Mahony Jeff, Helms Stephen E, Brodell Robert Thomas
University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216.
Department of Dermatology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216.
Clin Dermatol. 2014 Sep-Oct;32(5):654-9. doi: 10.1016/j.clindermatol.2014.04.013.
Although the cause of sarcoidosis is unknown, there is growing support for the concept that sarcoidal granulomas result from a hypersensitivity reaction producing a nonspecific response to an extrinsic or intrinsic (autoimmune) antigen in genetically susceptible individuals. The immune milieu associated with these antigens, localized in a specific cutaneous area, produces a variant of Ruocco's "immunocompromised district." This may explain the predilection for sarcoidal granulomas in association with foreign bodies, tattoos, herpes zoster-affected dermatomes, and scars. Similar antigenic stimulation produces sarcoidal granulomas surrounding internal tumors. Finally, systemic sarcoidosis, as manifested by hilar adenopathy, may reflect the lymphatic spread of foreign antigens.
虽然结节病的病因尚不清楚，但越来越多的人支持这样一种观点，即结节样肉芽肿是由超敏反应引起的，在遗传易感个体中对外部或内部（自身免疫）抗原产生非特异性反应。与这些抗原相关的免疫环境定位于特定的皮肤区域，产生了Ruocco“免疫受损区”的变体。这可能解释了结节样肉芽肿与异物、纹身、带状疱疹累及的皮节和瘢痕相关的偏好。类似的抗原刺激会在内部肿瘤周围产生结节样肉芽肿。最后，以肺门淋巴结肿大为表现的系统性结节病可能反映了外来抗原的淋巴扩散。
