Dermatophyte Infection and Clinical Feature of Dermatophytosis in an Individual with Cell-Mediated Immunodeficiency.

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In order to justify the previous speculation proposed by Takahashi and Kakutani, which acanthotic and hyperkeratotic changes in the epidermis of experimental chronic dermatophytosis (ECD) produced in human skin grafted onto nude mouse may be a defensive reaction against dermatophyte infection in an individual with cell-mediated Immunodeficiency, we studied on such proliferative epidermis light- and electron microscopically and immunohistochemically. [Result] In ECD remarkable acanthosis, and many BrdU-positive keratinocytes not only in basal layer but lower spinous layer just above basal layer, were observed. Involucrin-positive keratinocytes were demonstrated in a wide range from granular layer to middle or lower portion of spinous layer in 19 case out of 20 ECD. On the contrary, almost all cases of control were negative for involucrin staining. Human Langerhans's cell in the epidermis were specifically detected in only 5 cases of ECD. IL-1, TNF, β-IFN and OKM-5 monoclonal staining showed to be negative in all ECD as well as controls. Electron microscopic examination of the epidermis of ECD revealed to appear many Odland bodies in keratinocytes from granular layer to middle or lower spinous layer, and to persist a residual of unit membrane of them in intercellular space between corneocytes. [Conclusion] Increase of S-phase keratinocytes represents proliferative changes of the epidermis, and early production of involucrin causes thickening of cell membrane of corneocytes, and early and many appearance of Odland bodies leads to the acceleration of desquamation. It may be conceivable that these morphological and biological changes of the epidermis cooperate for defensive mechanism against dermatophyte infection in cell-mediated immunodeficient condition.
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