Electron microscopy of epidermal and dermal Langerhans' cells in long-lasting allergy patch tests. 1989

L Kanerva
Division of Occupational Dermatology, National Institute of Occupational Health, Solna, Sweden.

In rare cases, normal allergy patch tests persist for weeks or months. Here, seven biopsies from six patients with long-lasting allergy patch tests, taken 15-75 days after allergen challenge, were analysed by transmission electron microscopy. In accordance with clinical expression of the test site, fine structural evidence of persistent activity of immunocompetent cells in the epidermis and dermis was observed. Moderate numbers of exocytic lymphocytes and macrophages were seen in the epidermis. Langerhans' cells (LC) appeared active, and LCs with Birbeck granules were detected both in the epidermis and the dermis and were also seen to cross the dermoepidermal junction. LC-mononuclear cell contacts were more frequent in the epidermis than is normal in allergy patch tests. A strong infiltrate of lymphocytes, macrophages, fibroblasts, mast cells, and cells resembling LCs but devoid of Birbeck granules, i.e. indeterminate cells, was seen in the upper dermis. Less than 10% of the dermal cells showing the fine structural appearance of LCs had Birbeck granules, as seen in a single section. Both indeterminate cells and LCs were apposed by lymphocytes in the dermis, often in a rosette-like fashion. The present paper is descriptive but gives background to the understanding of events in long-lasting allergy patch tests. However, the reason for and the basic mechanisms of long-lasting allergy patch tests are not known. A defect in down-regulation of the contact hypersensitivity reaction and/or a constant antigen stimulation could be responsible for the persistence of these allergy patch test reactions.

UI MeSH Term Description Entries
D006968 Hypersensitivity, Delayed An increased reactivity to specific antigens mediated not by antibodies but by sensitized T CELLS. Hypersensitivity, Tuberculin-Type,Hypersensitivity, Type IV,Tuberculin-Type Hypersensitivity,Type IV Hypersensitivity,Delayed Hypersensitivity,Delayed Hypersensitivities,Hypersensitivity, Tuberculin Type,Tuberculin Type Hypersensitivity,Tuberculin-Type Hypersensitivities,Type IV Hypersensitivities
D007801 Langerhans Cells Recirculating, dendritic, antigen-presenting cells containing characteristic racket-shaped granules (Birbeck granules). They are found principally in the stratum spinosum of the EPIDERMIS and are rich in Class II MAJOR HISTOCOMPATIBILITY COMPLEX molecules. Langerhans cells were the first dendritic cell to be described and have been a model of study for other dendritic cells (DCs), especially other migrating DCs such as dermal DCs and INTERSTITIAL DENDRITIC CELLS. Langerhans Cell,Dendritic Cells, Dermal,Dendritic Cells, Epidermal,Dendritic Cells, Skin,Dermal Dendritic Cells,Epidermal Dendritic Cells,Skin Dendritic Cells,Cell, Dermal Dendritic,Cell, Epidermal Dendritic,Cell, Langerhans,Cell, Skin Dendritic,Cells, Dermal Dendritic,Cells, Epidermal Dendritic,Cells, Langerhans,Cells, Skin Dendritic,Dendritic Cell, Dermal,Dendritic Cell, Epidermal,Dendritic Cell, Skin,Dermal Dendritic Cell,Epidermal Dendritic Cell,Skin Dendritic Cell
D008854 Microscopy, Electron Microscopy using an electron beam, instead of light, to visualize the sample, thereby allowing much greater magnification. The interactions of ELECTRONS with specimens are used to provide information about the fine structure of that specimen. In TRANSMISSION ELECTRON MICROSCOPY the reactions of the electrons that are transmitted through the specimen are imaged. In SCANNING ELECTRON MICROSCOPY an electron beam falls at a non-normal angle on the specimen and the image is derived from the reactions occurring above the plane of the specimen. Electron Microscopy
D010328 Patch Tests Skin tests in which the sensitizer is applied to a patch of cotton cloth or gauze held in place for approximately 48-72 hours. It is used for the elicitation of a contact hypersensitivity reaction. Patch Testing,Patch Test,Patch Testings,Test, Patch,Testing, Patch,Testings, Patch,Tests, Patch
D004817 Epidermis The external, nonvascular layer of the skin. It is made up, from within outward, of five layers of EPITHELIUM: (1) basal layer (stratum basale epidermidis); (2) spinous layer (stratum spinosum epidermidis); (3) granular layer (stratum granulosum epidermidis); (4) clear layer (stratum lucidum epidermidis); and (5) horny layer (stratum corneum epidermidis).
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.

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