Casper Claus, Groth Wolfgang, Hunzelmann Nicolas
Department of Dermatology, University of Cologne, Germany.
Am J Dermatopathol. 2004 Feb;26(1):59-62. doi: 10.1097/00000372-200402000-00008.
As body piercing is increasingly en vogue, complications are on the rise as well. Biopsies of such lesions can impose special problems to the reviewing dermatopathologist. We present two patients who developed papulonodular lesions at the sites of ear piercings. Unexpectedly, the findings included prominent sarcoidal granuloma formation with confluent areas of fibrinoid necrosis. An infectious etiology was excluded. However, patch testing revealed contact allergy to palladium, platinum, and nickel. Interestingly, histopathologic examination of the patch test sites also demonstrated granuloma formation. These findings suggest that the lesions represent allergic contact granulomas. When confronted with this special type of tissue reaction in skin biopsies of piercing sites, the reviewing dermatopathologist should consider the possibility of an allergic reaction. Careful history and thorough diagnostic procedures, including biopsy of the patch test site can establish the diagnosis of contact allergic granuloma.
随着身体穿刺越来越流行，并发症也在增加。对此类病变进行活检会给阅片的皮肤病理学家带来特殊问题。我们报告了两名在耳垂穿刺部位出现丘疹结节性病变的患者。出乎意料的是，检查结果包括显著的结节病样肉芽肿形成以及纤维蛋白样坏死融合区域。排除了感染性病因。然而，斑贴试验显示对钯、铂和镍有接触性过敏。有趣的是，斑贴试验部位的组织病理学检查也显示有肉芽肿形成。这些发现表明这些病变代表过敏性接触性肉芽肿。当在穿刺部位的皮肤活检中遇到这种特殊类型的组织反应时，阅片的皮肤病理学家应考虑过敏反应的可能性。详细的病史和全面的诊断程序，包括对斑贴试验部位进行活检，可确立接触性过敏性肉芽肿的诊断。
