Interleukin-36γ (IL-1F9) identifies psoriasis among patients with erythroderma

Abstract

Erythroderma is an acute and serious medical condition characterized by inflamed red skin affecting over 90% of the skin surface. Palmoplantar involvement with hyperkeratosis and fissuring is common. A serious and potentially life-threatening complication is the loss of fluid and albumin through the eroded skin, leading to displacement of electrolytes. As a result, patients become dehydrated and hypothermic. Psoriasis vulgaris, eczema, cutaneous T-cell lymphoma (CTCL) and drug reactions are the most common underlying causes of erythroderma (1, 2). Despite their differing pathomechanisms, clinical diagnosis of erythroderma cases can be problematic. The criteria for histological examination cannot be defined precisely at any stage of the disease (1, 2). Exact diagnosis of the underlying disease is, however, of great importance for patients, due to the considerable differences between the therapeutic regimes. We have recently found that interleukin (IL)-36γ, an IL-1-family member, is expressed specifically in the epidermis of psoriasis vulgaris patients and thus is a reliable marker in distinguishing psoriasis from other erythematosquamous skin diseases, including atopic dermatitis and lichen planus (3). The aim of this study was to investigate the usefulness of immunohistological IL-36γ staining in the diagnosis of psoriasis-based erythroderma among erythrodermic cases.