Exaggerated arthropod-bite lesions in patients with chronic lymphocytic leukemia: A clinical, histopathologic, and immunopathologic study of eight patients
Exaggerated arthropod-bite lesions in patients with chronic lymphocytic leukemia: A clinical, histopathologic, and immunopathologic study of eight patients
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DOI：
10.1016/s0190-9622(98)70398-6
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发表时间：
1998-07-01
影响因子：
13.8
通讯作者：
Leiferman, KM
中科院分区：
文献类型：
--
作者：
Davis, MDP;Perniciaro, C;Leiferman, KM
背景：在慢性淋巴细胞白血病（CLL）患者中有类似节肢动物咬伤的不寻常丘疹疱性病变。目的：我们的目的是进一步描述和表征这些病变的临床、组织病理学和免疫病理学特征。方法：回顾性分析8例CLL伴特征性皮肤病变患者。记录临床及组织学特征。对皮肤活检标本进行免疫组化分析，检测嗜酸性粒细胞颗粒主要碱性蛋白、嗜酸性粒细胞衍生神经毒素、中性粒细胞弹性酶和肥大细胞胰蛋白酶。结果：临床特征，包括病变分布，提示节肢动物咬伤，尽管大多数患者不记得曾经被咬过。病变内可见T细胞和b细胞混合淋巴样细胞浸润，并伴有明显的嗜酸性粒细胞浸润和嗜酸性粒细胞颗粒蛋白沉积。结论：CLL患者出现大量丘疹疱性病变显然是对节肢动物咬伤的过度反应。这些病变内明显的嗜酸性粒细胞浸润和脱颗粒可能导致症状的严重程度。
Background: Unusual papulovesicular lesions resembling arthropod bites have been described in patients with chronic lymphocytic leukemia (CLL).Objective: Our purpose was to describe and characterize further the clinical, histopathologic, and immunopathologic features of these lesions.Methods: Eight patients were identified retrospectively who had CLL and characteristic skin lesions. Clinical and histologic features were recorded. Skin biopsy specimens were analyzed immunohistochemically for eosinophil granule major basic protein, eosinophil-derived neurotoxin, neutrophil elastase, and mast cell tryptase.Results: The clinical features, including the lesional distribution, suggested arthropod bites, although most patients could not recall having been bitten. Mixed T- and B-cell lymphoid cell infiltrates were present within lesions, along with prominent eosinophil infiltration and eosinophil granule protein deposition.Conclusion: Exuberant papulovesicular lesions develop in patients with CLL apparently as an exaggerated response to arthropod bites. Prominent eosinophil infiltration and degranulation within these lesions likely contribute to the severity of symptoms.