Unit of Dermatology, Brest University Medical School Hospital, Brest, France.
J Autoimmun. 2010 Nov;35(3):241-7. doi: 10.1016/j.jaut.2010.06.014. Epub 2010 Jul 22.
There is a crucial need for reliable diagnostic criteria for SS. Our objective was to evaluate the frequency of xerosis in patients with primary Sjögren's syndrome (SS), and compare histopathology of cutaneous sweat glands and labial salivary glands (LSGs), with respect to their contribution to the diagnosis. Twenty-two patients with primary SS and 22 matched normal volunteers were invited to rate their skin dryness on a visual analog scale. The skin was dryer (58.3 ± 10.1 versus 38.9 ± 7.6, P < 0.01), and xerosis more frequent (9 of 22 versus 2 of 22, P < 0.02) in the patients than in the controls. The axilla skin was chosen for a 6-mm punch biopsy. Lymphocytic infiltration was seen in the skin of 8 of the 12 patients tested. Two of them had normal LSGs. Most interestingly, B cell infiltrates were identified in patients' skin infiltrates, so that their presence might be a clue to the diagnosis of primary SS. These cell aggregates associated memory CD10-/CD20+/CD27+/IgD- B lymphocytes and immature CD20+/CD24 + lymphocytes. These latter findings strongly suggest that skin biopsies warrant inclusion into the routine clinical care of patients suspected of suffering from primary SS.
原发性干燥综合征（SS）的可靠诊断标准至关重要。我们的目的是评估原发性 SS 患者的皮肤干燥症的发生率，并比较皮肤汗腺和唇腺（LSG）的组织病理学，以评估其对诊断的贡献。邀请 22 例原发性 SS 患者和 22 名匹配的正常志愿者对其皮肤干燥程度进行视觉模拟评分。患者的皮肤更干燥（58.3 ± 10.1 比 38.9 ± 7.6，P < 0.01），且干燥症更常见（9/22 比 2/22，P < 0.02）。选择腋窝皮肤进行 6-mm 打孔活检。在测试的 12 名患者中的 8 名中观察到淋巴细胞浸润。其中 2 名患者的 LSG 正常。最有趣的是，在患者的皮肤浸润中发现了 B 细胞浸润，因此它们的存在可能是原发性 SS 诊断的线索。这些细胞聚集物与记忆性 CD10-/CD20+/CD27+/IgD-B 淋巴细胞和未成熟的 CD20+/CD24+淋巴细胞有关。这些发现强烈表明，皮肤活检值得纳入疑似患有原发性 SS 的患者的常规临床护理中。
