Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.
Int J Dermatol. 2011 Dec;50(12):1480-5. doi: 10.1111/j.1365-4632.2011.04990.x.
Acantholysis has been described in biopsies of pityriasis rubra pilaris (PRP), but this has not been emphasized in the dermatology literature. It is helpful for dermatologists to associate acantholysis with PRP in the correct clinical setting.
This study aims to further elucidate the clinical context and associated histologic features of acantholysis in PRP.
Eight cases of PRP with acantholysis, 16 other cases of PRP, 26 cases of psoriasis, and 17 cases of erythroderma of different causes were studied in an academic setting.
The presence of acantholysis initially confounded the diagnosis in two cases of PRP. Acantholysis was focal or extensive and resembled Darier's disease, Hailey-Hailey disease, or pemphigus vulgaris. Acantholysis was seen in biopsies from early, isolated papulosquamous lesions from the trunk as well as from erythroderma. By comparison, 26 cases of psoriasis and 17 cases of erythroderma showed only focal acantholysis in two cases of erythroderma.
Acantholysis is a histologic feature of PRP and can serve as a histologic clue to the diagnosis of PRP before the onset of erythroderma. Eosinophils and/or a lichenoid infiltrate may also be evident.
棘层松解已在棘层松解性类银屑病（PRP）的活检中被描述过，但在皮肤科文献中并未得到强调。皮肤科医生在正确的临床环境下将棘层松解与 PRP 联系起来是有帮助的。
本研究旨在进一步阐明 PRP 中棘层松解的临床背景和相关组织学特征。
在学术环境中研究了 8 例伴棘层松解的 PRP、16 例其他 PRP、26 例银屑病和 17 例不同病因的红皮病。
棘层松解最初在 2 例 PRP 中混淆了诊断。棘层松解为局灶性或广泛性，类似于 Darier 病、Hailey-Hailey 病或寻常性天疱疮。棘层松解见于躯干早期孤立的丘疹鳞屑性损害以及红皮病的活检中。相比之下，26 例银屑病和 17 例红皮病仅在 2 例红皮病中出现 2 例局灶性棘层松解。
棘层松解是 PRP 的组织学特征，可在红皮病发生前作为 PRP 诊断的组织学线索。嗜酸性粒细胞和/或苔藓样浸润也可能明显。
