Department of Pathology, University of Michigan, Ann Arbor, Michigan.
Department of Pathology, University of Michigan, Ann Arbor, Michigan; Department of Dermatology, University of Michigan, Ann Arbor, Michigan.
J Am Acad Dermatol. 2014 Jul;71(1):100-7. doi: 10.1016/j.jaad.2014.01.892. Epub 2014 Mar 20.
Distinction of rosacea and cutaneous lupus erythematosus (LE) can be challenging because of significant clinical and histologic overlap. A controlled study comparing these conditions is lacking.
We compared the histologic features, T-cell subsets, and plasmacytoid dendritic cells in rosacea and LE.
Biopsy specimens of rosacea (n = 27) and facial LE (n = 30) were retrospectively reviewed and reacted with Alcian blue and periodic acid-Schiff stains, and CD4, CD8, CD25, and CD123 immunostains.
LE demonstrates a lower CD4:CD8 ratio (1.74 vs 2.80, P = .0064), fewer CD4(+)CD25(+) regulatory T cells (13% vs 31%, P < .0001), and more CD123(+) plasmacytoid dendritic cells (18% vs 6%, P = .0137) than rosacea. The plasmacytoid dendritic cells in LE are more likely to form clusters (P = .0137) and comprise at least 20% of the infiltrate (P = .0340). Also associated with LE are follicular plugging (P = .0039), perineural lymphocytic infiltrate (P = .0211), abundant mucin deposition (P = .0031), and conspicuous basement membrane thickening (P = .0073), whereas Demodex infestation (P = .0064) and sebaceous hyperplasia (P = .0029) are significantly associated with rosacea.
Although statistically significant, the immunophenotypic differences are rather small and limited for routine use.
The infiltrates in rosacea and LE differ immunophenotypically, and may aid in their distinction in addition to conventional histologic examination.
由于临床和组织学表现有显著重叠，所以区分酒渣鼻和盘状红斑狼疮（LE）可能具有挑战性。目前缺乏这两种疾病的对照研究。
我们比较了酒渣鼻和 LE 的组织学特征、T 细胞亚群和浆细胞样树突状细胞。
回顾性分析了酒渣鼻（n=27）和面部 LE（n=30）的活检标本，并用阿尔辛蓝和过碘酸雪夫染色以及 CD4、CD8、CD25 和 CD123 免疫染色进行反应。
与酒渣鼻相比，LE 显示出更低的 CD4:CD8 比值（1.74 比 2.80，P=0.0064）、更少的 CD4+CD25+调节性 T 细胞（31%比 13%，P<0.0001）和更多的 CD123+浆细胞样树突状细胞（18%比 6%，P=0.0137）。LE 中的浆细胞样树突状细胞更有可能形成簇（P=0.0137），并且至少占浸润的 20%（P=0.0340）。与 LE 相关的还有滤泡性堵塞（P=0.0039）、神经周围淋巴细胞浸润（P=0.0211）、丰富的黏蛋白沉积（P=0.0031）和明显的基底膜增厚（P=0.0073），而蠕形螨感染（P=0.0064）和皮脂腺增生（P=0.0029）与酒渣鼻显著相关。
尽管具有统计学意义，但免疫表型差异相当小，并且对常规使用有一定限制。
酒渣鼻和 LE 的浸润在免疫表型上存在差异，除了常规组织学检查外，这些差异可能有助于区分这两种疾病。
