Aroni Kyriaki, Tsagroni Eugenia, Lazaris Andreas C, Patsouris Efstratios, Agapitos Emmanouil
Department of Dermatopathology, School of Medicine, National and Kapodistrian University of Athens, Greece.
Dermatology. 2004;209(3):177-82. doi: 10.1159/000079886.
There are few reports of the histological changes in rosacea, and little attempt has been made to correlate such changes with clinical findings. In the present study, we describe in detail the histopathological features of rosacea in a large number of patients and simultaneously investigate the aetiopathogenesis of the disease based on the comparative assessment of epidemiological, clinical and histological findings.
The study included 73 patients with rosacea. A skin biopsy with a 4-mm punch was performed in each case. All biopsy specimens included subcutaneous tissue. In 10 randomly selected patients, facial biopsy specimens were obtained from both involved and uninvolved (non-lesional) skin. Demodex mite presence was estimated semi-quantitatively under light microscopy. Patients with self-reported gastro-intestinal symptoms were submitted to upper gastro-intestinal endoscopy, and a rapid urease test was performed. Serological antibodies, IgG and IgA, against Helicobacter pylori were also detected.
The patients had a broad clinical spectrum of lesions. No specific histological features associated with either erythematous-telangiectatic or papulopustular clinical forms were noticed. Histological examination showed that there is no histological pattern unique to rosacea. Three different types of granulomas were observed: small palisaded ones around altered collagen and other granulomas of elastolytic and non-specific epithelioid type, all coexisting in 5 cases. The deep dermis and subcutis were frequently involved. Comparative study in 10 rosacea patients between lesional and non-lesional skin biopsies revealed almost the same histological changes to the latter biopsies, to a lesser degree though.
Rosacea seems to be a reaction pattern to which a variety of pathogenetic routes may lead.
关于酒渣鼻组织学变化的报道较少，且很少有人尝试将这些变化与临床发现相关联。在本研究中，我们详细描述了大量酒渣鼻患者的组织病理学特征，并同时基于对流行病学、临床和组织学发现的比较评估来研究该疾病的病因发病机制。
该研究纳入了73名酒渣鼻患者。每例患者均进行了4毫米钻孔皮肤活检。所有活检标本均包括皮下组织。在随机选择的10名患者中，从受累皮肤和未受累（非病变）皮肤获取面部活检标本。在光学显微镜下对毛囊蠕形螨的存在情况进行半定量评估。对自述有胃肠道症状的患者进行上消化道内镜检查，并进行快速尿素酶试验。还检测了抗幽门螺杆菌的血清学抗体IgG和IgA。
患者的病变具有广泛的临床谱。未发现与红斑毛细血管扩张型或丘疹脓疱型临床形式相关的特定组织学特征。组织学检查表明，酒渣鼻没有独特的组织学模式。观察到三种不同类型的肉芽肿：围绕变性胶原的小栅栏状肉芽肿以及弹性溶解型和非特异性上皮样型的其他肉芽肿，所有这些在5例中同时存在。深层真皮和皮下组织经常受累。对10名酒渣鼻患者的病变皮肤活检和非病变皮肤活检进行的比较研究显示，后者活检的组织学变化几乎相同，只是程度较轻。
酒渣鼻似乎是一种多种致病途径均可导致的反应模式。
