Grover's disease: Clinicopathologic review of 72 cases
Grover's disease: Clinicopathologic review of 72 cases
复制标题
DOI：
10.4065/74.3.229
复制
发表时间：
1999-03-01
影响因子：
8.9
通讯作者：
Gibson, LE
中科院分区：
文献类型：
--
作者：
Davis, MDP;Dinneen, AM;Gibson, LE
目的：报道格罗弗氏病的临床病理表现。材料和方法：我们回顾了在罗切斯特梅奥诊所检查的72例一过性棘突溶解性皮肤病（格罗弗病）患者的医疗记录和活检标本。对所有患者的苏木精-伊红染色活检标本进行评估。采用BRST-2、CAM 5.2和CD44免疫组化染色对8例标本进行染色。回顾了直接免疫荧光报告。所选标本经间接免疫荧光染色检测主要碱性蛋白。结果：72例患者中，男性63例（88%），平均年龄48岁（31 ~ 85岁），病变主要分布于躯干71例（31 ~ 85岁）和近端25例（25例），多发发热和出汗是加重因素。15例患者（21%）卧床不起。并发非皮肤恶性疾病18例（25%），获得性免疫缺陷综合征2例（3%），随访28例(平均38个月；13例复发，3例持续，12例消退，活检标本复查显示棘层松解为寻常型天疱疮样40例（56%），达尔氏病样16例（22%），海绵状12例（17%），叶状天疱疮样2例（3%），海绵状2例（3%），64例（89%）标本中不同强度的血管周围淋巴细胞浸润与嗜酸性粒细胞相关16例（22%）。在9例皮肤嗜酸性粒细胞染色的活检标本中，主要碱性蛋白存在不同的真皮细胞和细胞外沉积。在17例病例中，直接免疫荧光研究结果为阴性或非特异性，在8例标本中，除汗腺外，有2例（25%）的棘囊溶解区被CD44染色。结论：需要进一步研究Grover病的发病机制。易感条件、受累部位和这种疾病的复发性可能暗示肢侧注射器功能障碍是病因。
Objective: To report the clinicopathologic findings in patients with Grover's disease.Material and Methods: We reviewed the medical records and biopsy specimens from 72 patients with transient acantholytic dermatosis (Grover's disease) examined at Mayo Clinic Rochester. Hematoxylin-eosin-stained biopsy specimens (from all patients) were assessed. Immunohistochemistry stains BRST-2, CAM 5.2, and CD44 were used to stain eight specimens. Direct immunofluorescence reports were reviewed. Selected specimens were stained by indirect immunofluorescence to detect major basic protein.Results: Of the 72 patients, 63 (88%) were men, and the mean age was 48 years (range, 31 to 85), Lesions were distributed mainly on the trunk tin 71 patients) and proximal extremities (in 25), Heat and sweating frequently were exacerbating factors. Fifteen patients (21%) were bed-bound. Concurrent nondermatologic malignant disease was present in 18 patients (25%), Two patients (3%) had acquired immunodeficiency syndrome, Follow-up in 28 patients (mean, 38 months; range, 3 months to 7 years) revealed that the disease had recurred in 13, persisted in 3, and resolved in 12, Review of the biopsy specimens showed that acantholysis was pemphigus vulgaris-like in 40 patients (56%), Darier's disease-like in 16 (22%), spongiotic in 12 (17%), pemphigus foliaceus like in 2 (3%), and Hailey-Hailey disease-like in 2 (3%), A perivascular lymphocytic infiltrate of varied intensity in 64 specimens (89%) was associated with eosinophils in 16 (22%). In nine biopsy specimens with dermal eosinophilia stained for major basic protein, varied dermal cellular and extracellular deposition of major basic protein was present. Results of direct immunofluorescence studies, performed in 17 cases, were negative or nonspecific, CD44 stained acantholytic areas in addition to sweat glands in two of eight specimens (25%),Conclusion: Further studies of the pathogenesis of Grover's disease are needed. The predisposing conditions, site of involvement, and relapsing nature of this disorder may implicate acrosyringeal dysfunction as the cause.