antibodies against CD3, CD8, T-cell-restricted intracellular antigen (TIA-1) and granzyme B (GrB). TIA-1 labels cytotoxic granules of resting and activated T cells, whereas GrB designates activated cytotoxic T lymphocytes (CTL). Results: In all cases, numerous T cells were consistently found expressing cytotoxic granules. The results indicated a high number of infiltrating CD8+ TIA+ T cells. Furthermore, a notable number of GrB+ activated CTL associated with hydropic degeneration of the basal cell layer were found within the dermal infiltrate and at the dermoepidermal interface. Conclusion: This study shows that a high proportion of skin-infiltrating T cells in LSA has a potential cytotoxic function. The results indicate that hydropic degeneration of basal keratinocytes may at least partially be mediated by CTL-dependent mechanisms. Our data also indicate that a cell-mediated immune response may play an important role in the pathogenesis of the disease.

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Section: Discussionmentioning

confidence: 99%

Identification of TIA-1+ and Granzyme B+ Cytotoxic T Cells in Lichen sclerosus et atrophicus

Gross¹,

Wagner²,

Ugurel³

et al. 2001

Dermatology

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“…The aetiology of BXO remains obscure. Genetic factors have been implicated in association with HLA subtypes [2], which may explain our observation of brothers, or of fathers and sons, presenting with this condition. Several publications [3,4] including ours, noted an increased incidence of other auto‐immune type conditions (e.g.…”

Section: Introductionmentioning

confidence: 99%

The treatment of balanitis xerotica obliterans

Depasquale¹,

Park²,

Bracka³

2000

BJU International

286

240

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“…The aetiology of LS/BXO has yet to be determined and multiple theories have been proposed . Previous studies have identified an association between LS/BXO and systematic factors (autoimmune, genetic and/or hormonal) , as well as local causes (trauma, infection or radiation) . LS/BXO involvement of extragenital skin grafts used for genital reconstruction supports the theory that, when systematically predisposed skin is exposed to local factors of the genital region, the development of LS/BXO is induced .…”

Section: Discussionmentioning

confidence: 81%

Genital lichen sclerosus/balanitis xerotica obliterans in men with penile carcinoma: a critical analysis

et al. 2013

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What's known on the subject? and What does the study add?• The European Association of Urology guidelines identify lichen sclerosus (LS) as a strong risk factor for penile squamous cell carcinoma (pSCC). However, this statement is based on the findings of case-control studies (Level of Evidence 2a) and a direct causal relationship between LS/balanitis xerotica obliterans (BXO) and pSCC remains to be established. Firm guidelines with respect to the appropriate follow-up policy for LS/BXO are lacking, whereas the impact of synchronous LS/BXO on the prognosis of pSCC remains to be determined.• The presence of histologically-confirmed synchronous LS/BXO in patients diagnosed with pSCC is relatively high, although it is not associated with an increased risk of adverse histopathological features. LS/BXO can develop in extragenital skin grafts used for reconstruction after organ-sparing surgery for pSCC. Objectives• To determine the rate of lichen sclerosus/balanitis xerotica obliterans (LS/BXO) in patients with penile squamous cell carcinoma (pSCC) and establish whether the presence of LS/BXO is associated with adverse histopathological features of pSCC.• To report the phenomenon of LS involving non-genital skin grafts in patients who underwent organ-sparing surgery and split-skin graft (SSG) reconstruction Patients and Methods• Between January 2002 and January 2010, 223 men underwent surgical treatment for pSCC. • A group of 52 patients with histologically-confirmed synchronous LS was identified (group A; overall rate of LS/BXO = 23.3%) and compared with a group of patients without synchronous LS (group B; n = 171; 76.7%).• A subgroup of patients who underwent surgical excision and SSG reconstruction was also identified • The histology reports of graft biopsies obtained during follow-up were reviewed and the rate of LS involving the graft was also recorded. Results• Mean (range) age at diagnosis was 60.9 (34-81) years and 60.7 (28-89) years for groups A and B, respectively (P = 0.958).• The mean (range) duration of follow-up was 38.3 (4-92) months for group A and 45.5 (4-107) months for group B (P = 0.162) • No statistically significant differences were noted between groups A and B in terms of tumour grade (P = 0.091), stage (P = 0.697), presence of lymphovascular invasion (P = 0.333), histological subtype (P = 0.107), associated carcinoma in situ (P = 0.246) or nodal status at initial diagnosis (P = 0.555).• In the subgroup of 188 patients who underwent SSG reconstruction, 41 (21.8%) patients had histologically-confirmed synchronous LS; in this subgroup, 26 (13.8%) patients underwent graft biopsy during follow-up.• Genital LS involving the graft was identified in seven specimens, although none of these seven cases had associated recurrent pSCC. Conclusions• The presence of histologically-confirmed synchronous LS in patients with pSCC is relatively high but is not associated with increased rates of adverse histopathological features, including carcinoma in situ.• LS can develop in extragenital skin grafts, although i...

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HLA Antigens in Lichen Sclerosus et Atrophicus

Cited by 44 publications

References 12 publications

Identification of TIA-1+ and Granzyme B+ Cytotoxic T Cells in Lichen sclerosus et atrophicus

Identification of TIA-1+ and Granzyme B+ Cytotoxic T Cells in Lichen sclerosus et atrophicus

The treatment of balanitis xerotica obliterans

Genital lichen sclerosus/balanitis xerotica obliterans in men with penile carcinoma: a critical analysis

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