Elevations in Vascular markers and Eosinophils in Chronic Spontaneous Urticarial Weals with Low Level Persistence in Uninvolved Skin.

British Journal of Dermatology

PubMedID: 24665899

Barry Kay A, Ying S, Ardelean E, Mlynek A, Kita H, Clark P, Maurer M. Elevations in Vascular markers and Eosinophils in Chronic Spontaneous Urticarial Weals with Low Level Persistence in Uninvolved Skin. Br J Dermatol. 2014;171(3):505-11.
BACKGROUND
In chronic spontaneous urticaria (CSU) mast cell activation together with inflammatory changes in the skin are well documented and may play an important role in mechanisms of tissue oedema OBJECTIVE: To confirm and extend these observations by measuring microvascular markers, leukocytes and mast cells numbers in lesional and uninvolved skin and to compare findings with a control group.

METHODS
Paired biopsies (one from 4- 8 hour spontaneous weals and one from uninvolved skin) were taken from eight patients with CSU and nine control subjects and studied by immunohistochemistry and confocal microscopy using the lectin UEA-1.

RESULTS
Lesional skin in CSU contained significantly more CD31+ endothelial cells and CD31+ blood vessels, neutrophils, eosinophils, basophils, macrophages and CD3+ T cells, than non-lesional skin. Increased vascularity was confirmed by confocal imaging using the lectin UEA-1. Uninvolved skin from CSU contained significantly more CD31+ endothelial cells, CD31+ blood vessels and eosinophils compared to the control subjects. There was a three-fold increase in mast cell numbers when CSU was compared to controls but no difference was observed between lesional and uninvolved skin.

CONCLUSIONS
Increased vascular markers together with eosinophil and neutrophil infiltration are features of lesional skin in CSU and might contribute to tissue oedema. Eosinophils and microvascular changes persist in uninvolved skin which, together with increased mast cells, suggests that non-lesional skin is primed for further wealing. This article is protected by copyright. All rights reserved.