Hashimoto K, Fedoronko L
Department of Dermatology & Syphilology, Wayne State University School of Medicine, Detroit, Michigan, USA.
Am J Dermatopathol. 1999 Oct;21(5):491-3. doi: 10.1097/00000372-199910000-00017.
Acantholytic foci have been reported several times in pityriasis rubra pilaris (PRP). Lichenoid tissue reactions were also mentioned in the literature regarding PRP. We report a 58-year-old patient who, after having colon cancer, had PRP with biopsies showing acantholytic lesions and a heavy lichenoid lymphocytic infiltration. Investigation by serial sectioning of the acantholytic lesion suggested an involvement of the intraepidermal eccrine duct and further investigation with carcinoembryonic antigen (CEA) staining demonstrated a CEA-positive eccrine duct in the acantholytic foci. We suggest that acantholysis in PRP is induced by proteolytic enzymes, urea, and other substances in eccrine sweat in keratin-plugged acrosyringia. This patient had a combination of three relatively rare features of PRP-acantholysis, lichenoid reaction, and a cancer background.
棘层松解灶在毛发红糠疹（PRP）中已有多次报道。关于PRP的文献中也提到了苔藓样组织反应。我们报告了一名58岁的患者，该患者在患结肠癌后出现PRP，活检显示有棘层松解性病变和大量苔藓样淋巴细胞浸润。对棘层松解性病变进行连续切片检查提示表皮内小汗腺导管受累，进一步用癌胚抗原（CEA）染色检查显示棘层松解灶中有一个CEA阳性的小汗腺导管。我们认为，PRP中的棘层松解是由角蛋白堵塞的顶泌汗腺内的蛋白水解酶、尿素和其他物质在小汗腺汗液中诱导产生的。该患者具有PRP的三个相对罕见的特征组合——棘层松解、苔藓样反应和癌症背景。
