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March 1990

In Situ Characterization of Cellular Infiltrates in Lupus Vulgaris Indicates Lesional T-Cell Activation

Author Affiliations

From the Department of Dermatology, Safdarjang Hospital (Drs Ramesh and Misra), and Department of Biotechnology, All India Institute of Medical Sciences (Drs Samuel and Nath), New Delhi, India.

Arch Dermatol. 1990;126(3):331-335. doi:10.1001/archderm.1990.01670270063010

• Skin biopsy specimens from nine patients with lupus vulgaris were examined in situ by means of monoclonal antibodies directed against phenotypes of lymphocyte subsets, Langerhans cells, HLA-DR antigens, and interleukin 2 receptor. The epidermis showed prominent changes, including intense expression of HLA-DR on keratinocytes, increase in epidermal cell layers, moderate to high Langerhans cell hyperplasia, and infiltration by CD3+ pan-T cells as well as CD8+ (cytotoxic/suppressor) and CD4+ (helper/inducer) T cells. The predominant lymphocyte in the dermal granulomas was the activated CD3+ T cell, expressing major histocompatibility complex class II antigens and interleukin 2 receptor. CD4+ and CD8+ cells were randomly distributed among the epithelioid cells, which showed intense staining for major histocompatibility complex class II antigens. In all except two patients, the CD4+ population was greater than that of the CD8+ cells. CD1+ Langerhans cells were scattered in moderate numbers in the dermal granulomas. Acid-fast bacilli were conspicuously absent in the biopsy specimens. These features suggest that T-cell activation and Langerhans cell hyperplasia are prominent features of dermal tuberculosis.

(Arch Dermatol. 1990;126:331-335)