Immunohistochemical characteristics of inducible nitric oxide synthase and estrogen receptors alpha expression in patients with keratoderma climactericum

Abstract

Aim. To examine the characteristics of immunohistochemical expression of inducible nitric oxide synthase and estrogen receptors alpha in patients with keratoderma climactericum compared to postmenopausal women with clinically intact skin, to reveal possible correlation between these markers’ expression levels and pathomorphogenesis of menopausal keratoderma. Materials and methods. The pathomorphological and immunohistochemical analysis was performed on the biopsy material of 22 patients with keratoderma climactericum, who constituted the study group, and on the autopsy material from 32 women in a postmenopausal period without any signs of climacteric keratoderma, who were considered as a control group. Results. A significant difference was found in the area and intensity of inducible nitric oxide synthase expression between the study group diagnosed with keratoderma climactericum and the control group with unaffected skin, with increasing expression parameters among patients with keratoderma. A significant difference was also observed in the area and intensity of estrogen receptors alpha expression between the study and the control group, this time with increasing expression parameters among the control group. Conclusions. Patients with keratoderma climactericum demonstrate statistically significantly higher levels of nuclear and cytoplasmatic expression of inducible nitric oxide synthase in epidermal and dermal cells than individuals from the control group, which may indicate acute inflammation as a part of climacteric keratoderma pathogenesis. The area and intensity of estrogen receptors alpha expression in material from patients diagnosed with menopausal keratoderma are lower than in the material from the control group, which demonstrates a correlation between estrogen-deficient state in postmenopausal period and the development of skin changes in women with keratoderma climactericum.

Keywords

• palmoplantar keratoderma
• climacteric
• inducible nitric oxide synthase
• estrogen receptor alpha
• pathomorphological and immunochemical studies