Ruokonen H, Hietanen J, Malmström M
Department of Oral and Maxillofacial Surgery, University of Helsinki, Finland.
Acta Derm Venereol. 1990;70(3):199-203.
The ultrastructure of oral lesions in 6 patients with erythema multiforme (EM) and of one apparently clinically healthy oral mucosa in one patient with recurrent EM during remission is described. Alterations were observed in epithelium, basal lamina and lamina propria. Both intercellular and intracellular oedema, intracellular vacuolization, decreased numbers of desmosomes, and also loss of cytoplasmic organelles and occasional nuclei were noted in the epithelium. Inflammatory cells--mainly lymphocytes--were found intra-epithelially. Several discontinuities together with some evidence of duplication of the basal lamina were seen in five of the six lesional mucosa specimens. The inflammatory infiltrate in the lamina propria consisted mainly of lymphocytes, although plasma cells, neutrophilic and eosinophilic leukocytes, macrophages and mast cells were also found. Some of the mast cells were partly degranulated. The apparently clinically healthy oral mucosa in the patient with EM in remission showed mild inflammatory changes. The changes observed in the lesional mucosa in EM are thus according to our study mostly non-specific inflammatory alterations and are not pathognomonic for EM.
本文描述了6例多形红斑（EM）患者口腔损害的超微结构，以及1例复发性EM缓解期患者看似临床健康的口腔黏膜的超微结构。在上皮、基底膜和固有层均观察到了改变。上皮细胞间和细胞内水肿、细胞内空泡化、桥粒数量减少，还可见细胞质细胞器丧失以及偶尔的细胞核丢失。上皮内发现了炎症细胞，主要是淋巴细胞。在6个病变黏膜标本中的5个中，可见基底膜有几处连续性中断以及一些重复的迹象。固有层的炎症浸润主要由淋巴细胞组成，不过也发现了浆细胞、嗜中性和嗜酸性白细胞、巨噬细胞和肥大细胞。一些肥大细胞部分脱颗粒。EM缓解期患者看似临床健康的口腔黏膜显示出轻度炎症改变。因此，根据我们的研究，EM病变黏膜中观察到的改变大多是非特异性炎症改变，并非EM所特有的。
