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. 2019 Jul 31;10:1808. doi: 10.3389/fimmu.2019.01808

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Copyright © 2019 Solimani, Pollmann, Schmidt, Schmidt, Zheng, Savai, Mühlenbein, Pickert, Eubel, Möbs, Eming and Hertl.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Clinical response of oral lichen planus to treatment with guselkumab and phenotypical analysis of the T cell infiltrate by immunohistochemistry and multiplex immunohistochemistry. (A) Clinical appearance of the oral mucosa with marked ulcerative lesions (dotted blue line) of patient 5 on treatment with guselkumab before treatment at week 0 (W0) and at W4, W8, W26, and W30 with the clinical course assessed by ABSIS score. There is a complete resolution of the ulcerative lesions of the tongue by W30. (B) Immunohistochemical staining for CD4, CD8, and IL-17 before treatment with guselkumab. Single staining with CD4⁺, CD8⁺ (red), and IL-17 (green) as well as double positive-staining of CD4⁺ or CD8⁺ T cells with IL-17 (black) are highlighted by arrows. (C) Multiplexed immunohistochemistry images of skin lesions showing each of the individual markers in the composite image after spectral unmixing. Markers are as below: CD4 (Opal 620, pseudocoloured red), CD8 (Opal 690, pseudocoloured cyan), IL−17 (Opal 540, pseudocoloured green), and DAPI as a nuclear marker (blue) (upper row), Multiplexed immunohistochemistry images of CD4 or/and CD8 staining merged with IL-17 (middle row). Multiplexed immunohistochemistry images of CD4 or/and CD8 along with IL-17 merged with DAPI (lower row). The cell phenotyping map identifies CD4⁺IL17⁺ cells (red dots), CD8⁺IL17⁺ cells (yellow dots), CD4⁺IL17⁻ cells (cyan dots), CD8⁺IL17⁻ cells (green dots), and other cells (blue dots).