LYVE-1 expression in skin in necrotizing necrobiosis lipoidica

Background. The mechanisms underlying skin structural changes in necrobiosis lipoidica (NL), which has a torpid course, remain unclear. The role of the lymphatic system and the significance of the LYVE-1 receptor in the etiology and pathogenesis of NL have not been studied. Objective. To evaluate LYVE-1 expression in skin with necrotizing NL. Materials and methods. Clinical observation, detection of the LYVE-1 marker in histological skin sections using immunohistochemistry were used. Results. A decrease in the expression of the LYVE-1 marker was detected in the epidermis and dermis of a patient with necrotizing NL. A study of prelymphatics in the epidermis and lymphatic vessels in the dermis was carried out. The involvement of the vascular and extravascular lymphatic network of various layers of the skin in the development of the disease was established. It was first demonstrated that in the skin of a patient with NL, in areas of the basal and spinous layers with necrobiotically altered cells, in the endothelium of the lymphatic vessels of the papillary layer and deeper layers of the dermis, the LYVE-1+ signal is less pronounced compared to the LYVE-1+ signal in the skin of a healthy person. This is considered as one of the important factors underlying metabolic and functional disorders of all parts of the skin lymphatic system. Conclusion. Low LYVE-1 expression is one of the important factors underlying metabolic and functional disorders of all parts of the skin lymphatic system. Morphologically, this is manifested in changes in the prelymphatics of the epidermis, intercellular connective tissue spaces of the dermis of the skin, swelling of the interstitium, dilatation of the lymphatic vessels of the papillary and reticular layers of the skin, which is evidence of a disturbance of the drainage and detoxification function of the lymphatic system of the skin and, as a consequence, leads to a decrease in the participation of the lymphatic system in maintaining fluid and immune homeostasis.