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Biomedical subjects

J Kanitakis

Publications and source records attributed to J Kanitakis.

At least 91 records · Page 5Linked to original sources
PubMed1997

Skin cancers in organ transplant recipients.

Organ transplant recipients on immunosuppressive therapy are prone to skin cancers, especially squamous cell carcinomas developing on sun-exposed areas. Their frequency increases with time after transplantation reaching 40-70% of the patients after 20 years. Squamous cell carcinomas tend to be multiple and may have a life-threatening course. Most studies concern kidney transplant recipients but new data are now available on recipients of other organs. Carcinogenic factors include mainly immunosuppressive treatments, UV light and human papillomaviruses; the role of genetic factors is more equivocal. Melanomas and other rare tumors such as Merkel cell tumors or sarcomas are also increased. Surgical excision with histological examination represents the treatment of choice. When lesions become multiple and/or aggressive, additional therapeutic methods are necessary, such as topical or oral retinoids and in some cases, reduction of the immunosuppressive treatment. Radiotherapy should be reserved to limited cases. Prevention must be undertaken by a regular dermatological examination and sun protection.

Carcinoma, Squamous Cell↗
PubMed1996

[Linear IgA bullous dermatosis in children with autoantibodies against 180 kDa pemphigoid antigen].

BACKGROUND: Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal blistering disease defined on the basis of direct immunofluorescence findings. CASE REPORT: An 18 month-old girl suffering from LABD was studied by indirect immunofluorescence on salt-split skin and by Western blot in an attempt to characterize the involved autoantigen. Direct immunofluorescence showed an exclusive linear IgA deposit at the dermal-epidermal junction. Indirect immunofluorescence revealed circulating autoantibodies that reacted with the epidermal side of salt-split skin; they reacted by Western blot with a 180 kDa epidermal antigen, as in bullous pemphigoid. CONCLUSION: This dermatosis fulfilling the clinical features and direct immunofluorescence criteria for childhood LABD seems to represent a case of IgA bullous pemphigoid. It further underscores the nosologic heterogeneity of LABD, which probably includes, apart from bullous pemphigoid, epidermolysis bullosa acquisita and cicatricial pemphigoid.

Autoantibodies↗
PubMed1996

Immunohistochemical study of CD34-positive dendritic cells of human dermis.

The human dermis contains a heterogeneous network of cells with a dendritic morphology, including factor XIIIa+ dermal dendrocytes and CD34+ dendritic cells located around epidermal adnexae. Whereas dermal dendrocytes have been immunohistochemically studied, CD34+ dermal cells have not yet been well characterized. We studied by simple and double immunolabeling techniques on tissue sections of normal human skin the phenotype of these cells and found them to express vimentin and Te7 but none of the remaining markers sought (factor XIIIa, von Willebrand factor, CD1a, CD3, CD4, CD8, CD14, CD25, CD36, CD45, CD54, CD56, LFA-1, EGF-R, S-100 protein, Mac 387, and muscle-specific actin). Rare CD34+ cells of the interstitial dermis expressed human leukocyte antigen (HLA)-DR antigens, but this was not the case for periadnexal CD34+ cells. These results show that CD34+ dendritic cells of human dermis are mesenchymal cells bearing a unique immunophenotype different from that of (myo)fibroblasts, monocytes-macrophages, Langerhans cells, and factor XIIIa+ dermal dendrocytes. Whereas the involvement of CD34+ cells in some cutaneous tumors is well known, their physiologic role in normal skin remains to be established. On the basis of our results, we speculate that these cells could represent uncommitted mesenchymal cells, unique by virtue of CD34 antigen expression.

Actins↗
PubMed1996

Kaposi's sarcoma after liver transplantation.

BACKGROUND: Kaposi's sarcoma (KS), is a known complication following kidney transplantation. It has been reported more rarely following liver transplantation. OBJECTIVE: To assess the clinico-epidemiologic data of KS after liver transplantation. METHODS: 150 liver graft recipients were examined; those presenting with KS were studied clinically, histologically and virologically. RESULTS: Three cases of KS were observed. The three patients had been treated with OKT3 antiserum in addition to the standard regimen. The delay of appearance varied from 5 to 36 months. Two patients had a few cutaneous lesions and 1 had more extensive involvement; none of them had visceral localizations. In 2 cases, herpesvirus-like DNA sequences were detected within the lesions. Therapy consisted in decreasing the immunosuppressive treatment, in association with alpha-interferon or vindesine in 2 cases, respectively. All patients were alive after a follow-up of 19-45 months. CONCLUSION: KS seems relatively frequent (2%) and appears within a short delay after liver transplantation; the prognosis may be more favourable than previously reported.

Adult↗
PubMed1996

Expression of the CD34 antigen distinguishes Kaposi's sarcoma from pseudo-Kaposi's sarcoma (acroangiodermatitis).

The differential diagnosis between Kaposi's sarcoma and the so-called 'pseudo-Kaposi's sarcoma' or acroangiodermatitis of the feet is often fraught with difficulty, not only on clinical but also on histological grounds. The aim of this study was to assess whether immunolabelling for the CD34 antigen, a marker of Kaposi's sarcoma cells, could be of value in the distinction between these two angioproliferative disorders. We comparatively examined 16 biopsy specimens from cases of Kaposi's sarcoma and seven biopsies from patients with pseudo-Kaposi's sarcoma, by a streptavidin-biotin-peroxidase method, using a monoclonal antibody to the CD34 antigen. All cases of Kaposi's sarcoma showed CD34 labelling both on endothelial cells and on the characteristic spindle-shaped, perivascular cells. Biopsies of pseudo-Kaposi's sarcoma showed a strong labelling of endothelial cells of hyperplastic vessels. However, in sharp contrast with Kaposi's sarcoma, a complete absence of perivascular CD34 expression was noted. It seems therefore that immunolabelling for the CD34 antigen appears to be a valuable tool in the differential diagnosis between Kaposi's sarcoma and pseudo-Kaposi's sarcoma.

Acrodermatitis↗
PubMed1996

[Transient bullous epidermolysis of the newborn infant. A benign clinical form of dystrophic bullous epidermolysis or an autonomous entity?].

INTRODUCTION: Transient bullous dermolysis of the newborn is a bullous eruption limited to friction zones. It appears at birth and disappears during the first months of life. CASE REPORT: Immediately after delivery, an infant girl presented cutaneous bullae on areas of trauma which spontaneously regressed after a few weeks. The histology examination confirmed subepidermal involvement (the roof of the bullae took up the anticollagen IV antibody) and ultrastructure anomalies in the baseline membrane: intracellular vacuoles in the keratinocytes containing fibrillary material, disorganization of the anchoring fibers. DISCUSSION: Transient bullous dermolysis of the newborn is a rare (less than 15 cases reported in the literature) benign disease which regresses spontaneously, possibly an explanation of the small number of cases reported. The anomalies in the ultrastructure observed in the baseline membrane strongly suggest transient impairment in collagen VII maturation and excretion. These anomalies are not pathognomonic and can be observed in dystrophic bullous epidermolysis. Currently there is no specific genetic marker to established transient bullous dermolysis as unique entity.

Epidermolysis Bullosa↗
PubMed1996

Comparative sensitivity of indirect immunofluorescence to immunoblot assay for the detection of circulating antibodies to bullous pemphigoid antigens 1 and 2.

The sera of 263 patients with bullous pemphigoid (BP) were tested by indirect immunofluorescence (IIF) on salt-split skin (SSS) and immunoblot (IB) assay, in order to assess the diagnostic sensitivity of these techniques. Among the 263 sera tested, 198 sera (75%) contained antibasement membrane zone antibodies demonstrable by IIF reacting to the epidermal (98%) or both the dermal and epidermal sides (2%) of SSS. One hundred and eighty-two of the 263 sera (69%) reacted by IB with BP antigens (Ag), most commonly the BPAg1 (93 cases, 51%), and a complex of BPAg1 and the 180 kDa minor BP antigen (BPAg2) (47 cases, 26%). BPAg2 alone was found in 42 cases (23%). A good correlation was found between the detection of autoantibodies by IIF and labelling of BPAg1 and/or BPAg2 by IB assay, in which 152 of 198 sera with an epidermal pattern in IIF identified a BP antigen. IB analysis of the 65 sera negative by IIF yielded positive results in 30 cases (46%). Thirty-one percent (13 of 42) of sera recognizing by IB BPAg2, were negative by IIF, as compared with 12% (11 of 93) of those recognizing BPAg1 (P < 0.01). Comparing the sensitivity of the two tests, IIF (75%) was found to be more sensitive than IB (69%). Thirty-five of the 263 sera (13%) remained negative by both techniques. It can be concluded from this study that IIF on SSS appears to be a sensitive and reliable assay for screening BP; IB should be performed for the sera that are negative by IIF as it may reveal circulating antibodies, particularly to BPAg2.

Adult↗
PubMed1995

Altered expression of a new antigen of the dermal-epidermal junction (NU-T2 DEJ Ag) in junctional epidermolysis bullosa.

NU-T2 antigen (Ag) is a new and recently described antigen of the dermal-epidermal junction, recognized by an anti-CD1b monoclonal antibody denominated NU-T2. We studied NU-T2 Ag expression in junctional epidermolysis bullosa (13 patients) and in other forms of hereditary epidermolysis bullosa (23 patients), comparing the results with nicein expression. In junctional epidermolysis bullosa gravis type no differences were found between the expression of NU-T2 and nicein, both being negative in bullous as well as in non-bullous skin. Interestingly, in mitis type junctional epidermolysis bullosa, NU-T2 Ag was found to be absent or reduced in five of six patients both in lesional and in uncleaved skin. When compared with nicein expression, clearcut differences were found, further suggesting that these two antigens are different. These data confirm that NU-T2 Ag is a novel epitope of the dermal-epidermal junction, probably relevant in dermal-epidermal cohesion, and it could be responsible, together with nicein, 19-DEJ-1 and other adhesion molecules, for the different subtypes of junctional epidermolysis bullosa. Finally, NU-T2 monoclonal antibody is a new relevant tool for the diagnosis, classification, and prenatal diagnosis of junctional epidermolysis bullosa.

Antigens↗
PubMed1995

Comparative epidemiologic study of premalignant and malignant epithelial cutaneous lesions developing after kidney and heart transplantation.

BACKGROUND: Cutaneous carcinomas are the most frequent cancers in organ transplant recipients. OBJECTIVE: Our purpose was to compare the epidemiologic data of cutaneous premalignant and malignant epithelial lesions in kidney and heart transplant recipients. METHODS: A total of 580 kidney and 150 heart transplant recipients were examined for the presence of premalignant and malignant epithelial lesions. RESULTS: A twofold increase in incidence of premalignant and malignant epithelial lesions was found in heart compared with kidney transplant recipients. Heart transplant recipients were older at transplantation, received more intense immunosuppressive treatment, and had a shorter delay from transplantation to the development of the first lesion. The squamous cell carcinoma/basal cell carcinoma ratio was 2.37:1 in kidney and 1.08:1 in heart transplant recipients. The extracephalic location represented 60% of the premalignant and malignant epithelial lesions in kidney and 30% in heart transplant recipients. CONCLUSION: Cutaneous premalignant and malignant epithelial lesions in kidney and heart transplant recipients show epidemiologic differences that can tentatively be explained by the older age and the more intense immunosuppressive treatment of heart transplant recipients.

Adult↗
PubMed1995

Expression of ICAM-3/CD50 in normal and diseased skin.

ICAM-3 is a newly recognized adhesion molecule, which is a member of the immunoglobulin supergene family of ICAMs, and has been shown to be identical with the CD50 antigen. Recent functional studies have shown that ICAM-3 is a ligand for LFA-1, and plays an important part in immune reactions. To date, very few data exist in the literature concerning its expression in the skin. In the present study, we investigated the expression of ICAM-3 in normal skin and in 98 biopsy specimens of various inflammatory and neoplastic dermatoses. ICAM-3 was found to be expressed by epidermal CD1a+ Langerhans cells, by cells of Langerhans cell histiocytosis, by T and B lymphocytes infiltrating the dermis in cutaneous lymphomas and in a wide spectrum of inflammatory dermatoses. Epidermal keratinocytes were consistently negative; endothelial expression of ICAM-3 was observed in six of the 98 cases. These results show that ICAM-3 is constitutively and widely expressed by cells participating in inflammatory dermatoses (including Langerhans cells and T and B lymphocytes), and that it can be, albeit rarely, induced on endothelial cells and dermal dendrocytes. These results highlight the important part that ICAM-3 may play in cutaneous inflammatory and immune reactions.

Antigens, CD↗
PubMed1995

Generalized eruptive histiocytoma evolving into xanthoma disseminatum in a 4-year-old boy.

We report a 4-year-old boy who developed a generalized and symmetrical eruption of brownish papules over a period of 8 months, with spontaneous regression of some lesions. Clinical, histopathological and ultrastructural studies were suggestive of the diagnosis of generalized eruptive histiocytoma (GEH). The clinical features subsequently changed to a generalized eruption of confluent, yellowish papules, and diabetes insipidus developed. The clinical, histopathological and ultrastructural features of the new lesions were those of xanthoma disseminatum with cerebral involvement. This evolution suggests that GEH and xanthoma disseminatum may be variants of a continuous spectrum of histiocytic diseases.

Child, Preschool↗
PubMed1995

[Disseminated cutaneous neurilemmomatosis].

INTRODUCTION: Neurilemmomatosis is a rare, non-inherited disease which has several features similar to type I neurofibromatosis. CASE REPORT: A 30-year-old man had more than 300 cutaneomucosal tumours. Most were sessile and of firm consistency on normal coloured skin. Histology reported masses of fusiform dermal cells S100 protein (+), NSE (-), actin (-). The cells had a polygonal ultrastructure with fine ramifications. Neurilemmomatosis (schwannomatosis) was diagnosed. No neurological or systemic disorder could be detected. The most bothersome tumors were destroyed. DISCUSSION: This is a typical anatomoclinical presentation of cutaneous neurilemmomatosis. This exceptional state raises the problem of differential diagnosis and nosological distinction from von Recklinhausen's disease. A characteristic feature in this case was the total absence of any malformation or associated tumour, notably neurological tumours. To our knowledge, this is the only documented case of disseminated neurilemmomatosis strictly limited to the skin.

Adult↗
PubMed1994

Comparative study of indirect immunofluorescence and immunoblotting for the diagnosis of autoimmune pemphigus.

The diagnosis of pemphigus relies on immunopathological criteria including the detection of circulating autoantibodies to desmosomal components. In the present work we compared the usefulness of immunoblotting (IB) and indirect immunofluorescence (IIF) in the diagnosis of pemphigus using monkey oesophagus (MO) and rabbit lip (RL) as epithelial substrates. Among 54 sera from patients with well-documented pemphigus (40 pemphigus vulgaris, PV, and 14 pemphigus foliaceus, PF), 46 (85%) proved positive by IIF (46 on MO and 41 on RL) as compared with 44 (81.5%) positive by IB. IIF and IB were equally sensitive (90%) for the diagnosis of PV whereas IIF (on RL) was more sensitive (71%) than IB (57%) for the detection of PF autoantibodies. However, when the two techniques were considered in combination, the sensitivity of the detection of pemphigus autoantibodies rose to 94.5%. An IB study would therefore be warranted in the presence of an (alleged) pemphigus serum that was IIF-negative since approximately 10% of these were found to be positive. Furthermore, the pattern of IB reactivity may assist in classification, since the 130- and the 160-kDa antigens seem specifically correlated with PV and PF, respectively.

Adult↗