Breier F H, Aberer E, Stanek G, Khanakaha G, Schlick A, Tappeiner G
Department of Dermatology, Lainz Municipal Hospital, Wolkersbergenstr. 1, A-1130 Vienna, Austria.
Br J Dermatol. 1999 May;140(5):925-30. doi: 10.1046/j.1365-2133.1999.02828.x.
A 45-year-old man presented with circumscribed scleroderma (CS) on the extremities. Histology of lesional skin showed the typical manifestations of scleroderma including a perivascular and interstitial infiltrate of lymphocytes and plasma cells; in one of the biopsies spirochaetes could be detected. Despite treatment with penicillin, progression of CS was observed and spirochaetes were isolated from skin cultures obtained from active scleroderma lesions. These spirochaetes were identified as Borrelia afzelii by sodium dodecyl sulphate-polyacrylamide gel electrophoresis of outer surface proteins and polymerase chain reaction (PCR) analysis of their chromosome. After two courses with ceftriaxone the lesions stopped expanding and sclerosis of the skin was diminished. At this time cultures for spirochaetes and PCR of lesional skin for Borrelia afzelii DNA remained negative. The pathogenetic role of Borrelia afzelii in the development of CS is discussed.
一名45岁男性患者出现四肢局限性硬皮病（CS）。病变皮肤的组织学检查显示硬皮病的典型表现，包括血管周围和间质淋巴细胞及浆细胞浸润；在一次活检中可检测到螺旋体。尽管使用青霉素治疗，但仍观察到CS进展，且从活动性硬皮病病变的皮肤培养物中分离出螺旋体。通过外表面蛋白的十二烷基硫酸钠 - 聚丙烯酰胺凝胶电泳及其染色体的聚合酶链反应（PCR）分析，这些螺旋体被鉴定为阿氏疏螺旋体。使用头孢曲松两个疗程后，病变停止扩展，皮肤硬化减轻。此时，螺旋体培养及病变皮肤中阿氏疏螺旋体DNA的PCR检测均为阴性。本文讨论了阿氏疏螺旋体在CS发病中的作用。
