Inflammatory
linear verrucous epidermal nevus (ILVEN) is a rare skin disorder with a clinical and histological resemblance to
psoriasis. In the past clinical and histological criteria have been defined. However, there remains a discussion as to whether ILVEN is a disease entity distinct from linear
psoriasis. Our objective was to compare by quantitative immunohistochemistry the subsets of T-lymphocytes and markers for epidermal growth and keratinisation in biopsies taken from skin lesions of 4 patients with
psoriasis and 3 patients with ILVEN: 1. patients with
psoriasis (case 1-4) 2. patient with ILVEN cum
psoriasis (case 5) 3. patients with ILVEN sine
psoriasis (case 6 and 7). Our aim was to delineate ILVEN from
psoriasis. Four patients with active
psoriasis and three patients with signs and symptoms of ILVEN are described in this case report. Two patients of the ILVEN group had only linear verrucous lesions (ILVEN sine
psoriasis), and one patient had linear lesions combined with widespread
psoriasis outside the linear verrucous lesion (ILVEN cum
psoriasis). The following markers were investigated in skin biopsies taken from the aforementioned patients by quantitative immunohistochemistry: CD2, CD4, CD8, CD25, CD161, CD94, CD45RO, CD45RA,
HLA-DR,
Keratin-10, Ki-67. In patients with ILVEN (cum and sine
psoriasis) the number of Ki-67 positive nuclei, tended to be lower, the number of
keratin-10 positive cells and
HLA-DR expression higher as compared to
psoriasis. In ILVEN sine
psoriasis all T-cell subsets and cells expressing NK receptors were reduced as compared to
psoriasis, except for CD45RA+ cells, whereas in the patient with ILVEN cum
psoriasis the number of these T cell subsets had an intermediary position. In particular the density of CD8+, CD45RO+ and CD2+, CD94 and CD161 showed a marked difference between ILVEN sine
psoriasis and
psoriasis. In addition to the increased
keratin 10 expression in ILVEN sine
psoriasis, T cells relevant in the pathogenesis of
psoriasis are markedly reduced in ILVEN sine
psoriasis as compared to
psoriasis. T-cell subsets in ILVEN cum
psoriasis had an intermediary position.