Elafin is a serine proteinase inhibitor highly expressed in psoriatic epidermal keratinocytes, but expressed scarcely, if at all, in normal skin. In addition to the proteinase inhibiting domain, elafin contains multiple transglutaminase substrate domains and has been identified as a constituent of the epidermal cornified cell envelope. It also contains a signal peptide sequence, and elafin has been detected by immunoelectron microscopy in lamellar granules and also in the intercellular spaces of stratum corneum . These findings strongly suggest that elafin-containing granules are disintegrated upon the initiation of cell envelope formation, and that elafin is cross-linked on to the involucrin -positive cell envelope from the inside of keratinocytes. It has been observed that elafin is a major component of the cell envelope in psoriatic skin.
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