Tomasini Carlo, Pippione Mario
Department of Medical and Surgical Specialties, Second Dermatologic Clinic, University of Turin, Italy.
J Am Acad Dermatol. 2002 Jun;46(6):892-9. doi: 10.1067/mjd.2002.120532.
Interstitial granulomatous dermatitis is a histopathologic pattern with variable clinical appearance associated with autoimmune systemic diseases. The frequency of its different cutaneous expressions and its association with autoimmune diseases are not known.
We describe the clinical, serologic, and histologic features in 17 patients with interstitial granulomatous dermatitis with a clinical presentation consisting of large erythematous plaques.
Skin biopsy specimens fulfilling criteria for diagnosis of interstitial granulomatous dermatitis were selected and correlated with the clinical and laboratory findings.
The study included 1 man and 16 women with multiple, asymptomatic, round to oval, erythematous plaques, most often on folds of the skin, in a bilateral and somewhat symmetric distribution. Most of patients had rheumatoid polyarthralgias along with various serologic abnormalities, often connected to collagen vascular diseases. Histologic examination disclosed a distinctive interstitial granulomatous dermatitis characterized by a diffuse infiltration of the interstitium by histiocytes with piecemeal fragmentation of collagen and formation of small granulomas around degenerative areas in concert with variable numbers of polymorphonuclear leukocytes sprinkled within the infiltrate. Churg-Strauss granulomas in miniature and flame figures were occasionally observed and indicated continued or increased activity of the associated autoimmune disease(s).
Interstitial granulomatous dermatitis with plaques is a distinct entity with highly reproducible clinical and histopathologic features; recognition of these features identifies a patient who may have an underlying systemic autoimmune disorder.
间质性肉芽肿性皮炎是一种组织病理学模式，其临床表现多样，与自身免疫性全身性疾病相关。其不同皮肤表现的频率及其与自身免疫性疾病的关联尚不清楚。
我们描述了17例间质性肉芽肿性皮炎患者的临床、血清学和组织学特征，这些患者的临床表现为大片红斑性斑块。
选择符合间质性肉芽肿性皮炎诊断标准的皮肤活检标本，并将其与临床和实验室检查结果相关联。
该研究纳入1名男性和16名女性，患者有多个无症状的圆形至椭圆形红斑性斑块，最常见于皮肤褶皱处，呈双侧且 somewhat 对称分布。大多数患者有类风湿性多关节痛以及各种血清学异常，常与胶原血管疾病有关。组织学检查显示一种独特的间质性肉芽肿性皮炎，其特征为组织细胞弥漫性浸润间质，伴有胶原的碎片状断裂，并在变性区域周围形成小肉芽肿，同时浸润内散在数量不等的多形核白细胞。偶尔观察到微小的Churg-Strauss肉芽肿和火焰状图形，提示相关自身免疫性疾病持续或活动增加。
伴有斑块的间质性肉芽肿性皮炎是一种具有高度可重复性临床和组织病理学特征的独特疾病；认识这些特征可识别可能患有潜在系统性自身免疫性疾病的患者。
