Raphael Szalat1, Gentiane Monsel2, Wilfried Le Goff3, Maxime Battistella4, Djaouida Bengouffa5, Marie-Helene Schlageter6, Jean-David Bouaziz2, Bertrand Arnulf7, Marguerite Vignon8, Philippe Lesnik3, Anne Saussine2, Marion Malphettes7, Anne Lazareth7, Marie-Dominique Vignon-Pennamen9, Martine Bagot10, Jean-Claude Brouet11, Jean-Paul Fermand7, Michel Rybojad2, Bouchra Asli7. 1. Department of Clinical Immunology, Saint-Louis Hospital, Assistance Publique des Hopitaux de Paris, Paris, France; Institut National de la Sante et de la Recherche Medicale (INSERM) Unite Mixte de Recherche (UMR)_1126, Institut Universitaire d'Hematologie, Universite Paris 7 Denis Diderot, Paris, France; Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, Paris, France. Electronic address: raphaelszalat@hotmail.com. 2. Department of Dermatology, Saint-Louis Hospital, Paris, France; Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, Paris, France. 3. INSERM, UMR_S U1166, Integrative Biology of Atherosclerosis Team, Pitie-Salpetriere Hospitals, Paris, France. 4. Department of Pathology, Saint-Louis Hospital, Paris, France; UMR_S1165, INSERM, Universite Paris 7 Denis Diderot, Paris, France; Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, Paris, France. 5. Department of Biological Immunology, Saint-Louis Hospital, Paris, France; Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, Paris, France. 6. Cellular Biology Unit, Saint-Louis Hospital, Paris, France. 7. Department of Clinical Immunology, Saint-Louis Hospital, Assistance Publique des Hopitaux de Paris, Paris, France; Institut National de la Sante et de la Recherche Medicale (INSERM) Unite Mixte de Recherche (UMR)_1126, Institut Universitaire d'Hematologie, Universite Paris 7 Denis Diderot, Paris, France; Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, Paris, France. 8. Department of Clinical Immunology, Saint-Louis Hospital, Assistance Publique des Hopitaux de Paris, Paris, France; Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, Paris, France. 9. Department of Pathology, Saint-Louis Hospital, Paris, France. 10. Department of Dermatology, Saint-Louis Hospital, Paris, France. 11. Department of Clinical Immunology, Saint-Louis Hospital, Assistance Publique des Hopitaux de Paris, Paris, France.
Abstract
BACKGROUND: Neutrophilic dermatoses refer to a group of cutaneous inflammatory disorders characterized by neutrophilic infiltration of the skin. Neutrophilic dermatoses have been reported in association with various conditions including autoimmune diseases, inflammatory bowel diseases, and neoplasia. In the later condition, myeloproliferative disorders and monoclonal gammopathy (monoclonal immunoglobulin [MIg]) are the most frequent. Only few data are available in case of neutrophilic dermatoses associated with MIg regarding the pathophysiology and the clinical outcome. OBJECTIVE: We sought to gain further insight into clinical and biological aspects of neutrophilic dermatoses associated with MIg. METHODS: We report a retrospective series of 26 patients with neutrophilic dermatoses associated with MIg focusing on clinical and biological aspects, with a study of a large panel of cytokines, chemokines, and adhesion molecules. RESULTS: This study reveals an association between MIg IgA isotype and neutrophilic dermatoses, and a specific inflammatory pattern including elevated interleukin 6, vascular endothelial growth factor, monocyte chemotactic protein-1, epidermal growth factor, and intercellular adhesion molecule-1. LIMITATIONS: This is a retrospective study from a single institution with a limited number of participants. CONCLUSION: Our data highlight a strong association between IgA isotype and neutrophilic dermatoses, and the existence of a specific inflammatory profile involving several molecules.
BACKGROUND:Neutrophilic dermatoses refer to a group of cutaneous inflammatory disorders characterized by neutrophilic infiltration of the skin. Neutrophilic dermatoses have been reported in association with various conditions including autoimmune diseases, inflammatory bowel diseases, and neoplasia. In the later condition, myeloproliferative disorders and monoclonal gammopathy (monoclonal immunoglobulin [MIg]) are the most frequent. Only few data are available in case of neutrophilic dermatoses associated with MIg regarding the pathophysiology and the clinical outcome. OBJECTIVE: We sought to gain further insight into clinical and biological aspects of neutrophilic dermatoses associated with MIg. METHODS: We report a retrospective series of 26 patients with neutrophilic dermatoses associated with MIg focusing on clinical and biological aspects, with a study of a large panel of cytokines, chemokines, and adhesion molecules. RESULTS: This study reveals an association between MIg IgA isotype and neutrophilic dermatoses, and a specific inflammatory pattern including elevated interleukin 6, vascular endothelial growth factor, monocyte chemotactic protein-1, epidermal growth factor, and intercellular adhesion molecule-1. LIMITATIONS: This is a retrospective study from a single institution with a limited number of participants. CONCLUSION: Our data highlight a strong association between IgA isotype and neutrophilic dermatoses, and the existence of a specific inflammatory profile involving several molecules.