Ekspresi Endotelin-1 pada Berbagai Variasi Histopatologis Keratosis Seboroik

Abstract

Background: Seborrheic keratosis is a benign tumor, composed of keratynocites with increased pigmentation. Seborrheic keratosis histopathological variants are acanthotic, flat, irritated, stuccokeratosis, pigmented, reticulated, pedunculated, dermatosis papulose nigra, and klonal. It suggested that the enhanced pigmentation in seborrheic keratosis is attributable to the upregulated expression of endothelin-1 by highly proliferating basaloid cells. Objective: To describe endothelin-1 expression on seborrheic keratosis histopathological variants. Materials and Methods: This study was descriptive observasional and cross sectional study, used 40 samples of seborrheic keratosis’ lesions that diagnosed based on histopathological examinations, and the histopathological variants have determined. Result: Endothelin-1 expressions of 14 acanthotic variants were strong 4 samples (28,57%), moderate 4 samples (28,57%), and weak 6 samples (42,85%) and endothelin-1 was located in stratum basale 9 samples (64,28%), one-third lower part of the epidermis 1 sample (7,14%), and epidermis 4 samples (28,57%). Endothelin-1 expressions of 6 flat variants were strong 1 sample (16,67%), moderate 2 samples (33,33%), and weak 3 samples (50%) and endothelin-1 was located in stratum basale 5 samples (83,33%) and one-third lower part of the epidermis 1 sample (16,66%). Endothelin-1 expression of 1 irritated variant was weak 1 sample (100%) and endothelin-1 was located in epidermis 1 sample (100 %). Endothelin-1 expressions of 3 stuccokeratosis variants were strong 2 samples (33,33%), moderate 1 sample (16,67%), and weak 3 samples (50%) and endothelin-1 was located in stratum basale 4 samples (66,67%), one-third lower part of the epidermis 1 sample (16,66%), and epidermis 1 sample (16,66%). Endothelin-1 expressions of 2 pigmented variants were strong 2 (10%) and endothelin-1 was located in stratum basale 1 sample (50%), and epidermis 1 sampel (50%). Endothelin-1 expressions of 7 reticulated variants were strong 1 sampel (14,28%), moderate 4 samples (57,14%), and weak 2 samples (28,57%) and endothelin-1 was located in stratum basale 7 samples(100%). Endothelin-1 expression of 1 pedunculated variant was moderate 1 sample (100%) and endothelin-1 was located in stratum basale 1 sample (100%). Endothelin-1 expressions of 3 dermatosis papulose nigra variants were moderate 2 samples (66,67%) and weak 1 sample (33,33%) and endothelin-1 was located in stratum basale 2 samples (66,67%) and epidermis 1 sample (33,33%). Conclusion: Endothelin-1 expressions of seborrheic keratosis histopathological variants were strong 25% (acanthotic 10 %, stuccokeratosis 5%, pigmented 5%, flat 2,5%, and reticulated 2,5%), moderate 35% (acanthotic 10%, flat 5%, stuccokeratosis 2,5%, reticulated 10%, pedunculated 2,5%, dermatosis papulose nigra 5%), and weak 40% (acanthotic 15%, flat 7,5%, irritated 2,5%, stuccokeratosis 7,5%, reticulated/adenoid 5% and dermatosis papulose nigra 2,5%).

Latar belakang: Keratosis seboroik adalah suatu tumor benigna yang terdiri dari keratinosit epidermis dengan pigmentasi meningkat. Variasi histopatologis keratosis seboroik adalah: akantotik, flat, irritated, stuccokeratosis, pigmented, reticulated, pedunculated, dermatosis papulose nigra, dan klonal. Diduga bahwa melanisasi yang meningkat yang terobservasi pada keratosis seboroik dikaitkan dengan produksi endotelin-1 yang meningkat pada proliferasi keratinosit yang tinggi sehingga menimbulkan neoplasma. Tujuan: Mengetahui ekspresi endotelin-1 pada berbagai variasi histopatologis keratosis seboroik. Metode: Penelitian ini menggunakan studi deskriptif observasional laboratoris dengan rancangan potong lintang yang menggunakan 40 blok parafin yang telah diperiksa secara histopatologis sebagai keratosis seboroik dan telah ditentukan variasi histopatologinya. Hasil: Ekspresi endotelin-1 pada 14 sampel keratosis seboroik varian akantotik didapati kuat 4 sampel (28,57%), sedang 4 sampel (28,57%), dan lemah 6 sampel (42,85%), dan letak endotelin-1 pada stratum basalis 9 sampel (64,28%), 1/3 bawah lapisan epidermis 1 sampel (7,14%), dan seluruh lapisan epidermis 4 sampel (28,57%). Ekspresi endotelin-1 pada 6 sampel keratosis seboroik varian flat didapati kuat 1 sampel (16,67 %), sedang 2 sampel (33,33%), dan lemah 3 sampel (50 %) dan letak endotelin-1 pada stratum basalis 5 sampel (83,33%), dan 1/3 bawah lapisan epidermis 1 sampel (16,66%). Ekspresi endotelin-1 pada1 sampel keratosis seboroik varian irritated didapati lemah 1 sampel (100%) dan letak endotelin-1 pada seluruh lapisan epidermis 1 sampel (100%). Ekspresi endotelin-1 pada 6 sampel keratosis seboroik varian stuccokeratosis didapati kuat pada 2 sampel (33,33 %), sedang 1 sampel (16,67%), dan lemah 3 sampel (50%) dan letak endotelin-1 pada stratum basalis 4 sampel (66,67%), 1/3 bawah lapisan epidermis 1 sampel (16,66%), dan seluruh lapisan epidermis 1 sampel (16,66%). Ekspresi endotelin-1 pada 2 sampel keratosis seboroik varian pigmented didapati kuat pada 2 sampel (100 %) dan letak endotelin-1 pada stratum basalis 1 sampel (50%), dan seluruh lapisan epidermis 1 sampel (50%). Ekspresi endotelin-1 pada 7 sampel keratosis seboroik varian reticulated didapati kuat 1 sampel (14,28%), sedang 4 sampel (57,14%), dan lemah 2 sampel (28,57%) dan letak endotelin-1 pada stratum basalis 7 sampel (100%). Ekspresi endotelin-1 pada 1 sampel keratosis seboroik varian pedunculated didapati sedang 1 sampel (100%) dan letak endotelin-1 pada lapisan stratum basalis 1 sampel (100%). Ekspresi endotelin-1 pada 3 sampel keratosis seboroik varian dermatosis papulose nigra didapati sedang 2 sampel (66,67%), dan lemah 1 sampel (33,33%) dan letak endotelin-1 pada stratum basalis 2 sampel (66,67%), dan seluruh lapisan epidermis 1 sampel (33,33%). Kesimpulan: Dilihat dari ekspresi endotelin-1 pada berbagai variasi histopatologis keratosis seboroik maka didapatkan ekspresi endotelin-1 yang kuat 25% (tipe akantotik 10%, stuccokeratosis 5%, pigmented 5%, flat 2,5%, dan reticulated 2,5%), sedang 35% (akantotik 10%, flat 5%, stuccokeratosis 2,5%, reticulated 10%, pedunculated 2,5%, dermatosis papulose nigra 5%), dan lemah 40% (akantotik 15%, flat 7,5%, irritated 2,5%, stuccokeratosis 7,5%, reticulated/ adenoid 5%, dan 1 dermatosis papulose nigra 2,5%).