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Expression of IFN-γ, IL-4, and IL-17 in cutaneous schistosomal granuloma

Authors

  • Sameh K. Attia MD,

    1. Department of Dermatology, Sexually Transmitted Diseases and Andrology, Al-Minya University Hospital, Al-Minya University, Al-Minya, Egypt
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  • Noha H. Moftah MD,

    Corresponding author
    1. Department of Dermatology, Sexually Transmitted Diseases and Andrology, Al-Minya University Hospital, Al-Minya University, Al-Minya, Egypt
    • Correspondence

      Noha H. Moftah, md

      Department of Dermatology, STDs and Andrology

      Al-Minya University

      191 El-Horya Street Al-Minya 11511

      Egypt

      E-mail: nohamoftah2013@yahoo.com

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  • Eman S. Abdel-Azim MD

    1. Department of Dermatology, Sexually Transmitted Diseases and Andrology, Al-Minya University Hospital, Al-Minya University, Al-Minya, Egypt
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  • Conflicts of interest: None.

Abstract

Objectives

Cutaneous schistosomal granuloma (CSG) is a rare dermatological disease, the clinical and histopathological features of which are well defined. Although a panoramic picture of its immunopathogenesis in humans is not yet available, it is believed to be induced by T helper 1 (Th1), Th2, or Th17 cytokines in animals. This study evaluated the expression of different types of Th cytokines, including Th1 cytokine interferon-γ (IFN-γ), Th2 cytokine interleukin-4 (IL-4), and Th17 cytokine IL-17, in human CSG.

Methods

This study included nine patients with CSG. Dermatological examinations were conducted in all subjects. Skin biopsy specimens were stained with hematoxylin and eosin (H&E). Immunohistochemical examination was performed using three monoclonal anti-human antibodies against IFN-γ, IL-4, and IL-17 to evaluate Th1, Th2, and Th17 cytokines, respectively.

Results

The most common site of CSG manifestation was the paraumbilical area, which was affected in 66.7% of patients. All lesional skin biopsy specimens revealed multiple dermal granulomas surrounding schistosomal eggs. Positive immunoreactivity for IFN-γ, IL-4, and IL-17 was present in dermal inflammatory infiltrate in 88.9, 11.1, and 88.9% of subjects, respectively. There were statistically significant negative correlations between the duration of disease and both IFN-γ and IL-17 (≤ 0.05), and a statistically significant positive correlation between IFN-γ and IL-17 (≤ 0.05).

Conclusions

This study suggests that CSG is formed by the action of both Th1 (IFN-γ) and Th17 (IL-17) cytokines, which have been shown to be directed against the schistosomal egg to induce a cell-mediated immune response.

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