Aloi F, Tomasini C, Pippione M
Department of Dermatology, University of Turin, Italy.
Am J Dermatopathol. 1999 Aug;21(4):320-3. doi: 10.1097/00000372-199908000-00002.
We report on the clinical and histopathologic findings of four patients who had asymptomatic, erythematous to violaceous plaques symmetrically distributed on the upper aspect of the thighs, lateral chest, and in two cases also on the abdomen and flexor surface of the elbows. All of the patients were women; two of them had arthritis, which in one case was associated with an autoimmune disorder, and another had autoimmune thyroiditis. Histopathologically, all cases showed similar changes consisting of an interstitial granulomatous dermatitis involving mostly the lower reticular dermis. Histiocytes were the predominant cellular component, arranged interstitially and in small palisades around foci of degenerated collagen bundles in concert with large numbers of neutrophils and eosinophils. Interstitial granulomatous dermatitis can present different clinical expressions, including linear cords, papules, and, as in our cases, plaques. This peculiar histopathologic pattern falls into the spectrum of cutaneous extravascular necrotizing granuloma, a condition that is often associated with systemic autoimmune disease.
我们报告了4例患者的临床和组织病理学发现，这些患者的大腿上部、侧胸部出现无症状的、从红斑到紫斑的斑块，其中2例患者的腹部和肘部屈侧也有此类斑块。所有患者均为女性；其中2例有关节炎，1例与自身免疫性疾病相关，另1例患有自身免疫性甲状腺炎。组织病理学上，所有病例均表现出相似的变化，即主要累及网状真皮下部的间质性肉芽肿性皮炎。组织细胞是主要的细胞成分，呈间质排列，并围绕变性胶原束灶形成小栅栏状，同时伴有大量中性粒细胞和嗜酸性粒细胞。间质性肉芽肿性皮炎可呈现不同的临床表型，包括线状条索、丘疹，以及如我们病例中的斑块。这种特殊的组织病理学模式属于皮肤血管外坏死性肉芽肿范畴，该病症常与系统性自身免疫性疾病相关。
