Tosti A, Fanti P A, Guerra L, Piancastelli E, Poggi S, Pileri S
Department of Dermatology, University of Bologna, Italy.
Contact Dermatitis. 1990 Feb;22(2):81-5. doi: 10.1111/j.1600-0536.1990.tb01522.x.
This histological and immunohistochemical study of 6 food handlers affected by immediate contact dermatitis due to foods shows that apparently normal skin of patients with this condition presents several histological and immunohistochemical abnormalities. Skin biopsies of normal hand skin showed focal parakeratosis and moderately dense dermal infiltrates. Immunohistochemistry showed an increased number of Langerhans cells in the epidermis and in the superficial dermis and a mononuclear dermal infiltrate consisting of peripheral T lymphocytes with a CD4/CD8 ratio of 5-6/1. Biopsies of the immediate vesicular reactions induced by foods showed spongiotic vesicles within the epidermis and a moderate to dense mononuclear dermal perivascular infiltrate. The immunohistochemical features were similar to those described in apparently normal skin. The mechanism of this immediate vesicular reaction requires further research. The rapid appearance of the lesions (after 20-30 min) probably excludes an immunological cell-mediated pathogenesis. A non-immunological mechanism due to direct liberation of mediators by foods is more readily conceivable than an immediate immunological type of contact reaction.
这项对6名因食物引发速发型接触性皮炎的食品处理人员进行的组织学和免疫组织化学研究表明，患有这种疾病的患者看似正常的皮肤存在一些组织学和免疫组织化学异常。正常手部皮肤活检显示灶性角化不全和中度致密的真皮浸润。免疫组织化学显示，表皮和浅表真皮中朗格汉斯细胞数量增加，真皮单核浸润由外周T淋巴细胞组成，CD4/CD8比值为5 - 6/1。食物引发的速发型水疱反应活检显示表皮内有海绵状水疱以及中度至致密的真皮血管周围单核浸润。免疫组织化学特征与看似正常皮肤中描述的特征相似。这种速发型水疱反应的机制需要进一步研究。病变迅速出现（20 - 30分钟后）可能排除了免疫细胞介导的发病机制。与速发型免疫性接触反应相比，食物直接释放介质导致的非免疫机制更容易理解。
