| Objective: Pityriasis rubra pilaris (PRP) is a kind ofspecial inflammatory skin disease with papula and squame.Typical symptoms of PRP are red plaques, palmoplantarkeratoderma and diffuse scales at epicranium, which alwaysbecome erythroderma desquamativum. Differential diagnosisinclude of psoriasis and universal allergic reaction et al. Thecauses of PRP are still unclear, but it mostly have somedoctrines:(1) Heredity factor (2) Vitamin deficiency (3)Keratinization disturbance (4) Incretion dysfunction (5) Other.Departed investigationes even more paied close attention tosymptoms of PRP that were produced by the lack of vitamin A,and curative effect was effective by used vitamin A. Theresearch in recent years prompted that the changes of keratin'sexpresstion played the important roles in the PRP. It displaiedthat the epidermis was hyperplasy and growed faster thannormol skin .The changes in expression of the keratin pairswhich is K1/K10 were important factors in keratinizationdisorder of PRP. Otherwise people researched K17 more thanbefore years, some reports showed that K17 was induced togenerate in the hyperplasied epidermis .A scholar made use ofprotein blot to find the expression of K17 in the skin of threepatients who were three patients of PRP with family history. Buthow keratin to express in PRP that not reported in domestic andabroad. In this study we detected the expression level of K1,K5,K10 and K17 in the epidermis of patients with PRP andnormal people by immunohistochemical method. We analyedthe relationships between them with the PRP, and providedproof for the pathogenesis of PRP.Methods: The 10 normal person's epidermis and 40 lesionsof PRP were used as the researched object which had beenparaffin-embedded, and were detected by immunohistochemicalmethod to examin the expression level of K1,K5,K10 and K17.The results were detected by HPIAS-1000 analytical system.We detected the relative amount and intensity of K1,K5,K10and K17. The comparison of two controls adopted t-test and thedependability of two indexes adopted the Sperman correlationanalysis. They were completed by the SPSS11.0 software .Results: 1. Among the 40 examples of PRP, K1 expressed2 weak positive results, and the remaining were negativeexpressions in the base layer; In the spinous layer and granularlayer, one expressed weak positive result, 10 examplesexpressed positive results, 29 examples were strong positiveexpressions. Positive staining mostly expressed in the cytoplasmof keratinocytes. Among the normal controls, K1 expressed 1weak positive result, and the remaining were negativeexpressions in the base layer; In the spinous layer and granularlayer, 2 examples expressed positive results and 8 exampleswere strong positive expressions. The two controls werecompared by t-test, and we found the relative amount andintensity of K1 in PRP were higher than those of controls andhad significant difference (P<0.05).2. Among the 40 examples of PRP, K5 expressed 2 weakpositive results, 12 examples expressed positive results and 26examples were strong positive expressions in the base layer; Inthe spinous layer and granular layer, K5 expressed 6 weakpositive results, and the remaining were negative expressions.Positive staining mostly expressed in cytoplasm. Among thenormal controls, one example expressed weak positive resultand 2 examples expressed positive results, 8 examples werestrong positive expressions in the base layer; In the spinouslayer and granular layer, K5 expressed 1 weak positive result,and the remaining were negative expressions. The compare oftwo controls had no significant difference (P>0.05).3. Among the 40 examples of PRP, K10 expressed 3 weakpositive results, and the remaining were negative expressions inthe base layer; In the spinous layer and granular layer, oneexpressed weak positive result, 12 examples expressed positiveresults, and 27 examples were strong positive expressions.Among the normal controls, K10 expressed two weak positiveresults, and the remaining were negative expressions in the baselayer; In the spinous layer and granular layer, 4 examplesexpressed positive results, 6 examples were strong positiveexpressions. The two groups were compared by t-test, we foundthe relative amount and intensity of K10 in PRP were higherthan those of controls and had significant difference (P<0.05).4. Among the 40 examples of PRP, K17 expressed 1 weakpositive result, and the remaining were negative expressions inthe base layer; In the spinous layer and granular layer, 12examples expressed weak positive results, 24 examplesexpressed positive results, and 4 examples were strong positiveexpressions. But among the normal controls, K17 had noexpressions not only in the base layer but also in the spinouslayer and granular layer. The two groups were compared byt-test, we found the relative amount and intensity of K17 in PRPwere higher than those of controls and had significant difference(P<0.05).5. The expression of K1 was positively correlated with K10(P<0.05, r=0.867); While the expression of K17 had nocorrelation with K10 (P>0.05).Conclusions: K1/ K10 may play the important functions inthe pathogenesy of pityriasis rubra pilaris. High expression ofK1/ K10 in pityriasis rubra pilaris will be one of the causeswhich induced the epidermis to grow in PRP faster than innormal skin, and can become the auxiliary diagnosis index ofpityriasis rubra pilaris. The expression of K1 was positivelycorrelated with K10, which is consistent to specificity pairing...
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