Kim Daehwan, Kang Won Hyoung
Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
J Korean Med Sci. 2002 Oct;17(5):648-54. doi: 10.3346/jkms.2002.17.5.648.
Stasis dermatitis is an itchy, scaly, and hyperpigmented condition of the lower leg due to venous insufficiency. Hemosiderin and/or melanin have been considered responsible for the brown pigmentation. However, there are not sufficient histopathologic studies. In this retrospective study the hospital records and biopsy slides of 20 patients were reviewed to determine the pathogenetic mechanisms of brown pigmentation in stasis dermatitis. Fifteen were men (75%) and 5 were women (25%) with a mean age of 46.2+/-8.2 yr (18-76), mean age at onset of 43.4+/-18.0 yr (17-73), and a mean duration of the disease 2.8+/-2.5 yr (0.25-10). All patients had varicose vein and complained of pruritus. On histopathologic evaluation, two cases out of 20 (3 skin biopsy specimens from 25 samples) showed dermal melanocytes containing melanin, and incontinence of melanin pigment was observed in 5 cases, which indicates that melanin pigments from epidermis could contribute to cutaneous pigmentation in stasis dermatitis. However, the existence of dermal melanocytes in two cases cannot be explained because normally the dermis contains no melanocytes. Further studies concerning the role of iron or inflammatory cytokines on the development of dermal melanocytes should be conducted.
淤积性皮炎是一种因静脉功能不全导致小腿出现瘙痒、鳞屑和色素沉着过度的病症。含铁血黄素和/或黑色素被认为是导致褐色色素沉着的原因。然而，目前尚无足够的组织病理学研究。在这项回顾性研究中，我们查阅了20例患者的医院记录和活检切片，以确定淤积性皮炎中褐色色素沉着的发病机制。其中15例为男性（75%），5例为女性（25%），平均年龄为46.2±8.2岁（18 - 76岁），平均发病年龄为43.4±18.0岁（17 - 73岁），疾病平均持续时间为2.8±2.5年（0.25 - 10年）。所有患者均有静脉曲张并伴有瘙痒症状。经组织病理学评估，20例中有2例（25份样本中的3份皮肤活检标本）显示真皮黑素细胞含有黑色素，5例观察到黑色素失禁，这表明来自表皮的黑色素可能导致淤积性皮炎的皮肤色素沉着。然而，有2例真皮黑素细胞的存在无法解释，因为正常情况下真皮中不含黑素细胞。应进一步开展关于铁或炎性细胞因子在真皮黑素细胞发育中作用的研究。
