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Lee D. Kaufman, MD; Barry L. Gruber, MD; Juan J. Gomez-Reino, MD; Frederick Miller, MD

Arch Dermatol. 1994;130(1):41-47.

Abstract
Background and Design
We sought to determine if growth factors of potential pathogenetic significance are deposited in the skin, muscle, and peripheral nerve lesions of eosinophilia-myalgia (EMS) and toxic oil syndrome. Immunohistochemical studies using affinity-purified peroxidase-conjugated antibodies to detect transforming growth factor-β, platelet-derived growth factor_AA and growth factor_BB, fibroblast growth factor, epidermal growth factor, and interleukin 4 were performed on formalin-fixed, paraffin-embedded specimens. Seven skin biopsy specimens from EMS, six skin biopsy specimens from toxic oil syndrome, nine muscle biopsy specimens from EMS, and one sural nerve biopsy specimen from EMS were studied.

Results
Growth factor staining was noted primarily in the epidermis and periappendageal locations of the dermis. The presence of TGF-β and platelet-derived growth factor_AA in the periappendageal dermis was significantly more prevalent in EMS than toxic oil syndrome (57% vs 0%). Prominent staining of transforming growth factor-β was also present in the perimysial connective tissue of five (63%) of eight EMS muscle biopsy specimens and one sural nerve biopsy specimen.

Conclusions
These studies implicate transforming growth factor-β and platelet-derived growth factor_AA as potentially important cytokines in EMS and suggest that the pathogenesis of tissue fibrosis in EMS and toxic oil syndrome may be dependent on different growth factors.

(Arch Dermatol. 1994;130:41-47)

Author Affiliations
From the Departments of Medicine, Division of Allergy, Rheumatology, and Clinical Immunology (Drs Kaufman and Gruber), Dermatology (Dr Gruber), and Pathology (Dr Miller), State University of New York at Stony Brook; the Northport Veterans Affairs Medical Center (Dr Gruber); and the Department of Medicine, Section of Rheumatology, Hospital 12° de Octubre, Madrid, Spain (Dr Gomez-Reino).

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