Zembowicz Artur, Mastalerz Lucyna, Setkowicz Malgorzata, Radziszewski Waldemar, Szczeklik Andrzej
Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Warren 820, 55 Fruit Street, Boston, MA 02114, USA.
J Cutan Pathol. 2004 Apr;31(4):323-9. doi: 10.1111/j.0303-6987.2004.0195.x.
During a clinical trial, we obtained 16 biopsies of skin eruptions induced by aspirin in patients with chronic idiopathic urticaria (CIU). In this setting, aspirin triggers skin eruptions through a well-established non-immunological mechanism involving the inhibition of cyclooxygenase type I. This presented the rare opportunity to evaluate histological features of a series of skin eruptions induced by a drug acting through a defined mechanism in a controlled experimental setting.
Histological analysis of 16 biopsies of skin eruptions induced by oral aspirin challenge in patients with CIU.
Microscopic analysis of tissue sections.
16 patients with CIU.
Aspirin (up to 500 mg) induced a restricted range of histological responses with a classic pattern of urticarial tissue reaction occurring in the majority of (12 of 16) cases. Two biopsies showed an interstitial fibrohistiocytic (granuloma annulare-like) reaction pattern. One case showed only a sparse perivascular lymphocytic infiltrate, and paucicellular dermal mucinosis was observed in one case.
Polymorphism of histological patterns induced by aspirin suggests that in addition to the drug-specific mechanisms triggering drug eruptions, individual factors also play a role in determining the ultimate histological phenotype of a drug response.
在一项临床试验中，我们获取了16例慢性特发性荨麻疹（CIU）患者因阿司匹林诱发的皮肤疹活检样本。在这种情况下，阿司匹林通过一种成熟的非免疫机制引发皮肤疹，该机制涉及抑制I型环氧化酶。这提供了一个难得的机会，在可控的实验环境中评估由一种通过特定机制起作用的药物诱发的一系列皮肤疹的组织学特征。
对16例CIU患者口服阿司匹林激发试验诱发的皮肤疹活检样本进行组织学分析。
对组织切片进行显微镜分析。
16例CIU患者。
阿司匹林（高达500毫克）诱发的组织学反应范围有限，大多数（16例中的12例）病例出现典型的荨麻疹组织反应模式。两份活检样本显示间质纤维组织细胞（环状肉芽肿样）反应模式。1例仅显示稀疏的血管周围淋巴细胞浸润，1例观察到少细胞性真皮粘蛋白沉积症。
阿司匹林诱发的组织学模式多态性表明，除了引发药疹的药物特异性机制外，个体因素在决定药物反应的最终组织学表型中也起作用。
