The Cutaneous Telocytes.

Telocytes (TCs) are interstitial cells found in stroma of many organs, including the skin dermis. Ultrastructurally, normal skin TCs recapitulates all the previously documented features in interstitum of other organs. Their (ultra)structural hallmark is the presence of particular shaped cellular prolongations (termed telopodes), along other features as cellular organelles representation and their distribution within cell body and its prolongations. Transmission electron microscopy (TEM) or high magnification light microscopy indicated that the particular shape of telopodes alternate characteristically thin segments (termed podomeres) and dilated segments (called podoms). A new and powerful technique, focused ion beam scanning electron microscopy (FIB-SEM), indicated that, ultrastructurally, telopodes could be either irregular ribbon-like structures, or uneven tubular-like structures. TEM images shown that podoms consists mitochondria, elements of endoplasmic reticulum and caveolae. Immunohisochemical studies on skin TCs revealed their positive expression for CD34 and PDGFRα, but for vimentin and c-kit, also. In normal dermis, TCs are involved in junctions, either homocellular (TCs-TCs), or heterocellular (TCs - other type of cells). The junctional attribute of TCs underlies their ability of forming a 3D network within dermis. Beyond the physical interactions, the connections between TCs and other cells could be also chemical, by paracrine secretion via shed vesicles as ultrastructural studies demonstrated. In normal dermis, TCs were found distributed in particular spatial relationships with other interstitial structures and/or cells: vascular structures, nerves, skin adnexa, stem cells and immune reactive cells.To date, the study of TCs was approached into two pathologic conditions: systemic sclerosis and psoriasis. In both diseases, the normal ultrastructure of TCs and also their distribution were shown to be altered. Moreover, the pattern of TCs ultrastructural changes differs in systemic sclerosis (cytoplasmic vacuolization, swollen mitochondria, lipofuscin bodies) from those appeared in psoriasis, characterized by important dystrophic changes (telopodes fragmentation, cytoplasmic disintegration, apoptotic nuclei, nuclear extrusions). Furthermore, in psoriasis, the lesional remission is (ultra)structurally displaying a recovery of dermal TCs at values similar to normal.Considering TCs ultrastructural features, their connections and spatiality in normal dermis and also their pathologic changes, TCs are credited with roles in skin homeostasis and/or pathogeny of dermatological disorders. In our opinion, further researches should be focused on identifying a specific marker for TCs and also on comprehending the pattern of their response in different dermatoses.