الفهرس 
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Abstract
Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucosa due to the presence of autoantibodies against the components of desmosomes. To date, less is known about the expression levels of beta-catenin in blistering diseases.
The aim of the work to evaluate the immunohistochemical expression of β-catenin in pemphigus vulgaris and to determine their possible role in disease development.
This case-control study was carried out on 40 subjects. These included 20 patients of PV and 20 age and sex matched normal subjects. Patients were selected from the Outpatient Dermatology Clinic, Menoufia University Hospital in the period between august 2016 and July 2018. All patients were subjected to history taking and complete general and dermatological examination. A punch biopsy was taken from lesional and perilesional skin of all PV patientsafter taking a written consent.
Each biopsy was processed to form paraffin block. Several paraffin sections, each 4 micron thick, were cut from each block, one of them was stained by haematoxylin and eosin to evaluate pathological changes and the other sections were cut on positive charged slides for immunostaining with β catenin mouse monoclonal antibodies.
Haematoxylin and eosin stained sections were examined microscopically to evaluate and verify epidermal and dermal pathological changes.
Histopathological evaluation of lesional skin epidermis revealed spongiosis in 90% of them. It was either isolated without inflammatory cells in 50%, or eosinophilic spongiosis in 25%, esinophilic and neutrophilic spongiosis in 15% of them. In 75% of cases suprabasal blister with tomb stone feature were present, while the remaining 15% of cases had intraspinous level with multilayered base.The blister cavity was empty in 15%, contained acantholytic cells in 10%, acantholytic cells plus esinophils in other 10%, acantholytic cells plus esinophils and neutrophils in 55%, acantholytic cells plus esinophils, neutrophils and lymphocytes in 10%.
Histopathological examination of the perilesional epidermis showed various pathological changes as: Spongiosis in 90% of them. It was either isolated in 65%, esinophilic spongiosis in 20%, or esinophilic and neutrophilic spongiosis in 5%. It also showed inflammatory infiltrate in only 35%; 25% of them had esinophils, 10% had both esinophils and neutrophils and 5% had mixed infiltrate.
The dermis of both lesional and perilesional skin showed the same findings as regard to adenexal acantholysis and inflammatory infiltrate; lesional skin showed adenexal acantholysis in 30% of cases. The outer root sheath acantholysis was present in 25% and sweat glands acantholysis in 5%.
Regarding the inflammatory infiltrate, 13 cases (65%) had perivascular mixed infiltrate (esinophlis, neutrophils and lymphocytes), 1 case (5%) had perivascular and periadenexal mixed, 2 cases (10%) had perivascular lymphocytic infiltate, 1 case (5%) had perivascular mixed and perifollicular (PF) esinophilic and neutrophilic infiltrate, 2 cases (10%) had perivascular lymphocytic and PF esinophilic and neutrophilic infitrate, 1 case (5%) had perivascular lymphocytic and PF esinophilic and neutrophilic infiltrate and 1 case (5%) had no infiltrate.
As regards β catenin expression, it was diffusely expressed in all control, lesional and perilesional skin sections both in epidermis, and dermis (adenexa, dermal fibroblasts).