Palmoplantar pustulosis: a clinical and immunohistological study
Palmoplantar pustulosis: a clinical and immunohistological study
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掌跖脓疱病：临床和免疫组织学研究
DOI：
10.1046/j.1365-2133.1998.02113.x
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发表时间：
1998
影响因子：
10.3
通讯作者：
G. Michaëlsson
中科院分区：
文献类型：
--
作者：
M. Eriksson;E. Hagforsen;I. P. Lundin;G. Michaëlsson
掌跖脓疱病(PPP)是一种常见的慢性皮肤病，对治疗具有很强的抗药性。目前尚不清楚病变位于手掌和脚掌的原因。关于该病的研究很少，尤其是组织学方面的研究。59名PPP患者回答了关于他们的病史的问卷，其中39人接受了临床检查。对39例患者中的22例患者的皮肤活检标本进行了类胰蛋白酶+肥大细胞、EG2+嗜酸性粒细胞、Lipocalin+中性粒细胞和CD3+T淋巴细胞的免疫组织化学研究。用AE1/AE3抗体(细胞角蛋白1~8、10、14/15、16、19)显示汗腺和汗管。除脓疱处的中性粒细胞和真皮上部的淋巴细胞外，脓疱下区也有大量的肥大细胞和嗜酸性粒细胞。脓疱处可见大量嗜酸性粒细胞。在PPP患者的任何标本中均未检测到分泌腺导管的表皮部分，但在所有9名对照组(包括两名吸烟者)中均可检测到。结果表明，肢端空洞参与炎症反应，肥大细胞和嗜酸性粒细胞以一种未知的方式参与炎症反应。在接受临床检查的39名患者中，两名先前诊断为甲状腺疾病，两名患有面筋过敏症。17人有一种或多种血清促甲状腺激素、甲状腺激素、抗甲状腺球蛋白或甲状腺过氧化物酶抗体异常，10人有醇溶蛋白免疫球蛋白(Ig)A抗体。血清免疫球蛋白和嗜酸性粒细胞阳离子蛋白的平均 ± SD增加。从问卷调查中，最值得注意的发现是，59名患者中有56人已经或仍然是吸烟者，所有这些人都在PPP首次出现迹象之前就开始吸烟了。我们假设肢端脊髓空洞可能是炎症的靶点，PPP与自身免疫性甲状腺疾病和吸烟有关。
Pustulosis palmoplantaris (PPP) is a common chronic skin disease, which is very resistant to treatment. It is not known why the lesions are located in the palms and soles. There are few studies of the disease and in particular studies of the histology. Fifty‐nine patients with PPP answered a questionnaire concerning their medical history and 39 of them were clinically examined. Biopsy specimens were taken from involved skin in 22 of the 39 patients and studied immunohistologically for tryptase+ mast cells, EG2+ eosinophils, lipocalin+ neutrophils and CD3+ T lymphocytes. The sweat gland and sweat duct were visualized with AE1/AE3 antibody (cytokeratins 1–8, 10, 14/15, 16, 19). In addition to neutrophils in the pustule and lymphocytes in the upper dermis, there were also large numbers of mast cells and eosinophils in the subpustular area. Numerous eosinophils were present in the pustule. The epidermal part of the eccrine duct was not detectable in any of the specimens from patients with PPP but was present in all of the nine control persons (including two smokers). The results indicate that the acrosyringium is involved in the inflammation and also that mast cells and eosinophils participate in a hitherto unknown way. Of the 39 patients clinically examined, two had previously diagnosed thyroid disease and two had gluten hypersensitivity. Seventeen had one or several abnormal serum concentrations of thyroid‐stimulating hormone, thyroxin, antibodies against thyroglobulin or thyroperoxidase and 10 had immunoglobulin (Ig) A antibodies to gliadin. The mean ± SD for serum IgA and for eosinophil cationic protein was increased. From the questionnaire the most notable finding was that 56 of the 59 patients had been or still were smokers, all of whom had started smoking before the first signs of PPP. We hypothesize that the acrosyringium might be the target for the inflammation and that PPP is linked to autoimmune thyroid disease and smoking.
影响因子：
6.5
作者：
GRANDO, SA;HORTON, RM;CONTIFINE, BM
通讯作者：
CONTIFINE, BM