Role of Immunohisto Chemistry and its Correlation with Histopathological Grading and Severity of Psoriatic Disorder
- 1. Assistant professor, Department of Pathology, Government Medical College, Namakkal, Tamilnadu, India
- 2. Assistant Professor, Department of Pathology, Government Dharmapuri Medical College, Dharmapuri, Tamilnadu, India
Description
Introduction: Skin diseases are the leading cause of non-fatal burden of diseases in India. Psoriasis is one of the main dermatological disorder with psychological distress. Psoriasis is a chronic, disfiguring, inflammatory dermatosis in which both genetic and environmental influences have a critical role. Psoriasis is a complex Tcell mediated disorder characterized by presence of CD4+ and CD8+ T cells in dermis and epidermis, T cell activation is followed by cytokine release leads to cascade of reaction including abnormal keratinocyte proliferation, neutrophil migration, potentiation of Th1 cell response and angiogenesis. Vascular alteration observed in lesions are considered to be most important feature of the disease. Angiogenesis plays an important role by promoting inflammation through recruitment of inflammatory cells. Angiogenesis in skin lesions and activation of endothelial cells via cytokines form a bridge between altered keratinocytes and immunological component of the disease. The study was done to represent the importance of angiogenesis in disease process and its implication in the disease severity. Aims and Objectives: 1) To study the histomorphological features of psoriasis. 2) To assess the expression of monoclonal antibody CD34 with reference to severity of lesion. Material and Methods: This retrospective study includes 50 cases received from the dermatology outpatient clinic in Government Mohan kumaramangalam Medical College, salem from November 2018 to June 2020. Assesment of severity of the clinically confirmed cases was done using Psoriasis Assessment severity index (PASI) Score method. Punch biopsy was taken from the lesional area, the biopsy tissue was processed and stained with hematoxylin and eosin stain. After staining, the slides were examined under light microscope and various histological parameters were studied and observations were recorded. Followed by immunohistochemistry using CD34 was done. Using CD34 staining, Micro vessel Density (MVD) was evaluated with hot spot method. The score is calculated. Finally, the intensity of staining was compared and correlated with PASI score. Observation and Results: In the present study, Severity of psoriasis was assessed using PASI score. Out of 50 cases, 33 patients (66%) had score < 10 and 17 patients (34%) had PASI score > 10. In this study 66% of cases was graded as mild psoriasis and 34% were graded as moderate / severe type psoriasis. All the patients with severe degree of CD34 staining had moderate/severe degree of psoriasis. And two patients with moderate/severe degree of psoriasis had moderate (2+) degree of CD34 staining. Patients with mild degree of CD34 staining had a mild degree of psoriasis. Conclusion: With respect to Micro vessel density patients with PASI score > 10 had high intensity of CD34 staining as compared with patients with PASI < 10. Thus, signifying angiogenesis as most important factor contributing the clinical progression and severity of the lesion.
Abstract (English)
Introduction: Skin diseases are the leading cause of non-fatal burden of diseases in India. Psoriasis is one of the main dermatological disorder with psychological distress. Psoriasis is a chronic, disfiguring, inflammatory dermatosis in which both genetic and environmental influences have a critical role. Psoriasis is a complex Tcell mediated disorder characterized by presence of CD4+ and CD8+ T cells in dermis and epidermis, T cell activation is followed by cytokine release leads to cascade of reaction including abnormal keratinocyte proliferation, neutrophil migration, potentiation of Th1 cell response and angiogenesis. Vascular alteration observed in lesions are considered to be most important feature of the disease. Angiogenesis plays an important role by promoting inflammation through recruitment of inflammatory cells. Angiogenesis in skin lesions and activation of endothelial cells via cytokines form a bridge between altered keratinocytes and immunological component of the disease. The study was done to represent the importance of angiogenesis in disease process and its implication in the disease severity. Aims and Objectives: 1) To study the histomorphological features of psoriasis. 2) To assess the expression of monoclonal antibody CD34 with reference to severity of lesion. Material and Methods: This retrospective study includes 50 cases received from the dermatology outpatient clinic in Government Mohan kumaramangalam Medical College, salem from November 2018 to June 2020. Assesment of severity of the clinically confirmed cases was done using Psoriasis Assessment severity index (PASI) Score method. Punch biopsy was taken from the lesional area, the biopsy tissue was processed and stained with hematoxylin and eosin stain. After staining, the slides were examined under light microscope and various histological parameters were studied and observations were recorded. Followed by immunohistochemistry using CD34 was done. Using CD34 staining, Micro vessel Density (MVD) was evaluated with hot spot method. The score is calculated. Finally, the intensity of staining was compared and correlated with PASI score. Observation and Results: In the present study, Severity of psoriasis was assessed using PASI score. Out of 50 cases, 33 patients (66%) had score < 10 and 17 patients (34%) had PASI score > 10. In this study 66% of cases was graded as mild psoriasis and 34% were graded as moderate / severe type psoriasis. All the patients with severe degree of CD34 staining had moderate/severe degree of psoriasis. And two patients with moderate/severe degree of psoriasis had moderate (2+) degree of CD34 staining. Patients with mild degree of CD34 staining had a mild degree of psoriasis. Conclusion: With respect to Micro vessel density patients with PASI score > 10 had high intensity of CD34 staining as compared with patients with PASI < 10. Thus, signifying angiogenesis as most important factor contributing the clinical progression and severity of the lesion.
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IJPCR,Vol15,Issue2,Article128.pdf
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Additional details
Dates
- Accepted
-
2023-02-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue2,Article128.pdf
- Development Status
- Active
References
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