Dabski K, Winkelmann R K
Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
J Am Acad Dermatol. 1989 Jan;20(1):28-39. doi: 10.1016/s0190-9622(89)70004-9.
Some form of collagen alteration (necrobiosis) was observed in 53% of patients with generalized granuloma annulare and in 79% of patients with localized granuloma annulare. Fragmentation of collagen bundles was the most common single type of collagen abnormality in both groups. Collagen sclerosis, accompanied by a strong palisading pattern of histiocytes, was more frequent in localized granuloma annulare. Results of microdroplet lipid staining were positive in 80% of annulare cases and 39.3% of nonannulare cases of generalized granuloma annulare. Inflammatory cells were confined to peripheral perivascular lymphocytes; bandlike granuloma below the epidermis was observed. Positive results of direct immunofluorescence tests in 12 of 23 patients with generalized granuloma annulare suggested that fibrin deposition in areas of altered collagen is less frequent in the generalized than in the localized form, a possible reflection of the lower rate of histologic collagen alteration in that group. Lymphohistiocytic granuloma with various degrees of collagen degeneration, microdroplet lipid accumulation, and mucin deposition form the basic pathologic description of granuloma annulare.
在53%的泛发性环状肉芽肿患者和79%的局限性环状肉芽肿患者中观察到某种形式的胶原改变（渐进性坏死）。胶原束断裂是两组中最常见的单一类型胶原异常。伴有组织细胞强栅栏状排列模式的胶原硬化在局限性环状肉芽肿中更为常见。微滴脂质染色结果在80%的环状病例和39.3%的泛发性环状肉芽肿非环状病例中呈阳性。炎症细胞局限于外周血管周围淋巴细胞；在表皮下方观察到带状肉芽肿。23例泛发性环状肉芽肿患者中有12例直接免疫荧光试验结果呈阳性，提示泛发性环状肉芽肿中胶原改变区域的纤维蛋白沉积比局限性环状肉芽肿少见，这可能反映了该组组织学胶原改变发生率较低。伴有不同程度胶原变性、微滴脂质积聚和粘蛋白沉积的淋巴细胞组织细胞性肉芽肿构成了环状肉芽肿的基本病理描述。
