Kim Y C, Triffet M K, Gibson L E
Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Am J Dermatopathol. 2000 Oct;22(5):408-12. doi: 10.1097/00000372-200010000-00004.
Sarcoidosis is a multisystem disease of unknown etiology. The demonstration of polarizable foreign bodies in cutaneous granulomas is generally thought to exclude a diagnosis of sarcoidosis. Nevertheless. some investigators have reported systemic sarcoidosis with cutaneous manifestations in which polarizable particles were associated with granuloma formation in the skin. We searched the biopsy specimens of granulomatous lesions from 50 patients with cutaneous sarcoidosis using polarization microscopy to estimate the frequency of polarizable foreign bodies in cutaneous lesions of sarcoidosis. Using electron probe microanalysis, we sought to determine what elements compose these foreign bodies. Polarizable foreign bodies were found in the granulomatous skin lesions of 12 of 50 patients with cutaneous sarcoidosis. All 12 patients also had at least one other granulomatous systemic lesion, and 4 had biopsy specimens of a systemic lesion available for review. Polarizable foreign bodies were found in two cases. The elements identified were calcium, phosphorus, silicon, and aluminum. Polarizable foreign bodies were found in cutaneous sarcoidosis far more often than expected. Foreign bodies were also found in granulomatous systemic lesions. The foreign body may serve as an inciting stimulus for granuloma formation in selected cases of sarcoidosis.
结节病是一种病因不明的多系统疾病。皮肤肉芽肿中可极化异物的出现通常被认为可排除结节病的诊断。然而，一些研究者报告了伴有皮肤表现的系统性结节病，其中可极化颗粒与皮肤肉芽肿形成有关。我们使用偏振显微镜检查了50例皮肤结节病患者肉芽肿性病变的活检标本，以评估结节病皮肤病变中可极化异物的出现频率。通过电子探针微分析，我们试图确定构成这些异物的元素。在50例皮肤结节病患者中，有12例的肉芽肿性皮肤病变中发现了可极化异物。所有12例患者还至少有一处其他肉芽肿性系统性病变，其中4例有系统性病变的活检标本可供复查，在2例中发现了可极化异物。鉴定出的元素为钙、磷、硅和铝。在皮肤结节病中发现可极化异物的频率远比预期高。在肉芽肿性系统性病变中也发现了异物。在某些结节病病例中，异物可能是肉芽肿形成的诱发刺激因素。
