The Studies On Immunity In Lesions And Peripheral Blood Of LMDF

Objective: Lupus Miliaris Disseminatus Faciei(LMDF) is a chronic disorder ,which affects adults of both sexes.The cause and pathogenesis of LMDF are unknown. Usually,the scar influences patients'health of heart and body badly.The histopathological picture of LMDF shows tubercular infiltration,conspicuous caseation necrosis. So for a long time, LMDF has been thought to be tuberculosis because of this typical histologic feature. However,all other facts including clinical observations,laboratory data and therapeutic results contradict this view. The early postulate of a tuberculosis-related condition had been generally abandoned. An allergic granulomatous reaction to foreign bodies has been suggested as the pathogenesis; it may,for instance, be a reaction to follicular contents, such as keratins and sebum, or even to Demodex folliculorum. Some studies show abnormal cell immunity of LMDF. Foreign scholars used immunoperoxi-dase technique to study the lysozyme activity in tissue samples from patients with LMDF. The result suggests that LMDF may be relevant with an immunological mechanisam associated with cell-mediated immunity. Internal studies find that TNF-α and sIL-2 in serum of LMDF are much higherthan in normal people's serum, which shows LMDF has something to do with low immunological functioning. It has no specific medicine on treatment. Because ICAM-1 and TGFβ1 play an important role on immunity and AgNORs reflects the level of body's immunity. So this study was designed to detect ICAM-1,TGFβ1 and AgNORs of LMDF in order to explore their relationship. In addition,we will use DDS and Transfer Factor to cure LMDF on trial, and observe curative effect in order to find a good way to cure LMDF.Materials and Methods: Twenty LMDF patients, diagnosed as LMDF, clinically and histopathologically, were collected rom the dermatology department of the Fourth Affiliated Hospital of Hebei Medical University from January, 2000 to September, 2002. The patients included 11 males and 9 females in this study, who had no other deseases and had not been treated by immunization therapy during 3 months; age range from 18 to 65 years ( average 31.82±12.28 years ); course from 1 to 12 months ( average 5.095±3.345 months ). On the basis of the course and lesion distribution, they were divided into three groups: light cases, duration less than two months, 6 patients; medium cases, duration between 3 and 5 months, 10 patients; severe cases, duration from 6 to 12 months, 4 patients. The lesion samples of twenty patients were investi-gated with histopathological and immunohistochemical methods. Using immunohistochemical methods, we detect the expression of ICAM-1 and TGFβ1 in lesions of LMDF and analyse cell immunity of LMDF. ten normal face specimens were taken as controls. DDS allied with Transfer Factor have been tried in these cases to observe the efficacy in 3 months. DDS 50mg, tid. p.o. Transfer factor, 3mg, q.o.d. Intramuscular injection. At the same time, the peripheral blood samples of twenty patients before and after treatment were used for AgNORs test respectively.Results: 1. Histopathological examination: It shows fairly large tubercles composed of epitheloid cells and some giant cells usually with a large central area of caseation necrosis. There is a slight to moderate dense lymphocytic infiltrate around the tubercles and an extensive fibrosis especially in the perifollicular areas. Mild thinning of the epidermis is seen in most cases. 2. immunohistochemistory appearance: It's showed that ICAM-1 and TGFβ1 were increased comparing to contrals. 3. The result of AgNORs and therapy: Compared with normal range(6％－10％), 17 patients were lower, 3 patients were in normal range. But after treatment, 16 patients increased to normal range ( P<0.05 ). AgNORs of peripheral blood were improved. the efficacy ( recovery rate, total effective rate ) was significantly positive correlated between AgNORs of peripheral blood and DDS allied with Transfer Factor. 4.Therapy:...