ULTRASTRUCTURE AND 3-DIMENSIONAL RECONSTRUCTION OF SEVERAL MACULAR AND PAPULAR TELANGIECTASES
ULTRASTRUCTURE AND 3-DIMENSIONAL RECONSTRUCTION OF SEVERAL MACULAR AND PAPULAR TELANGIECTASES
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DOI：
10.1111/1523-1747.ep12522736
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发表时间：
1983-01-01
影响因子：
6.5
通讯作者：
KEHYEN, A
中科院分区：
文献类型：
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作者：
BRAVERMAN, IM;KEHYEN, A
通过光镜、电镜和显微照片三维重建对8种类型的毛细血管扩张进行了研究。五种是黄斑斑：硬皮病的轻度毛细血管扩张，广泛性特发性毛细血管扩张，红痣和2种以前未描述的黄斑类型。三种是丘疹性：樱桃血管瘤、血管角质瘤（Fabry）和血管角质瘤（Fordyce）。黄斑毛细血管扩张是由上水平神经丛毛细血管后小静脉扩张引起的。没有新血管形成或血管畸形的证据。扩张后的小静脉壁增厚，周围有基底膜样物质混合网状纤维沉积。丘疹毛细血管扩张的超微结构和形态不同。樱桃血管瘤是由真皮乳头毛细血管袢呈球形和管状扩张而产生的。每个异常扩张的血管袢通过弯曲的血管通道与邻近的血管袢相连。上水平神经丛血管未受累。超微结构上，樱桃血管瘤由静脉毛细血管和毛细血管后小静脉组成，其壁增厚的方式与黄斑毛细血管扩张相同。法布里和福代斯的血管角肿也是由主要累及真皮乳头的血管异常引起的。在超微结构上，这些血管与通常在真皮-皮下界面上发现的小集合静脉相似。丘疹毛细血管扩张也由现有微血管的改变引起，而不是由随机吻合的新血管的增生引起。正常皮肤重建的上水平神经丛显示出小动脉及其伴随的毛细血管后小静脉的波动网络。未见小静脉、小动脉、小静脉排列的3层神经丛。
Eight types of telangiectases were studied by light microscopy and EM, and by 3-dimensional reconstruction from photomicrographs. Five were macular: mat telangiectasia of scleroderma, generalized essential telangiectasia, nevus flammeus, and 2 macular types not previously described. Three were papular: cherry angioma, angiokeratoma (Fabry), and angiokeratoma (Fordyce). The macular telangietases were produced by dilatation of postcapillary venules of the upper horizontal plexus. There was no evidence of neovascularization or vascular malformation. The walls of the dilated venules were thickened by the peripheral deposition of basement membrane-like material admixed with reticulin fibers. The ultrastructure and configuration of the papular telangiectases were different. The cherry angioma was produced by spherical and tubular dilatations of capillary loops in dermal papillae. Each abnormally dilated loop was connected to the neighboring loop or loops by tortuous vascular channels. The vessels in the upper horizontal plexus were not involved. Ultrastructurally, the cherry angiomas were composed of both venous capillaries and postcapillary venules whose walls were thickened in a manner identical to that observed in the macular telangiectases. The angiokeratomas of Fabry and Fordyce were also produced by vascular abnormalities predominantly involving the dermal papillae. Ultrastructurally these vesels were similar to the small collecting veins which are normally found at the dermal-subcutaneous interface. The papular telangiectases also arose by alterations of the existing microvasculature rather than by proliferation of new vessels with random anastomoses. Reconstruction of the upper horizontal plexus from normal skin showed an undulating network of arterioles and their accompanying postcapillary venules. A 3-layered plexus arranged as venules, arterioles and venules was not found.