Akosa A B, Lampert I A
Department of Histopathology, RPMS, Hammersmith Hospital, London, UK.
Histopathology. 1991 Oct;19(4):345-9. doi: 10.1111/j.1365-2559.1991.tb00049.x.
Lichenoid dermatosis is a pattern description of a variety of cutaneous lesions which primarily affect the dermoepidermal junction. Involvement of skin appendages has been restricted to hair follicles in lichen planopilaris and discoid lupus erythematosus. Sweat gland involvement has not been described in the four common members of this group, namely, lichen planus, discoid lupus erythematosus, fixed drug eruptions and erythema multiforme, although structural abnormalities have been reported in graft-versus-host disease. In a detailed morphological study of 59 cases, including lichen planus (12), discoid lupus erythematosus (18), fixed drug eruption (14) and erythema multiforme (15), 78% (47/59) showed sweat, gland abnormalities. The abnormalities included vacuolation of cell cytoplasm, with and without lymphocytic infiltration, apoptosis of basal cells and basal cell hyperplasia of the excretory ducts which predominantly affected the portion of the duct adjoining the acrosyringium. The portion of the duct close to the secretory gland was only involved in continuity and the secretory glands were unaffected. These abnormalities of the sweat gland mostly constitute primary involvement by the disease process in contrast to structural abnormalities secondary to fibrosis.
苔藓样皮肤病是对多种主要累及真皮表皮交界处的皮肤损害的一种形态学描述。在扁平苔藓性毛发角化病和盘状红斑狼疮中，皮肤附属器的受累仅限于毛囊。在这一组的四种常见疾病，即扁平苔藓、盘状红斑狼疮、固定性药疹和多形红斑中，尚未见汗腺受累的报道，尽管在移植物抗宿主病中曾有结构异常的报道。在一项对59例患者的详细形态学研究中，包括扁平苔藓（12例）、盘状红斑狼疮（18例）、固定性药疹（14例）和多形红斑（15例），78%（47/59）显示汗腺异常。这些异常包括细胞质空泡化，伴或不伴淋巴细胞浸润、基底细胞凋亡以及排泄管基底细胞增生，主要影响排泄管与汗腺导管末端相连的部分。靠近分泌腺的导管部分仅连续性受累，分泌腺未受影响。与纤维化继发的结构异常相反，这些汗腺异常大多构成疾病过程的原发性受累。
