Rossi A, Uzzauto M T
Istituto di Clinica Dermosifilopatica, I Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli.
G Ital Dermatol Venereol. 1990 Dec;125(12):583-91.
Two patients showing features of both lichen planus and lupus erythematosus are described: reticular whitish patches in the oral mucosa coexisting with chronic, partly atrophic LED-like skin lesions located on the face were present in both of them. The histological, histochemical and immunopathological findings allowed to diagnose a "LP-LE coexistence" more than a mixed LP-LE disease. The clinical, histological and immunological relationships between LP and LE are discussed and it is suggested that the pathogenesis of the coexistence of the two diseases could be related to a common pathophysiological pathway. It might be that LP and LE are due to a single aetiological agent (e.g. a virus) interacting with different genetic backgrounds to cause LE in some, LP in others and an intermediate disease in a small group of patients. The histopathological and immunopathological features that distinguish LP from LE are the concentration of lymphocytes in areas of keratinocyte damage, the different colloid bodies patterns and the direct IF findings. The Authors conclude that further studies should be performed on "LP-LE coexistence".
他们的口腔黏膜均出现网状白色斑块,且面部存在与慢性、部分萎缩性类似红斑狼疮的皮肤损害并存。组织学、组织化学和免疫病理学检查结果表明,这更像是一种“扁平苔藓 - 红斑狼疮共存”的情况,而非混合性扁平苔藓 - 红斑狼疮疾病。文中讨论了扁平苔藓和红斑狼疮之间的临床、组织学及免疫学关系,并提出两种疾病共存的发病机制可能与共同的病理生理途径有关。可能是扁平苔藓和红斑狼疮由单一病因(如病毒)引起,该病因与不同的遗传背景相互作用,在一些患者中导致红斑狼疮,在另一些患者中导致扁平苔藓,而在一小部分患者中导致中间型疾病。区分扁平苔藓和红斑狼疮的组织病理学和免疫病理学特征包括角质形成细胞损伤区域淋巴细胞的聚集、不同的胶样小体模式以及直接免疫荧光检查结果。作者得出结论,应对“扁平苔藓 - 红斑狼疮共存”进行进一步研究。