真皮
黄褐斑
免疫组织化学
病理
发病机制
基础(医学)
医学
表皮(动物学)
皮肤病科
病变
黑素细胞
解剖
内分泌学
黑色素瘤
癌症研究
胰岛素
作者
Bertha Torres‐Álvarez,Iraida Guadalupe Mesa‐Garza,Juan Pablo Castanedo‐Cazares,Cornelia Fuentes‐Ahumada,Cuauhtémoc Oros‐Ovalle,Josefina Navarrete-Solís,Benjamín Moncada
出处
期刊:American Journal of Dermatopathology
[Ovid Technologies (Wolters Kluwer)]
日期:2011-02-11
卷期号:33 (3): 291-295
被引量:119
标识
DOI:10.1097/dad.0b013e3181ef2d45
摘要
The pathogenesis of melasma has not been clearly elucidated. Using Fontana Masson; diastase-resistant periodic acid-Schiff stains; and immunohistochemistry to stem cell factor (SCF), its receptor c-kit, anti-mast cell tryptase, and anti-collagen type IV antibody, we evaluated melasma lesions and compared them with perilesional skin and photoprotected skin. Samples were taken from lesional and photoprotected nonlesional skin in 24 patients. In other 24 patients, we took biopsies of lesional and perilesional skin. With Fontana Masson, we observed many pigmented basal cells protruding into the dermis of the melasma skin. Periodic acid-Schiff stain and anti-collagen type IV showed damage on the basal membrane in 95.5% and 83%, respectively, in melasma lesion. The immunoreactivity of SCF and the prevalence of mast cells were increased in the dermis of melasma compared with perilesional dermis. The expression of c-kit was significantly increased at lesional epidermis; a frequent protrusion of c-kit-positive basal cells into the dermis was evident in 70% versus that in 29% of perilesional skin. The expression of c-kit was increased at lesional dermis of melasma compared with perilesional skin. We found a low correlation between c-kit expression and prevalence of mast cells; these were increased in melasma skin. The results may suggest a role of SCF, c-kit, and mast cells in the pathogenesis of melasma. We were surprised by the unexpected evidence of damage to basal membrane (BM), which could facilitate the fall or the migration of active melanocytes and melanin into the dermis allowing the constant hyperpigmentation in melasma.
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