Aloi F, Tomasini C, Soro E, Pippione M
Department of Dermatology, University of Turin, Italy.
J Am Acad Dermatol. 2000 Mar;42(3):468-72. doi: 10.1016/s0190-9622(00)90220-2.
We report the results of a clinicopathologic study of 17 patients with rhinophyma in different stages of evolution, with particular attention paid to the severe form of this disease. On the basis of clinical features, we identified 2 groups of patients: the first group (12/17 patients) included patients with the common form of rhinophyma, whereas the second one (5/17 patients) included patients with the severe form of the disease. There was no link between the clinical aspect and the duration of the disease. Microscopic examination of specimens obtained from the classic type of rhinophyma substantially showed the histopathologic features of fully developed rosacea, except for the presence of prominent sebaceous hyperplasia. The second group showed a very different histologic pattern displaying marked dermal thickness, absence of folliculosebaceous structures, sclerotic collagen bundles with large amounts of mucin, and spreading telangiectasia. The inflammatory infiltrate was inconspicuous, with numerous interstitial spindle and bizarre cells. Most of the interstitial cells were reactive to factor XIIIa. The severe form of rhinophyma shares many histologic characteristics with elephantiasis caused by chronic lymphedema.
我们报告了一项对17例处于不同演变阶段的鼻赘患者的临床病理研究结果，尤其关注了该疾病的严重形式。根据临床特征，我们将患者分为两组：第一组（12/17例患者）包括鼻赘常见形式的患者，而第二组（5/17例患者）包括疾病严重形式的患者。临床症状与病程之间没有关联。对经典型鼻赘标本的显微镜检查大体上显示出完全发展的酒渣鼻的组织病理学特征，但存在明显的皮脂腺增生。第二组显示出非常不同的组织学模式，表现为真皮显著增厚、毛囊皮脂腺结构缺失、有大量粘蛋白的硬化胶原束以及扩张的毛细血管。炎性浸润不明显，有许多间质梭形细胞和怪异细胞。大多数间质细胞对因子XIIIa有反应。严重形式的鼻赘与慢性淋巴水肿引起的象皮肿有许多组织学特征相同。
