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Case Reports
. 2009 Feb;160(2):423-5.
doi: 10.1111/j.1365-2133.2008.08844.x. Epub 2008 Sep 20.

Expression of 25-hydroxyvitamin D3-1alpha-hydroxylase in subcutaneous fat necrosis

A Farooque  1 , C Moss, D Zehnder, M Hewison, N J Shaw
Affiliations
Case Reports

Expression of 25-hydroxyvitamin D3-1alpha-hydroxylase in subcutaneous fat necrosis

A Farooque et al. Br J Dermatol. 2009 Feb.

Abstract

Background: The most serious complication of subcutaneous fat necrosis (SCFN), a rare condition of the newborn characterized by indurated purple nodules, is hypercalcaemia. However, the mechanism for this hypercalcaemia remains unclear.

Objectives: To determine whether the hypercalcaemia associated with SCFN involves expression of the vitamin D-activating enzyme 25-hydroxyvitamin D(3)-1alpha-hydroxylase (1alpha-hydroxylase) in affected tissue.

Methods: Skin biopsies from two male patients with SCFN and hypercalcaemia were taken. The histological specimens were assessed using a polyclonal antibody against 1alpha-hydroxylase.

Results: Histology in both cases showed strong expression of 1alpha-hydroxylase protein (brown staining) within the inflammatory infiltrate associated with SCFN. This was consistent with similar experiments in other granulomatous conditions.

Conclusions: Hypercalcaemia in SCFN appears to be due to abundant levels of 1alpha-hydroxylase in immune infiltrates associated with tissue lesions. This is consistent with previous observations of extrarenal 1alpha-hydroxylase in skin from other granulomatous conditions such as sarcoidosis and slack skin disease.

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Figures

Fig 1
Fig 1
An infant with an area of subcutaneous fat necrosis on the back.
Fig 2
Fig 2
Expression of 25-hydoxyvitamin D3-1α-hydroxylase (1α-hydroxylase) protein in skin from two male infants with subcutaneous fat necrosis. Subcutaneous fat with partial fibrosis and dense infiltrate. This dense filtrate of mononuclear cells is stained strongly for 1α-hydroxylase protein (a–c). Original magnification: (a) × 100, (b) × 150, (c) × 300. (d) Normal epidermis with expression of 1α-hydroxylase protein within the stratum basalis.
See this image and copyright information in PMC

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