Retrospective Analysis Of Clinical Characteristics In Pruritic Dermatosis From A Single Center And Study On The Expression Of BNP In Pruritic Dermatosis

Objective:Through the retrospective analysis of the clinical data of patients with pruritic dermatosis from a single center,we aim to explore the relevance between clinical data and visual analog scale(VAS)of pruritus.To observe the expression of type B natriuretic peptide(BNP)and its two receptors NPR1 and NPR2 in normal skin and pruritic dermatosis,and to discuss the role of BNP in pruritic dermatosis.Methods:In this retrospective study,We included 110 cases of atopic dermatitis(AD),118 cases of chronic eczema(CE),24 cases of prurigo nodular(PN),37 cases of chronic actinic dermatosis(CAD),107 cases of psoriasis vulgaris(PV),80 cases of bullous pemphigoid(BP),40 cases of urticarial drug eruption(UDE),15 cases of mycosis fungoides(MF),diagnosed clinically and/or pathologically in the dermatological inpatient department of the First Affiliated Hospital of Fujian Medical University from February 2016 to February 2021.After collecting the data of serum BNP,IgE,WBC,Eos,Eos%,Bas,Bas%,CRP,DD and VAS scores,we analyzed the relevance between them.For pathological investigation,we included 15 cases of AD,15 cases of CE,15 cases of PN,10 cases of CAD,15 cases of PV,15 cases of BP,9cases of UDE,7 cases of MF and 15 healthy controls of normal patients’skin tissues,diagnosed clinically and pathologically in the dermatology clinic and inpatient department of the First Affiliated Hospital of Fujian Medical University from February 2016 to February 2021.All cases above were stained with BNP,NPR1 and NPR2 with immunohistochemistry(IHC)staining and detected by image analysis.We further discussed the possible biological role of BNP,NPR1 and NPR2in the pathogenesis of pruritus in pruritic dermatosis.Result:1.There was no significant difference in the positive rate of BNP in each group compared with the control group(P>0.05);IgE was elevated in AD(X~2=5.75,P=0.02),CE(X~2=37.17,P<0.001),PN(X~2=25.66,P<0.001),CAD(X~2=23.27,P<0.001),PV(X~2=12.99,P<0.001),BP(X~2=31.64,P<0.001),UDE(X~2=19.86,P<0.001),MF(P=0.03)groups;D-Dimer was elevated in AD(X~2=12.06,P<0.001),CE(X~2=27.12,P<0.001),PN(X~2=6.55,P=0.01),CAD(X~2=13.46,P<0.001),BP(X~2=52.34,P<0.001),UDE(X~2=29.43,P<0.001)groups;Eos was elevated in AD(X~2=30.59,P<0.001),CE(X~2=27.12,P<0.001),PN(X~2=6.55,P=0.01),BP(X~2=52.34,P<0.001)groups;Bas was elevated in AD(X~2=4.9,P=0.03)group.2.There was no significant difference was observed in the Spearman correlation coefficient between BNP and VAS scores among the total(ρ=0.046,P>0.05).There was no relevance among BNP and AD(ρ=-0.166,P=0.319),CE(ρ=0.009,P=0.941),PN(ρ=0.152,P=0.33),CAD(ρ=0.181,P=0.42),PV(ρ=-0.112,P=0.453),BP(ρ=-0.014,P=0.923),UDE(ρ=-0.193,P=0.47),MF(ρ=0.401,P=0.83)groups respectively。Bas%was positively correlated with VAS scores in PN group.CRP was positively correlated with VAS scores in CAD and MF groups.3.IgE was positively correlated with VAS in AD severe pruritus group(ρ=0.222,P=0.029),CE moderate pruritus group(ρ=0.331,P=0.005),PN moderate pruritus group(ρ=0.609,P=0.047).D-dimer was positively correlated with VAS in the AD moderate pruritus group(ρ=0.361,P=0.001),AD severe pruritus group(ρ=0.306,P=0.047),CE moderate pruritus group(ρ=0.321,P=0.001),PN moderate pruritus group (ρ=0.666,P=0.036)and BP severe pruritus group(ρ=0.791,P=0.034).Eos%was positively correlated with VAS in AD moderate pruritus group(ρ=0.361,P=0.001),BP severe pruritus group(ρ=0.791,P=0.034)and UDE moderate pruritus group(ρ=0.393,P=0.016).4.The positive rate of BNP expression in normal skin,AD,CE,PN,CAD tissue was 0%,86.6%,80.0%,75%,80%respectively,the difference were statistically significant(P<0.001);the positive rate of BNP expression in psoriasis vulgaris tissue was 6.7%,while the difference was not statistically significant(P=0.5).BNP were negative in BP,MF and UDE.5.NPR2 was negatively expressed in all group of tissue.The positive rate of NPR1 expression in normal skin,AD,CE,PN,CAD tissue was 0%,86.6%,80.0%,75%,80%respectively,the difference were statistically significant(P<0.001).NPR1 were negatively expressed in PV,BP,MF and UDE.Conclusion:1.IgE,D-dimer,Eos%and Bas have the potential to be the pruritus-associated biomarkers.2.The risk of thrombosis in patients with eosinophils-related pruritic dermatosis should be correctly judged in clinical work.3.BNP/NPR1 pathway may be involved in the pathogenesis of pruritus of AD,CE,PN and CAD.