Crowson A N, Magro C M
Central Medical Laboratories, Winnipeg, MB, Canada.
Int J Dermatol. 2003 Dec;42(12):928-32. doi: 10.1111/j.1365-4632.2003.02110.x.
We describe 12 patients with an atrophying dermatitis in whom the biopsy findings were compatible with tinea versicolor.
We encountered 12 skin biopsies from 12 patients in whom a clinically atrophying dermatosis was associated with light microscopic (LM) evidence of atrophy and epidermal colonization by Pityrosporum sp. Formalin-fixed, paraffin-embedded tissue sections were cut at 5 microns and stained with H&E, alcian blue-PAS and PAS-diastase preparations.
Five men and seven women aged 17-73 years in whom lesions characterized as atrophic plaques, patches or macules prompted clinical differential diagnoses including parapsoriasis or mycosis fungoides (MF), anetoderma, lupus erythematosus, and steroid atrophy. A LM examination showed epidermal colonization with pityrosporum hyphae and spores accompanied by variable epidermal and dermal atrophy characterized by rete-ridge effacement, subepidermal fibroplasia, pigment incontinence and elastolysis.
Atrophying cutaneous lesions comprise part of the clinical spectrum of tinea versicolor for which we propose the term 'atrophying tinea versicolor'. The pathogenetic basis is unclear but could be the sequela of delayed type hypersensitivity and the release by T-helper lymphocytes of leukotrienes which perturb collagen metabolism and/or keratinocyte growth. Lesions may be mistaken clinically for MF or other atrophying dermatoses.
我们描述了12例萎缩性皮炎患者，其活检结果与花斑癣相符。
我们对12例患者的12份皮肤活检样本进行了研究，这些患者临床上患有萎缩性皮肤病，伴有光镜下萎缩及马拉色菌属表皮定植的证据。将福尔马林固定、石蜡包埋的组织切片切成5微米厚，并用苏木精-伊红、阿尔辛蓝-过碘酸雪夫染色法和过碘酸雪夫-淀粉酶制剂染色。
12例患者年龄在17至73岁之间，其中男性5例，女性7例，其皮损表现为萎缩性斑块、斑片或斑点，临床鉴别诊断包括副银屑病或蕈样肉芽肿、皮肤松弛症、红斑狼疮和类固醇性萎缩。光镜检查显示表皮有马拉色菌菌丝和孢子定植，伴有不同程度的表皮和真皮萎缩，特征为表皮嵴消失、表皮下纤维组织增生、色素失禁和弹力纤维溶解。
萎缩性皮肤损害是花斑癣临床谱的一部分，我们为此提出“萎缩性花斑癣”这一术语。其发病机制尚不清楚，但可能是迟发型超敏反应的后遗症，以及辅助性T淋巴细胞释放白三烯，干扰胶原蛋白代谢和/或角质形成细胞生长。临床上这些损害可能会被误诊为蕈样肉芽肿或其他萎缩性皮肤病。
