Vignale R A, Casella de Vilaboa E, Paciel J, Bruno J
Servicio de Dermatología, Hospital Maciel, Montevideo, Uruguay.
Med Cutan Ibero Lat Am. 1990;18(4):252-6.
A male patient of 52 years old is studied with an scabiei by Sarcoptes scabiei v. hominis. After a month the patient developed a clinic and histopathologic generalized granuloma annulare. With the specific local treatment of his scabiei, the disease was cured in 7 days. After this treatment, the generalized granuloma annulare disappeared within 2 months. Due to the sequence of both diseases and the way in which they disappeared after local therapy, we suggest that the antigens of the scabies are the ones responsible for the granulomatous lesions. We concluded this since once the antigens have disappeared, the immunologic mechanisms depending on the interactions of lymphocyte T-macrophage which form the granuloma are interrupted. Since the patient is homosexual, we studied the HIV antibodies which were negatives in several opportunities. Nevertheless, an immune disbalance which could be the coadjuvant factor was founded. With this case we show that specific exogens may cause a generalized granuloma annulare.
一名52岁男性患者感染了人疥螨。一个月后,患者出现了临床和组织病理学表现的全身性环状肉芽肿。经过针对疥疮的特异性局部治疗,7天内疾病治愈。此次治疗后,全身性环状肉芽肿在2个月内消失。鉴于两种疾病的先后顺序以及局部治疗后它们消失的方式,我们认为疥疮抗原是导致肉芽肿性病变的原因。我们得出这一结论是因为一旦抗原消失,依赖于形成肉芽肿的T淋巴细胞 - 巨噬细胞相互作用的免疫机制就会中断。由于该患者是同性恋者,我们多次检测其HIV抗体均为阴性。然而,发现存在可能作为辅助因素的免疫失衡。通过这个病例,我们表明特定的外源性因素可能导致全身性环状肉芽肿。