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Retinoids Strongly and Selectively Correlate With Keratin 13 and Not Keratin 19 Expression in Cutaneous Warts of Renal Transplant Recipients
Willeke A. M. Blokx, MD;
Jurgen V. Smit, MD;
Elke M .G. J. de Jong, MD, PhD;
Monique M. G. M. Link;
Peter C. M. van de Kerkhof, MD, PhD;
Dirk J. Ruiter, MD, PhD
Arch Dermatol. 2002;138:61-65.
Objective To compare the expression of keratin (K) 13 and K19 in cutaneous warts
of renal transplant recipients (RTRs) and immunocompetent individuals (ICIs).
Design Retrospective, nonrandomized immunohistochemical study.
Patients and Methods Specimens from cutaneous warts of RTRs and ICIs were retrieved from
the archives of the Department of Pathology, University Medical Center St
Radboud, Nijmegen, the Netherlands. Twenty-one warts from RTRs and 21 from
ICIs were examined. Nine RTRs (10 specimens) received either systemic acitretin
or topical all-trans retinoic acid, and their effect
on both keratins was assessed.
Main Outcome Measures Frequency and expression patterns of K13 and K19 in warts of RTRs vs
ICIs and the effect of retinoids.
Results A significantly higher percentage of warts of RTRs expressed K13 compared
with warts of ICIs (86% vs 14%, 18 vs 3 cases, respectively; P<.001). In warts of RTRs, retinoid treatment correlated significantly
with a particularly strong, segmental K13 expression pattern, which we termed zebroid. Without use of retinoids, K13 was mostly restricted
to suprabasal single cells. Keratin 19 was absent in all warts of both patient
groups.
Conclusions Retinoids strongly correlate with K13 in a characteristic zebroid pattern
in warts of RTRs, making K13 a sensitive marker for retinoid bioactivity in
skin (lesions) of RTRs. In non–retinoid-treated RTRs, K13 is also frequently
found in warts but without the dramatic zebroid pattern noted in retinoid-treated
warts.
From the Departments of Pathology (Drs Blokx and Ruiter and Ms Link)
and Dermatology (Drs Smit, de Jong, and van de Kerkhof), University Medical
Center St Radboud, Nijmegen, the Netherlands.
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