Herzberg A J, Dinehart S M, Kerns B J, Pollack S V
Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710.
Am J Dermatopathol. 1990 Apr;12(2):109-21. doi: 10.1097/00000372-199004000-00001.
The earliest stages of acne keloidalis are not well characterized. In the present study, transverse sections of the early lesions revealed follicular units in several stages of inflammation. These follicles surrounded the central follicular units that gave rise to the clinically evident papule. Despite a spectrum of inflammatory changes, the most marked inflammation consistently occurred in the deep infundibular and isthmian levels of the hair follicles. Two follicles, presumably in the earliest stage, exhibited primarily an acute folliculitis and perifolliculitis, with destruction of the follicular wall and the release of hair. Central follicles showed predominantly acute neutrophilic or chronic lymphocytic inflammation at the upper isthmian levels and granulomatous inflammation at the deeper isthmian levels. Other follicles showed scar at the isthmian levels trapping hair fragments in the inferior portion of the follicle, with granulomatous inflammation and scarring. Sebaceous glands were absent in all stages of folliculitis in seven of eight follicular units.
瘢痕疙瘩性痤疮的早期阶段特征尚不明确。在本研究中，早期病变的横切面显示毛囊单位处于炎症的几个阶段。这些毛囊围绕着中央毛囊单位，后者形成临床上明显的丘疹。尽管存在一系列炎症变化，但最显著的炎症始终发生在毛囊深部漏斗部和峡部水平。两个推测处于最早阶段的毛囊主要表现为急性毛囊炎和毛囊周炎，伴有毛囊壁破坏和毛发脱落。中央毛囊在上部峡部水平主要表现为急性中性粒细胞或慢性淋巴细胞炎症，在深部峡部水平表现为肉芽肿性炎症。其他毛囊在峡部水平显示瘢痕，将毛发碎片困在毛囊下部，伴有肉芽肿性炎症和瘢痕形成。在八个毛囊单位中的七个，皮脂腺在毛囊炎的所有阶段均未出现。
