Freyschmidt-Paul P, Hamm H, Happle R, Hoffmann R
Department of Dermatology, Philipp University, Deutschhaus-strasse 9, 35033 Marburg, Germany.
Eur J Dermatol. 1999 Mar;9(2):111-4.
Some authors have reported that severe destruction of follicular structures and even scarring patterns occur in those patients with alopecia areata (AA) who fail to respond to topical immunotherapy with contact sensitizers, such as diphencyprone (DCP). Other studies, however, gave contradictory results. Therefore, we re-examined histopathological changes in scalp samples obtained from 85 patients with severe alopecia areata before initiation of DCP treatment (40 responders and 45 non-responders in terms of hair regrowth after DCP treatment). The following parameters were evaluated: i) perifollicular lymphocytic infiltration; ii) perifollicular fibrosis, and iii) miniaturized hair follicles. No difference between responders and non-responders could be observed in the degree of miniaturization of hair follicles and proliferation of perifollicular fibrous tissue. In neither group was there any evidence of scarring or severe follicular destruction. 18 non-responders but only 6 responders showed a very dense perifollicular lymphocytic infiltration. In contrast, a particularly scarce infiltrate was seen in 9 non-responders and in 19 responders. We conclude that non-responders to topical sensitizers tend to have rather pronounced inflammatory reactions with dense perifollicular lymphocytic infiltrates.
一些作者报告称，那些对诸如二苯环丙烯酮（DCP）等接触致敏剂进行局部免疫治疗无反应的斑秃（AA）患者会出现毛囊结构的严重破坏甚至瘢痕形成模式。然而，其他研究给出了相互矛盾的结果。因此，我们重新检查了85例重度斑秃患者在开始DCP治疗前（根据DCP治疗后的毛发生长情况，其中40例有反应者和45例无反应者）头皮样本的组织病理学变化。评估了以下参数：i）毛囊周围淋巴细胞浸润；ii）毛囊周围纤维化，以及iii）小型化毛囊。在毛囊小型化程度和毛囊周围纤维组织增生方面，有反应者和无反应者之间未观察到差异。两组均未出现瘢痕形成或严重毛囊破坏的证据。18例无反应者但只有6例有反应者显示出非常密集的毛囊周围淋巴细胞浸润。相反，在9例无反应者和19例有反应者中观察到特别稀少的浸润。我们得出结论，对局部致敏剂无反应者往往有明显的炎症反应，伴有密集的毛囊周围淋巴细胞浸润。
