Virchows Archiv

, Volume 432, Issue 4, pp 363–370

Cutaneous nerves in atopic dermatitis

A histological, immunohistochemical and electron microscopic study
  • Reiko Urashima
  • M. Mihara

DOI: 10.1007/s004280050179

Cite this article as:
Urashima, R. & Mihara, M. Virchows Archiv (1998) 432: 363. doi:10.1007/s004280050179


 Although pruritus is the cardinal symptom of atopic dermatitis, its mechanism is not well understood. Free nerve endings in the skin are involved in pruritus as itching receptors. We studied the cutaneous nerve fibres in lichenified lesions of 16 patients with adult atopic dermatitis. On immunohistochemistry, fibres immunoreactive for neurofilament, neuron-specific enolase, and protein gene product 9.5 were observed in the papillary dermis and dermoepidermal junctions as well as in the epidermis. In these areas, no fibres stained positively for substance P, neuropeptide Y, vasoactive intestinal peptide, beta endorphin, somatostatin or serotonin. On electron microscopy, the ultrastructure of subepidermal and intraepidermal free nerve endings appeared to be essentially normal. However, the distribution density of the cutaneous nerve fibres was much higher than in normal controls, and the diameter of these fibres was much larger, because of the large number of axons in each nerve fibre. Degranulation of mast cells was not seen. These findings suggest that pruritus in lichenified atopic skin is probably not caused by damage to the cutaneous free nerve endings. In such lesions, the number of the cutaneous free nerve endings is greatly increased, but they may have a normal function.

Key words Atopic dermatitis Pruritus Cutaneous nerve Immunohistochemistry Electron microscopy 

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • Reiko Urashima
    • 1
  • M. Mihara
    • 1
  1. 1.Department of Dermatology, Faculty of Medicine, Tottori University, 36-1, Nishimachi, Yonago, 683, Japan Tel.: (+81) 859-34-8117, Fax: (+81) 859-34-8205JP

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