EPIDERMAL EXPRESSION OF 65 AND 72 KD HEAT-SHOCK PROTEINS IN PSORIASISAND AIDS-ASSOCIATED PSORIASIFORM DERMATITIS

Background: Psoriasiform dermatitis is common in patients with AIDS. T he expression of heat shock proteins by keratinocytes has been postula ted to be a significant factor in the physiopathology of psoriasis and might be subject to modulation in HIV-infected patients. Objective: W e sought to evaluate the epidermal expression of 65 and 72 kd heat sho ck proteins (HSPs) in lesions of AIDS-associated psoriasiform dermatit is (AIDS-PD) and compare it with that in psoriasis vulgaris and seborr heic dermatitis in patients not infected with HIV. Methods: Sections f rom paraffin-embedded blocks of biopsy specimens of AIDS-PD (eight cas es), psoriasis vulgaris (eight cases), seborrheic dermatitis (four cas es), and normal skin (four cases) in non-HIV-infected patients were im munohistochemically stained by the avidin-biotin-peroxidase method and two monoclonal antibodies directed against the major 65 kd HSP antige n (HSP65) and against 70/72 kd HSP. The intensity, distribution, and c ellular pattern of the epidermal stain were graded and assessed blindl y. Results: The epidermal expression of HSP65 in biopsy specimens from AIDS-PD lesions was irregular, with less intensity and less tendency to perinuclear arrangement than in psoriasis or seborrheic dermatitis not associated with AIDS. The expression of HSP72 was also less intens e and more uniform in AIDS-PD. Conclusion: The altered interplay of T cells and keratinocytes in a situation of immune derangement such as A IDS might account for the differences observed in the expression of HS P65 and HSP72 by keratinocytes in psoriasis and AIDS-PD.