Fernandez-Flores Angel, De Cabo-Lopez Erik, Diaz-Galvez Francisco-Javier
Departments of *Cellular Pathology; and †Hematology, Hospital El Bierzo, Ponferrada, Spain.
Am J Dermatopathol. 2014 Feb;36(2):e22-5. doi: 10.1097/DAD.0b013e31828cafbe.
Mediterranean spotted fever (MSF) is a tick-borne disease caused by Rickettsia conorii conorii. Some rare cases present without a rash, and they are known as "spotless." This fact is important; although the mortality rates for MSF are low and generally range from 0% to 3%, the absence of a rash usually leads to a delay in the diagnosis and, therefore, an increase in the rates of morbidity and mortality. Necrosis of the digits is one of the complications of MSF that has occasionally been reported in the literature. However, very few reports have studied the morphological changes seen in the cutaneous necrotic lesions. In this report, we describe the morphological changes found through examining a biopsy taken from a necrotic cutaneous lesion in a 69-year-old man who had been diagnosed with Mediterranean spotless fever due to R. conorii. The main morphological changes included areas of collagen degeneration in the papillary dermis, necrotic eccrine glands, and hypodermal collagen with a smudged homogeneous appearance.
地中海斑疹热（MSF）是一种由康氏立克次体引起的蜱传疾病。一些罕见病例没有皮疹，被称为“无疹型”。这一情况很重要；尽管地中海斑疹热的死亡率较低，一般在0%至3%之间，但无皮疹通常会导致诊断延迟，进而使发病率和死亡率上升。手指坏死是地中海斑疹热的并发症之一，文献中偶尔有报道。然而，很少有报告研究皮肤坏死病变中所见的形态学变化。在本报告中，我们描述了通过对一名69岁男性的坏死性皮肤病变活检标本进行检查所发现的形态学变化，该患者因康氏立克次体被诊断为无疹型地中海斑疹热。主要形态学变化包括乳头层真皮的胶原变性区域、坏死的汗腺以及皮下胶原呈现模糊的均匀外观。
