Brix William K, Nassau Sarah R, Patterson James W, Cousar John B, Wick Mark R
Department of Pathology, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
J Cutan Pathol. 2010 Apr;37(4):426-31. doi: 10.1111/j.1600-0560.2009.01371.x. Epub 2009 Jul 15.
In 1952, Zoon described a series of patients with dense plasma-cell infiltrates in the glans penis. Since then, similar Zoon-like lesions (ZLL) have been described on the external female genitalia and in the airways, for which over 20 designations currently exist.
Twenty-eight cases of ZLL, twenty-two cases of lichen planus, eight cases of plasmacytoma and two cases of syphilis were evaluated from the surgical pathology archive at the University of Virginia. Twenty-four histologic data points were tabulated in each case, including 12 epidermal and 12 dermal features.
Histopathologic findings were similar in the majority of cases of ZLL, regardless of their location. They demonstrated superficial cutaneous erosions, basal vacuolar alteration and many showed lozenge-shaped keratinocytes in the epiderms. The dermis contained a dense inflammatory infiltrate composed predominantly of plasma cells, with scattered neutrophils and lymphocytes. Dense fibrosis was seen in the upper dermis.
A uniform nomenclature for ZLL does not exist. Based on the results of this analysis, we suggest that the generic term idiopathic lymphoplasmacellular mucositis-dermatitis be considered to encompass the lymphoplasmacellular infiltrates in the skin and mucosal surfaces considered herein. This designation is morphologically descriptive and can be applied regardless of anatomic location.
1952年，佐恩描述了一系列阴茎头有密集浆细胞浸润的患者。从那时起，类似的佐恩样病变（ZLL）已在外阴和气道中被描述，目前对此有20多种命名。
从弗吉尼亚大学手术病理档案中评估了28例ZLL、22例扁平苔藓、8例浆细胞瘤和2例梅毒病例。在每个病例中列出了24个组织学数据点，包括12个表皮特征和12个真皮特征。
大多数ZLL病例的组织病理学表现相似，无论其位置如何。它们表现为浅表皮肤糜烂、基底空泡改变，许多病例在表皮中可见菱形角质形成细胞。真皮有密集的炎症浸润，主要由浆细胞组成，伴有散在的中性粒细胞和淋巴细胞。在上层真皮中可见致密纤维化。
目前不存在ZLL的统一命名法。基于本分析结果，我们建议考虑使用通用术语特发性淋巴细胞浆细胞性黏膜皮炎来涵盖本文所讨论的皮肤和黏膜表面的淋巴细胞浆细胞浸润。该命名在形态学上具有描述性，且无论解剖位置如何均可应用。
