Axel Emilson, Magnus Lindberg, Annika Scheynius
DOI: 10.1080/000155598442656

Allergic contact dermatitis and irritant contact dermatitis have different pathogenic mechanisms. It is therefore plausible that the epidermal expression of HLA-DR and the invariant chain associated with antigen processing and presentation might differ between allergic contact dermatitis and irritant contact dermatitis. We have quantified the volume of epidermal HLA-DR and invariant chain reactivity and the total epidermal volume in allergic contact dermatitis and irritant contact dermatitis using confocal laser scanning microscopy and indirect immunofluorescence on acetone-fixed 25 μm thick vertical skin sections. Eight nickel allergic patients were patch-tested with 5% nickel sulfate and 8 healthy volunteers were patch-tested with 4% sodium lauryl sulfate. Skin biopsy specimens were taken at 0, 6, 24, and 72 h after application of the patch tests. Sodium lauryl sulfate induced a statistically significant increased epidermal volume at 24 h and 72 h compared to 0 h and 6 h (p<0.003 and p<0.001, respectively), whereas an increase in epidermal volume in the allergic contact dermatitis group was not noted until 72 h after patch testing with nickel sulfate compared to 0, 6 h (p<0.001) and 24 h (p<0.004). No significant changes in the epidermal volume of HLA-DR reactivity were found at any time point within or between the two groups, nor was there any significant change in the epidermal volume of invariant chain reactivity in the allergic contact dermatitis group. In the irritant contact dermatitis group, however, the epidermal volume of invariant chain reactivity was significantly reduced from 17±8×103 μm3 at 24 h to 9±3×103 μm3 at 72 h (p<0.04), which was also significantly lower than the 14±4×103 μm3 observed in allergic contact dermatitis at 72 h (p<0.01). Furthermore, the invariant chain expression was significantly lower than the HLA-DR reactivity in the irritant contact dermatitis group at 72 h (p<0.001). The decrease of invariant chain reactivity at 72 h in irritant contact dermatitis might reflect an epitope-induced alteration by sodium lauryl sulfate or a down-regulated biosynthesis of the invariant chain due to variance in local cytokine production between allergic contact dermatitis and irritant contact dermatitis.