1887

Chapter 16 : Immune-Mediated Skin Diseases

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

Immune-Mediated Skin Diseases, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818012/9781555812027_Chap16-1.gif /docserver/preview/fulltext/10.1128/9781555818012/9781555812027_Chap16-2.gif

Abstract:

This chapter on immune mechanisms in skin diseases illustrates, in an organ system, the effects of various immune effector mechanisms. The skin is the largest organ of the body and the most common site for manifestations of immune reactions. Cytotoxic effects of antibodies to epithelial cell or basement membrane antigens could also produce separation and destruction of the cells or destruction of the basement membrane. The diseases listed in this chapter have complex features and most likely are due to an interplay of additional pathogenic mechanisms. Cytotoxic reactions produce blistering diseases, immune complex reactions, vascular lesions, anaphylactic reactions, whealing lesions, cell-mediated reactions, chronic infiltrative diseases, granulomatous reactions, and destructive mass lesions of the skin. Immune complex reactions are responsible for a variety of vascular reactions in the skin. Most lesions are secondary to deposition of immune complexes in dermal vessels. Wheal-and-flare reactions and urticarial skin eruptions are common occurrences, not only on contact with allergens but also during the course of infectious diseases or drug treatment. Skin reactions mediated by sensitized cells can be divided into those primarily due to T-cytotoxic (TCTL) cells and those mediated by T-delayed-type hypersensitivity (TDTH) cells. Granulomatous lesions in the skin result from the accumulation of macrophages and reactive fibrosis to poorly degradable phagocytosed debris. The reactions may be initiated by antibody to T cells reacting with antigen or to foreign bodies that are not immunogenic. A common manifestation of lesions of small vessels in the skin is purpura.

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 16.1
Figure 16.1

Diagrammatic representation of lesion location and deposits of immunoglobulin and complement cell infiltrates in some skin diseases.

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 16.2
Figure 16.2

Schematic drawing of the connecting structures of the skin. Depicted are basal cells overlying the papillary dermis with the basement membrane separating them. Morphologic structures are shown on the left: the proteins making up these structures are shown on the right. (Modified from J. Uitto and A. M. Christiano, J. Clin. Investig. 90:687, 1992.)

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555818012.chap16
1. Jordon, R. E. 1991. Immunologic Diseases of the Skin. Appleton & Lange, Norwalk, Conn.
2. Stone, J. 1985. Dermatologic Immunology and Allergy. The C. V. Mosby Co., St. Louis, Mo.
3. Bos, J. D. 1997. Skin Immune System, 2nd ed. CRC Press, Boca Raton, Fla.
4. Steinman, R. M. 1991. The dendritic cell system and its role in immunogenicity. Annu. Rev. Immunol. 9: 271 296.
5. Aoyama, Y.,, M. K. Owada,, and Y. Kitajima. 1999. A pathogenic autoantibody, pemphigus vulgaris-IgG, induces phosphorylation of desmoglein 3, and its dissociation from plakoglobin in cultured keratinocytes. Eur. J. Immunol. 29: 2233 2240.
6. Beutner, E. H.,, R. E. Jordon,, and T. P. Shorzelski. 1968. The immunopathology of pemphigus and bullous pemphigoid. J. Investig. Dermatol. 51: 63 80.
7. Ishii, K.,, M. Amagai,, A. Komai,, T. Ebihara,, T. P. Chorzelski,, S. Jablonska,, K. Ohya,, T. Nishikawa,, and T. Hashimoto. 1999. Desmoglein 1 and desmoglein 3 are the target autoantigens in herpetiform pemphigus. Arch. Dermatol. 135: 943 947.
8. Karpati, S.,, M. Amagai,, R. Prussick,, K. Cehrs,, and A. R. Stanley. 1993. Pemphigus vulgaris antigen, a desmoglein type of cadherin, is localized within keratinocyte desmosomes. J. Cell Biol. 122: 409 415.
9. Kowalczyk, A. P.,, E. A. Bornslaeger,, S. M. Norvell,, H. L. Palka,, and K. J. Green. 1999. Desmosomes: intercellular adhesive junctions specialized for attachment of intermediate filaments. Int. Rev. Cytol. 185: 237 302.
10. Riechers, R.,, J. Grotzinger,, and M. Hertl. 1999. HLA class II restriction of autoreactive T cell responses in pemphigus vulgaris: review of the literature and potential applications for the development of specific immunotherapy. Autoimmunity 30: 183 196.
11. Stanley, J. R. 1989. Pemphigus and pemphigoid as paradigms of organ-specific, autoantibody-mediated diseases. J. Clin. Investig. 83: 1443 1448.
12. Crowson, A. N.,, and C. M. Magro. 1996. The role of microvascular injury in the pathogenesis of cutaneous lesions of dermatomyositis. Hum. Pathol. 27: 15 19.
13. Hall, R. P. 1992. Dermatitis herpetiformis. J. Investig. Dermatol. 99: 873 881.
14. Magro, C. M.,, and A. N. Crowson. 1997. The immunofluorescent profile of dermatomyositis: a comparative study with lupus erythematosus. J. Cutan. Pathol. 24: 543 552.
15. Mascaro, J. M., Jr., G. Hausmann,, C. Herrero,, J. M. Grau,, M. C. Cid,, J. Palou,, and J. M. Mascaro. 1995. Membrane attack complex deposits in cutaneous lesions of dermatomyositis. Arch. Dermatol. 131: 1386 1392.
16. Ortonne, J.-P.,, and S. K. Bose. 1993. Vitiligo: where do we stand? Pigment Cell Res. 6: 61 72.
17. Scott, J. E.,, and A. R. Ahmed. 1998. The blistering diseases. Med. Clin. N. Am. 82: 1239 1283.
18. Volta, U.,, N. Molinare,, M. Fusconi,, F. Cassani,, and F. B. Bianchi. 1991. IgA antiendomysial antibody test: a step forward in celiac disease screening. Dig. Dis. Sci. 36: 752 756.
19. Lotta, T. M.,, C. Comacchi,, and I. Ghersetich. 1999. Cutaneous necrotizing vasculitis. Relation to system disease. Adv. Exp. Med. Biol. 455: 115 125.
20. Patterson, R.,, and A. Tripathi. 1999. Stevens-Johnson syndrome: getting ready for the year 2000 and beyond. Ann. Allergy Asthma Immunol. 83: 339 340.
21. Tan, E. M.,, and H. G. Kunkel. 1966. An immunofluorescent study of the skin lesions in systemic lupus erythematosus. Arth. Rheum. 9: 37 46.
22. Thomas, B. A. 1950. The so-called Stevens-Johnson Syndrome. Br. J. Med. 1: 1393.
23. Church, M. K.,, and G. F. Clough. 1999. Human skin mast cells: in vitro and in vivo studies. Ann. Allergy Asthma Immunol. 83: 471 475.
24. Cicardi, M.,, L. Bergamaschini,, M. Cugno,, A. Beretta,, L. C. Zingale,, M. Colombo,, and A. Agostini. 1998. Pathogenetic and clinical aspects of C1 inhibitor deficiency. Immunobiology 199: 366 376.
25. Greaves, M. 2000. Chronic urticaria. J. Allergy Clin. Immunol. 105: 664 672.
26. Grewe, M.,, C. A. Bruijnzeel-Koomen,, E. Schopf,, T. Thepen,, A. G. Langeveld- Wildschut,, T. Ruziecka,, and J. Krutmann. 1998. A role for Th1 and Th2 cells in the immunopathogenesis of atopic dermatitis. Immunol. Today 19: 359 361.
27. Karnam, U.,, and A. Rogers. 1999. Systemic mastocytosis. Dig. Dis. 17: 299 307.
28. Maurer, D.,, E. Fiebiger,, B. Reinger,, B. Wolff-Winiski,, M. H. Jouvin,, O. Kilgus,, J. P. Kinet,, and G. Stingl. 1994. Expression of functional high affinity immunoglobulin E receptors (FcϵRI) on monocytes of atopic individuals. J. Exp. Med. 179: 745 750.
29. Bedi, T. R.,, and H. Pinkus. 1976. Histopathologic spectrum of erythema multiforme. Br. J. Dermatol. 95: 243 250.
30. Budinger, L.,, and M. Hertil. 2000. Immunologic mechanisms in hypersensitivity reactions to metal ions. Allergy 55: 108 115.
31. Chosidow, O. 1994. Drug rashes: what are the targets of cell-mediated cytotoxicity? Arch. Dermatol. 130: 627 629.
32. Darragh, T. M.,, B. M. Egbert,, T. G. Berger,, and T. S. B. Yen. 1991. Identification of herpes simplex virus DNA in lesions of erythema multiforme by the polymerase chain reaction. J. Am. Acad. Dermatol. 24: 23 26.
33. Kohler, S.,, M. R. Hendrickson,, N. J. Chao,, and B. R. Smoller. 1997. Value of skin biopsies in assessing prognosis and progression of acute graft-versus-host disease. Am. J. Surg. Pathol. 21: 988 996.
34. McCracken, S. 1999. Latex glove hypersensitivity and irritation: a literature review. Probe 33: 13 15.
35. Miyauchi, H.,, H. Hosokawa,, T. Akaeda,, H. Iba,, and Y. Asada. 1991. T-cell subsets in drug-induced toxic epidermal necrolysis: possible pathogenic mechanism induced by CD8-positive T cells. Arch. Dermatol. 127: 851 855.
36. Nikaein, A.,, T. Poole,, R. Fishbeck,, G. Ordonez,, L. Dombrausky,, M. J. Stone,, R. H. Collins, Jr.,, and J. W. Fay. 1994. Characterization of skin-infiltrating cells during acute graft-versus-host disease following bone marrow transplantation using unrelated marrow donors. Hum. Immunol. 40: 68 76.
37. Paquet, P.,, A. Nikkels,, J. E. Arrese,, A. Vanderkelen,, and G. E. Pierard. 1991. Macrophages and tumor necrosis factor in toxic epidermal necrolysis. Arch. Dermatol. 127: 851 855.
38. Willis, C. M.,, C. J. M. Stephens,, and J. D. Wilkinson. 1991. Selective expression of immune-associated surface antigens by keratinocytes in irritant contact dermatitis. J. Investig. Dermatol. 96: 505 511.
39. Yoo, Y. H.,, B. S. Park,, D. Whitaker-Menezes,, R. Korngold,, and G. F. Murphy. 1998. Dermal dendrocytes participate in the cellular pathology of experimental acute graft-versus-host disease. J. Cutan. Pathol. 25: 426 434.
40. Arnason, B. G.,, and B. H. Waksman. 1964. Tuberculin sensitivity: immunologic considerations. Adv. Tuberc. Res. 13: 1.
41. Chase, M. C. 1976. Developments in delayed type hypersensitivity 1950-1975. J. Investig. Dermatol. 67: 136 148.
42. Paquet, P.,, and G. E. Peirard. 1997. Erythema multiforme and toxic epidermal necrolysis: a comparative study. Am. J. Dermatopathol. 19: 127 132.
43. Stone, N.,, S. Sheerin,, and S. Burge. 1999. Toxic epidermal necrolysis and graft vs. host disease: a clinical spectrum but a diagnostic dilemma. Clin. Exp. Dermatol. 24: 260 262.
44. Turk, J. L. 1975. Delayed Hypersensitivity, 2nd ed. Elsevier/North-Holland Publishing Co., Amsterdam, The Netherlands.
45. Epstein, W. L., 1983. Granulomatous inflammation in the skin, p. 21 59. In H. L. Ioachim (ed.), Pathology of Granulomas. Raven Press, New York, N.Y..
46. Stiltzbach, L. E. (ed.). 1976. Seventh International Conference on Sarcoidosis and Other Granulomatous Disorders. New York Academy of Sciences, New York, N.Y..
47. Turk, J. L.,, and A. D. M. Bryceson. 1971. Immunological phenomena in leprosy and related diseases. Adv. Immunol. 13: 209 266.
48. Adcock, D. M.,, J. Brozna,, and R. A. Marlar. 1990. Proposed classification and pathologic mechanisms of purpura fulminans and skin necrosis. Semin. Thromb. Hemostasis 16: 333 340.
49. Henoch, E. 1887. Über purpura fulminans. Berl. Klin. Wochenschr. 24: 8.

Tables

Generic image for table
Table 16.1

Comparison of immune-mediated skin reactionsa

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Generic image for table
Table 16.2

Cytokines produced by human keratinocytes in vitroa

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Generic image for table
Table 16.3

Immune mechanisms in some skin diseases a

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Generic image for table
Table 16.4

Level of lesions and connecting proteins in blistering skin diseases

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Generic image for table
Table 16.5

Classification of mastocytosis a

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16
Generic image for table
Table 16.6

Postulated pathogenic steps in psoriasis

Citation: Sell S. 2001. Immune-Mediated Skin Diseases, p 510-527. In Immunology, Immunopathology, and Immunity, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818012.ch16

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error