In AF, the skin shows large areas o

In AF, the skin shows large areas of necrosis, with
ulcerations covered by parakeratotic crusts formed by
agglomeration of PMNs. Ulcer base is occupied by a
necrotic and fibrinoid detritus and edema. Inflammatory
infiltrate contains intact and lysed PMNs and incorporates
partially destroyed vessels and apocrine sweat glands
[11]. As well as in the literature, to our patient, the
inflammatory reaction extended to the middle and deep
dermis, consisting of PMNs, macrophages, lymphocytes
and plasma cell [8]. Also, sometimes microabcesses form
and dissect the dermis in different direction or sinuous
tracts [14].
The results of few electron microscopic studies on
AF cases are published in the literature [10, 11, 15].
In AF, P. acnes could be also detected in perifollicular
dermal macrophages, but at extracellular, in their vicinity.
Also, besides the intense destructive processes of the
epidermis and dermis intense as a result of an extensive
inflammatory process evolving toward necrosis large areas
of fibrosis do occur [16]. As well as in the literature [17],
we also found numerous lysosomal vacuoles in which
partially altered P. acnes was found, and a large collagen
fibers, arranged in strips different directions, consequence
of the chronic inflammatory process.
Immunohistochemical investigations of acne lesions,
AF included, are extremely few worldwide.
Cytokeratins or prekeratins are part of a system of
intermediate filaments, which is found in the cytoplasm
of simple and multilayered epithelia, keratinized or nonkeratinized.
Intermediate filaments are a part of the cytoskeleton
of all cellular elements and, depending on their protein
structure, are divided into five classes: cytokeratins,
vimentin, desmin, neurofilaments, and glial filaments.
Moll divided cytokeratins into three groups and has
numbered them 1 to 20, as follows: high molecular weight
(MW) (1–2, 3, 9, 10–11), medium MW cytokeratins (4,
5, 6, 13, 14–15, 16) and the low MW cytokeratins (7, 8,
17, 18, 19, 20) [18, 19].
Expression of cytokeratins in normal skin varies
depending on the position of keratinocytes in the various
layers of the epidermis. Thus, basal layer cells express
cytokeratins 5, 14–15, 17 and 19 (according to Moll
classification) [19]. The cells of spinous, granular and
shiny layers are positive for cytokeratins 4, 5, 10–11, 13,
14–15, 17 and 19. Stratum corneum presents cytokeratins
1–2, 6, 10–11 and 16. Corneocytes that desquamate are
marked by cytokeratins 1–2, 9, 10–11 [20].
There are studies confirming the marked proliferation
of keratinocytes in the infrainfundibular portion of the
pilosebaceous follicle by increasing the expression of
cytokeratins 6 and 16, at their level, in acne patients or
in those likely to develop acne compared to normal
individuals. Another study, which used the monoclonal
antibodies Ki-67 that fixes on nuclei of cells undergoing
division, showed their marked expression in the keratinocytes
of comedone wall compared to the normal pilosebaceous
follicle wall.

Results (Indonesian) 1:

Dalam AF, kulit menunjukkan daerah besar nekrosis, denganulserasi ditutupi oleh remah parakeratotic dibentuk olehaglomerasi PMNs. ulkus basis diduduki olehsisa-sisa nekrotik dan fibrinoid dan edema. Inflamasimenyusup berisi PMNs utuh dan segaris dan menggabungkansebagian rusak kapal dan apocrine kelenjar keringat[11]. serta di dalam literature, untuk pasien kami,reaksi inflamasi yang diperpanjang ke tengah dan mendalamdermis, terdiri dari PMNs, makrofag, limfositdan sel plasma [8]. Juga, kadang-kadang microabcesses bentukdan membedah dermis arah yang berbeda atau berliku-likuTraktat [14].Hasil studi mikroskopis elektron beberapaAF kasus diterbitkan dalam literatur [10, 11, 15].Di AF, P. acnes bisa juga terdeteksi dalam perifolliculardermal makrofag, tetapi pada ekstraseluler, di sekitar mereka.Juga, selain proses destruktif intensepidermis dan dermis intens sebagai hasil dari luasproses inflamasi yang berkembang menuju daerah besar nekrosisdari fibrosis terjadi [16]. Serta di literatur [17],Kami juga menemukan banyak vakuola lisosomal di manasebagian berubah P. acnes ditemukan, dan kolagen yang besarserat, diatur dalam arah yang berbeda strip, konsekuensiproses inflamasi kronis.Imunohistokimia penyelidikan lesi jerawat,AF disertakan, yang sangat sedikit di seluruh dunia.Cytokeratins atau prekeratins adalah bagian dari sistemfilamen menengah, yang ditemukan di dalam sitoplasmadari sederhana dan berlapis-lapis epithelia, keratinized atau nonkeratinized.Filamen menengah adalah bagian dari SitoskeletonSemua selular elemen dan, tergantung pada protein merekastruktur, dibagi menjadi lima kelas: cytokeratins,vimentin, desmin, neurofilaments, dan glial filamen.Moll cytokeratins dibagi menjadi tiga kelompok dan memilikinomor 1 untuk 20, sebagai berikut: berat molekul tinggi(MW) (1-2, 3, 9, 10-11), menengah MW cytokeratins (4,5, 6, 13, 14-15, 16) dan cytokeratins MW rendah (7, 8,17, 18, 19, 20) [18, 19].Ekspresi cytokeratins di kulit normal bervariasitergantung pada posisi keratinocytes dalam berbagailapisan epidermis. Dengan demikian, sel-sel basal lapisan Checkcytokeratins 5, 14-15, 17 dan 19 (menurut Mollklasifikasi) [19]. Sel-sel spinous, rinci danlapisan mengkilap positif untuk cytokeratins 4, 5, 10-11, 13,14-15, 17 dan 19. Stratum memiliki menyajikan cytokeratins1 – 2, 6, 10-11 dan 16. Corneocytes yang desquamate adalahditandai dengan cytokeratins 1-2, 9, 10-11 [20].Ada studi yang mengkonfirmasikan proliferasi ditandaidari keratinocytes di bagian infrainfundibularfolikel pilosebaceous dengan meningkatkan ekspresicytokeratins 6 dan 16, pada tingkat mereka, pada pasien jerawat atauorang cenderung mengembangkan jerawat dibandingkan dengan normalindividu. Studi lain, yang digunakan monoklonalantibodi Ki-67 yang perbaikan pada inti sel yang mengalamiDivisi, menunjukkan ekspresi mereka ditandai dalam keratinocytescomedone dinding dibandingkan pilosebaceous biasadinding folikel.