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Electron microscopical study of psoriasis pustulosa

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Summary

Five cases of psoriasis pustulosa were examined by electron microscopy. The main features within the dermis were dilated capillaries filled with polymorphonuclear leukocytes and red cells. Neutrophils passed out of the vessels through the gaps and fenestrations and migrated towards the epidermis throughout the distinctly edematous corium. Lymphatic vessels could be found. Histiocytes containing Langerhans granules were observed in the dermis and epidermis. The morphological changes of the epidermis depented on the place examined and were most evident near fully developed pustules in the upper layers. The presence of previously described morphological findings could be confirmed. Perinuclear cytolysis and other changes in the keratinocytes, however, seem to be secondary, resulting from edema and accumulation of neutrophils within the epidermis. Immunological phenomenona may be responsible for the latter event.

Zusammenfassung

Fünf Fälle von Psoriasis pustulosa wurden elektronenmikroskopisch untersucht. Die Hauptveränderungen im Corium bestanden in Capillardilatation mit intravasculären polymorphonukleären Leukocyten und Erythrocyten. Leukocyten traten durch die vasculären Spalten und Fenestrationen und wanderten durch das deutlich ödematöse Corium zur Epidermis. Lymphgefäße fanden sich ebenfalls. Histiocyten mit Langerhansgranula wurden in der Dermis und Epidermis beobachtet. Die morphologischen Veränderungen in der Epidermis waren abhängig von der Lokalisation und besonders stark ausgeprägt in der Nähe von voll entwickelten Pusteln in höheren Zellschichten. Früher beschriebene Befunde konnten bestätigt werden. Perinukleäre Cytolyse und andere Veränderungen in den Keratinocyten scheinen sekundär aufgrund des Ödems und der Ansammlung von Neutrophilen innerhalb der Epidermis zu entstehen. Immunologische Phänomene könnten hierfür verantwortlich sein.

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Authors and Affiliations

  1. Department of Dermatology, University of Munich, Frauenlobstraße 11, D-8000, Munich 2, Federal Republic of Germany

    Otto Braun-Falco

  2. Fellow of the Alexander von Humboldt-Stiftung from Department of Dermatology, Warsaw Medical Academy, Poland

    Wojciech Maciejewski

Authors
  1. Otto Braun-Falco
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  2. Wojciech Maciejewski
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Supported by the Deutsche Forschungsgemeinschaft. The technical assistance of Mrs. I. Pfab is gratefully acknowledged

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Braun-Falco, O., Maciejewski, W. Electron microscopical study of psoriasis pustulosa. Arch. Derm. Res. 260, 167–178 (1977). https://doi.org/10.1007/BF00561411

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  • DOI: https://doi.org/10.1007/BF00561411

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