The role of extracellular polysaccharide substance produced by Staphylococcus epidermidis in miliaria

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      Abstract

      Background: Previous studies have indicated that cutaneous bacteria, particularly coagulasenegative staphylococci, play a role in the pathogenesis of miliaria. An accumulation of periodic acid-Schiff (PAS)-positive material has been described as blocking the sweat duct in miliaria. Furthermore, a PAS-positive extracellular polysaccharide substance (EPS) has been indentified as a product of some strians of Staphylococcus epidermidis.
      Objective: We evaluated the relative ability of various species of coagulase-negative staphylococci to induce miliaria with particular reference to the potential role of EPS.
      Methods: We inoculated various strains of coagulase-negative staphylococci on the volar forearms of subjects under an occlusive dressing coupled with thermal stimulation. Ability to induce miliaria as well as microbiologic, histologic, and immunostaining features were evaluated.
      Results: Miliaria was induced only with strains of S. epidermidis; other species including S. haemolyticus, S. hominis, S. cohnii, S. saprophyticus, and S. simulans were not capable of inducing miliaria. Moreover, only S. epidermidis strains capable of producing EPS were capable inducing miliaria.
      Conclusion: Our data indicate that EPS is the PAS-positive material that obstructs the delivery of sweat to the skin surface in miliaria and therefore demonstrate that the EPS produced by S. epidermidis plays a central role in the pathogenesis of miliaria. Furthermore, in a survey of staphylococcal flora isolated from 68 subjects, EPS-producing strains were found to be common.
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      References

        • Robinson AR
        Miliaria and sudamina.
        J Cutan Venreal Dis. 1884; 2: 362-365
        • Pollitzer S
        Prickly heat-lichen tropicus, miliaria papulosa, miliaria rubra, etc..
        J Cutan Genito-Urinary Dis. 1893; 11: 50-56
        • Schlacta J
        Ueber Experimentelle Erzeugung der Miliaria Crystallina.
        Monatshefte fur Praktische Dermatologie. 1908; 46: 165
        • Sulzberger MB
        • Zimmerman HM
        Studies on prickly heat. II. Experimental and histologic findings.
        J Invest Dermatol. 1946; 7: 61-68
        • Shelley WB
        • Horvath PN
        Experimental miliaria in man. III. Production of miliaria rubra (prickly heat).
        J Invest Dermatol. 1950; 14: 193-204
        • Dobson RL
        • Lobitz WC
        Some histochemical observations on the human eccrine sweat glands.
        Arch Dermatol. 1957; 75: 653-666
        • Cormia FE
        • Kuykendall V
        Studies on sweat retention in various dermatoses.
        Arch Dermatol. 1954; 69: 543-553
        • Papa CM
        • Kligman AM
        Mechanisms of eccrine anhidrosis. I. High level blockage.
        J Invest Dermatol. 1966; 47: 1-9
        • Unna PG
        The histopathology of diseases of the skin.
        in: William F Clay, Edinburgh1896: 908
        • Acton HW
        Prickly heat.
        Indian Medical Gazette. 1926; 61: 321
        • O'Brien JP
        The etiology of poral closure, I–IV.
        J Invest Dermatol. 1950; 15: 95-156
        • Lyons RE
        • Levine R
        • Auld D
        Miliaria rubra: a manifestation of staphylococcal disease.
        Arch Dermatol. 1962; 86: 282-286
        • Lyons RE
        • Hunt JA
        The treatment of miliaria rubra with neomycin lotion.
        J Invest Dermatol. 1954; 24: 557-559
        • Stillman MA
        • Hindson TC
        • Maibach HI
        The effect of pretreatment of skin in artificially induced miliaria rubra and hypohidrosis.
        Br J Dermatol. 1971; 84: 110-115
        • Holzle E
        • Kligman AM
        The pathogenesis of miliaria rubra: role of the resident microflora.
        Br J Dermatol. 1978; 99: 117-137
        • Yanagawa S
        • Yokozeki H
        • Sato K
        Origin of periodic acid-Schiff-reactive glycoprotein in human eccrine sweat.
        J Appl Physiol. 1986; 60: 1615-1622
        • Christensen GD
        • Simpson WA
        • Bisno AL
        • et al.
        Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surface.
        Infect Immun. 1982; 37: 318-326
        • Bayston R
        • Penny SR
        Excessive production of mucoid substance in staphylococcus SIIA: a possible factor in colonization of Holter shunts.
        Dev Med Child Neurol. 1972; 14: 25-28
        • Davenport DS
        • Massanari RM
        • Pfaller MA
        • et al.
        Usefulness of a test for slime production as a marker for clinically significant infections with coagulase-negative staphylococci.
        J Infect Dis. 1986; 153: 332-339
        • Christensen GD
        • Simpson WA
        • Bisno AL
        • et al.
        Experimental foreign body infections in mice challenged with slime-producing Staphylococcus epidermidis.
        Infect Immun. 1983; 40: 407-410
        • Ludwicka AG
        • Uhlenbruck G
        • Peters G
        • et al.
        Investigation on extracellular slime substance produced by Staphylococcus epidermidis.
        Zentralbl Bakteriol Microbiol Hyg (A). 1984; 258: 256-267
        • Peters G
        • Schumacher-Perdreau F
        • Jansen B
        • et al.
        Biology of S. epidermidis extracellular slime.
        in: Pulverer G Quie PG Peters G Pathogenicity and clinical significance of coagulase-negative staphylococci. G Fischer Verlag, Stuttgart, Germany1987: 15-31
        • Kotilainen P
        • Maki J
        • Oksman P
        • et al.
        Immunochemical analysis of the extracellular slime substance of Staphylococcus epidermidis.
        Eur J Clin Microbiol Infect Dis. 1990; 9: 262-270
        • Sulzberger MB
        • Emik LO
        Studies on prickly heat. I. Clinical and statistical findings.
        J Invest Dermatol. 1946; 7: 53-59
        • Lever WF
        Histopathology of the skin.
        in: 6th ed. JB Lippincott, Philadelphia1983: 114