The evolution of histopathologic findings in adult Still disease.
The evolution of histopathologic findings in adult Still disease.
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成人斯蒂尔病组织病理学结果的演变。
DOI：
10.1097/dad.0b013e31820c6dd1
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Andea,AleodorA
中科院分区：
文献类型：
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作者：
Woods,MatthewT;Gavino,ACarlo;Burford,HollyN;Hughey,SLauren;Mercado,Patricia;Danila,Maria;Andea,AleodorA
成人斯蒂尔病是一种典型的炎性关节炎，伴有每日高热、一过性皮疹、器官肿大、淋巴结病和实验室异常。典型的皮肤损害是麻疹样分布的粉红色丘疹，持续时间短。组织学上，这些病变的特征是浅表血管周围和间质性混合性皮炎，伴有淋巴细胞和可变中性粒细胞。一个变异的临床表现越来越多地认识到，这表明持续色素沉着斑块，往往与波纹或线性外观。组织学检查结果包括上表皮角化不良角质形成细胞、真皮粘蛋白增加和淋巴细胞和可能的中性粒细胞或嗜酸性粒细胞的浅表血管周围浸润。我们遇到了2例患者谁提出的特征性皮疹成人斯蒂尔病，他们都进展发展色素沉着的皮肤斑块。我们认为，这种变异的临床和组织学表现是持续性疾病活动的结果。
Adult Still disease is an inflammatory arthritis classically associated with daily spiking fevers, evanescent rash, organomegaly, lymphadenopathy, and laboratory anomalies. The typical cutaneous lesions are thin pink papules in a morbilliform distribution, of short duration. Histologically, these lesions are characterized by a superficial perivascular and interstitial mixed dermatitis with lymphocytes and variable neutrophils. A variant clinical presentation is increasingly recognized, which demonstrates persistent hyperpigmented plaques, often with a rippled or linear appearance. The histologic findings consist of upper epidermal dyskeratotic keratinocytes, increased dermal mucin, and a superficial perivascular infiltrate of lymphocytes and possibly neutrophils or eosinophils. We encountered 2 patients who presented with the characteristic rash of adult Still disease, both of whom progressed to develop the pigmented cutaneous plaques. We propose that this variant clinical and histologic appearance is the outcome of persistent disease activity.