Diagnostic histopathological features distinguishing palmoplantar pustulosis from pompholyx
Diagnostic histopathological features distinguishing palmoplantar pustulosis from pompholyx
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DOI：
10.1111/1346-8138.14850
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发表时间：
2019-05-01
影响因子：
3.1
通讯作者：
Sayama, Koji
中科院分区：
文献类型：
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作者：
Masuda-Kuroki, Kana;Murakami, Masamoto;Sayama, Koji
掌跖脓疱病（PPP）和汗疱疹都是发生在手掌和脚掌的慢性和复发性疾病。虽然这两种疾病被认为是完全不同的，但由于它们在临床表现上的相似性，有时甚至皮肤科医生也很难将它们区分开来。本研究旨在通过分析PPP和汗疱疹的组织病理学特征，寻找PPP和汗疱疹鉴别诊断的“线索”。对11例PPP和6例汗渍病患者进行了组织病理学观察，均具有典型的临床病史和组织病理学诊断。将PPP分为水疱、脓疱水疱和脓疱3个阶段，将汗疱疹分为水疱和脓疱2个阶段，并初步建立了PPP和汗疱疹的组织病理学表现和4点鉴别检查表。为了确认检查表是否建立了诊断线索，根据我们的检查表检查了43例已在5家医院确诊的患者（32例PPP和11例汗疱疹）的活检样本，没有任何额外的临床信息。根据我们的4点检查表，32例PPP患者中的31例和所有11例汗疱疹患者的组织病理学诊断与临床诊断一致。因此，组织病理学上之“无海绵状变之囊泡”及“囊泡边缘之微脓疡”可作为鉴别诊断之依据。4点检查表是可信的，以区分PPP和pompholyx。
Palmoplantar pustulosis (PPP) and pompholyx are both chronic and relapsing diseases occurring on the palms and soles. Although these two diseases have been considered completely different from each other, it is sometimes very difficult even for dermatologists to differentiate them from each other because of their similarities in clinical presentation. In this study, we aimed to analyze the histopathological features of PPP and pompholyx and find out "clues" to differentiate between PPP and pompholyx by their histopathological features. The histopathology of 11 PPP and six pompholyx patients, who were diagnosed with typical clinical history and histopathology, were carefully observed. PPP cases were divided into three phases (vesicle, pustulovesicule and pustule) and pompholyx cases were divided into two phases (vesicle and pustule), and histopathological findings and a 4-point checklist to distinguish between PPP and pompholyx were preliminarily established. To confirm whether the checklist establishes the clues for diagnosis, biopsy samples from 43 patients (32 PPP and 11 pompholyx) who had been already diagnosed at five hospitals were examined according to our checklist without any additional clinical information. According to our 4-point checklist, 31 of 32 PPP patients and all 11 pompholyx patients were diagnosed histopathologically consistent with their clinical diagnosis. In conclusion, histopathological findings of "vesicles without spongiosis" and "microabscess on the edges of vesicles" would be impact points for the differential diagnosis between PPP and pompholyx. The 4-point checklist was trustworthy to distinguish between PPP and pompholyx.