الفهرس 
PsoriasisOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a common chronic autoimmune and inflammatory skin disease of unsettled etiology and pathogenesis. It affects 2.7% of the world’s population. Psoriasis is unique because it represents excessive keratinocyte proliferation with incomplete differentiation. This aberrant epidermal growth results in loss of normal epidermal barrier function. However, its underlying mechanism remains controversial. Keratinocyte interact with each other through intercellular junctions to regulate cellular shape, proliferation, and the passage of ions and molecules through the paracellular pathway. Their proliferation outside the basal layer suggests an alteration in cell–cell interactions in active psoriasis. E-cadherin is a cell adhesion transmembrane molecule which is required for the adhesive properties of keratinocytes and skin differentiation The aim of this study was to evaluate immunohistochemical expression of E-cadherin in Egyptian psoriasis patients to clarify its possible role in the pathogenesis of this disease. This study was carried out on 25 patients presenting with psoriasis. The diagnosis was made on clinical and histopathologic bases and all patients had received neither topical nor systemic treatment for at least 2 weeks before skin biopsy. For comparison purposes, 10 specimens from age and sex-matched apparently normal volunteers during plastic surgery are included in the study representing controls. Both patients and control subjects were selected randomly from the Outpatient Dermatology Clinic,enofiya University Hospital during the period between June 2011 and January 2013. All patients were subjected to complete history taking with special emphasis on the duration of the disease, dermatological examination and registration of PASI. Skin biopsies were taken under local anesthesia from all cases (lesions) and controls after obtaining a written consent for histopathological and immunohistochemical evaluation. H&E-Stain was performed for light microscopy for histologic examination of the lesional skin for identification and histopathological confirmation of the clinical diagnosis of psoriasis. In addition, evaluation of epidermal and dermal changes if present. Immunohistochemical staining was performed to detect E-cadherin expression and distribution in both cases and control groups. The age of patients ranged from 14 to 68 years with a mean of 41.0± 15.5 years and a median of 37 year, while that of control group ranged from 22to 66 years with a mean of 41.7±14.20 years and a median of 42.5 years. Among 25 patients there were13 males (52%) and 12 females (48%) . The disease duration ranged between 1 month to 21 years with a mean of 6.01 ± 5.90 months and a median of 3 years. The PASI of the cases ranged between 1 – 69.2 with a mean value of 16.81±17.21 and a median value of 12. In the current work, normal skin tissues showed diffuse uniform E-cadherin expression within all layers of epidermis and marked down-regulation of E-cadherin expression was detected in the granular and basal layers of psoriasis lesional skin compared to normal skin (P<0.001).
Summary
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Furthermore, normal skin showed higher H score of E-cadherin expression than lesional skin (P=0.01). There was a significant negative relationship was found between H scores of E-cadherin and thinning of suprapapillary epidermis (P=0.007) as well as dermal angiogenesis (P=0.05).