Lymphangiectases Are Common Underlying Warts and in Normal Peritumoral Skin: Histologic Evidence of Decreased Immune Surveillance

Paul, Joan

doi:10.1097/dad.0b013e3181ef2d65

Cited by 25 publications

(23 citation statements)

References 59 publications

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“…The acquisition of solar elastotic material also disrupts lymphatic drainage, which may also play a role in decreased immunity [32]. We found that tumors removed from the head and neck expressed lower levels of CD3ε, CD25, ICAM-1, and IFN-γ mRNA compared to tumors from other sites.…”

Section: Discussionmentioning

confidence: 73%

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

et al. 2011

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BackgroundBasal cell carcinoma (BCC) tumors are the most common skin cancer and are highly immunogenic.ObjectiveThe goal of this study was to assess how immune-cell related gene expression in an initial BCC tumor biopsy was related to the appearance of subsequent BCC tumors.Materials and MethodsLevels of mRNA for CD3ε (a T-cell receptor marker), CD25 (the alpha chain of the interleukin (IL)-2 receptor expressed on activated T-cells and B-cells), CD68 (a marker for monocytes/macrophages), the cell surface glycoprotein intercellular adhesion molecule-1 (ICAM-1), the cytokine interferon-γ (IFN-γ) and the anti-inflammatory cytokine IL-10 were measured in BCC tumor biopsies from 138 patients using real-time PCR.ResultsThe median follow-up was 26.6 months, and 61% of subjects were free of new BCCs two years post-initial biopsy. Patients with low CD3ε CD25, CD68, and ICAM-1 mRNA levels had significantly shorter times before new tumors were detected (p = 0.03, p = 0.02, p = 0.003, and p = 0.08, respectively). Furthermore, older age diminished the association of mRNA levels with the appearance of subsequent tumors.ConclusionsOur results show that levels of CD3ε, CD25, CD68, and ICAM-1 mRNA in BCC biopsies may predict risk for new BCC tumors.

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Section: Discussionmentioning

confidence: 73%

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

et al. 2011

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“…In fact, in normal perimelanoma skin, lymphatic vessels are significantly dilated compared with normal skin surrounding nonmelanoma skin cancers and benign skin tumors attesting to impeded lymphatic drainage and compromised lymphatic function [30]. Thus, we conclude that impaired lymphatic function in the elderly may prevent melanoma cells from trafficking to the SLN, but also may …”

Section: Discussionmentioning

confidence: 93%

Tumor-infiltrating lymphocyte response in cutaneous melanoma in the elderly predicts clinical outcomes

Grotz

Vaince

Hieken³

2013

Melanoma Research

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Tumor-infiltrating lymphocytes (TILs) and regression are manifestations of the host immune response to tumor, but their influence on outcome remains undefined. There is a paucity of data on the elderly who represent a growing proportion of melanoma patients. The aim of this study was to evaluate the influence of TILs and regression as an indirect measure of immunity on outcome in elderly patients with melanoma. From a prospective database, we identified 250 consecutive cutaneous melanoma patients aged at least 65 years at the time of diagnosis. Data were verified by record review. Within the primary melanoma, a brisk TIL response was present in 66 (31%), nonbrisk TILs in 36 (17%), and absent in 111 (52%). The presence of a brisk infiltrate conferred a three-fold increased risk of sentinel lymph node (SLN) metastasis (P=0.02). Despite this, nonbrisk or absent TILs were associated with a five-fold increased risk of recurrence (P=0.0001). In multivariate analysis, nonbrisk or absent TILs were independently associated with recurrence (P<0.0001), diminished 5-year disease-free survival (76 vs. 91%, P=0.0006), and 5-year melanoma-specific survival (82 vs. 95%, P=0.0008). Regression was not an independent predictor of SLN metastasis, disease-free survival, or melanoma-specific survival. Our study demonstrates that an active antitumor immune response exists in elderly melanoma patients that, paradoxically, predicts both SLN metastasis and improved melanoma-specific outcomes. Further investigation to characterize this lymphocytic infiltrate and to confirm its clinical significance as a predictor of nodal status, patient outcome, and response to immunotherapy in elderly melanoma patients appears warranted.

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“…We found lymphangiectasias in the surrounding dermis, suggesting local lymphostasis and decreased immune surveillance as postulated by Paul and Carlson. 16 The fibrosis in LCFV may contribute to a maladaptive immune reaction that prevents normal transport of foreign antigen to a draining lymph node. The absence of any reaction in a friend of the patient who received an identical tattoo at the same time indicates the importance of unique host factors in this reaction.…”

Section: Discussionmentioning

confidence: 99%

Localized Chronic Fibrosing Vasculitis in a Tattoo

Deeken

Jefferson

Hawkinson

et al. 2014

The American Journal of Dermatopathology

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Decorative tattoos are associated with a variety of adverse cutaneous reactions. We describe a unique fibrosing vasculitic reaction to red tattoo ink. The histopathology was similar to that in localized chronic fibrosing vasculitis (LCFV), but sharply limited to sites of red tattoo ink injection and associated with florid verrucoid epidermal hyperplasia. LCFV has been described in a broad variety of slowly progressive disorders with a firm consistency such as erythema elevatum diutinum, plasma cell granuloma, granuloma faciale, and IgG4-associated sclerosing diseases. It has been hypothesized that LCFV is the result of maladaptive immune reaction with failure to clear the causative antigen. To the best of our knowledge, this is the first case of LCFV associated with tattoo. We speculate on the implications our case holds for the pathogenesis of LCFV.

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Lymphangiectases Are Common Underlying Warts and in Normal Peritumoral Skin: Histologic Evidence of Decreased Immune Surveillance

Abstract: Minor trauma and solar elastosis from chronic ultraviolet radiation exposure are likely the etiologic factors in the development of lymphostasis. By decreasing immune surveillance, latent lymphedema ostensibly facilitates human papillomavirus infection and carcinogenesis.

Cited by 25 publications

References 59 publications

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

Tumor-infiltrating lymphocyte response in cutaneous melanoma in the elderly predicts clinical outcomes

Localized Chronic Fibrosing Vasculitis in a Tattoo

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