TITLE:
The Disturbance of Melanogenesis and Melanosome Transfer in the Leukoderma Lesions of Extramammary Paget’s Disease
AUTHORS:
Atsushi Tanemura, Aya Tanaka, Fei Yang, Eiji Kiyohara, Yorihisa Kotobuki, Mari Wataya-Kaneda, Naoki Oiso, Ichiro Katayama
KEYWORDS:
Hypopigmentation, Extramammary Paget’s Disease (EMPD), Melanocyte to Paget’s Cell Interaction, Ultrastructural Analysis, Mechanism
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.8 No.1,
March
9,
2018
ABSTRACT: We frequently encounter characteristic color
variation including hypopigmentation, hyperpigmentation, and erythema in
extramammary Paget’s disease (EMPD) lesions. Owing to unclear hypopigmentation,
the lesional border of EMPD can be poorly defined and it is likely insufficient
to perform its complete resection. Although the existence of Toker’s cells and
lack of lesional bFGF production have been reported to cause hypopigmentation
inside of EMPD lesions, exact mechanisms of hypopigmentation in EMPD are not fully explored. We experienced three EMPD patients with obviously
hypopigmented EMPD macules and histopathologically confirmed a reduced number
of melanocytes on the hypopigmented macules and their loss on the erythematous
plaques or nodules. An ultrastructural
analysis on the hypopigmented lesions revealed disturbance of melanosome
maturation and melanosome transfer to the adherent Pagets’ cell on the basal
layer. No Paget’s cells even adhered to remaining melanocytes with dendrites
contained matured melanosome and a few
number of matured melanosome complexes were
observed in basal keratinocytes. In the present study, we hypothesize that
severe disturbance of not only melanogenesis but also melanosome transfer to surrounding
Paget’s cells and basal keratinocytes may cause characteristic hypopigmentation
in EMPD. Future bioanalysis would reveal molecular mechanisms for
hypopigmentation in EMPD.