Massone Cesare, Belachew Workalemahu Alemu, Schettini Antonio
Department of Dermatology, Medical University of Graz, Graz, Austria.
Mekelle University, College of Health Science, Mekelle, Ethiopia.
Clin Dermatol. 2015 Jan-Feb;33(1):38-45. doi: 10.1016/j.clindermatol.2014.10.003.
The histopathology of lepromatous skin varies according to the cell-mediated immunity of the host against Mycobacterium leprae. In tuberculoid and borderline tuberculoid leprosy, epithelioid noncaseating granulomas predominate, and acid-fast bacilli (AFB) are absent or only rarely present. In borderline lepromatous and lepromatous leprosy, the infiltrate is composed of macrophages with a vacuolar cytoplasm, lymphocytes, and plasma cells. AFB are numerous. Edema inside and outside the epithelioid granulomas, together with the appearance of large giant cells, are the main features of type 1 reactions. A conspicuous neutrophilic infiltrate in the subcutis with or without vasculitis is found in erythema nodosum leprosum. The main histopathologic features of leprosy and its particular forms are discussed in this review.
瘤型麻风皮肤的组织病理学根据宿主对麻风分枝杆菌的细胞介导免疫反应而有所不同。在结核样型和界线类偏结核样型麻风病中，上皮样非干酪样肉芽肿占主导，抗酸杆菌（AFB）不存在或仅很少出现。在界线类偏瘤型和瘤型麻风病中，浸润由具有空泡状细胞质的巨噬细胞、淋巴细胞和浆细胞组成。AFB数量众多。上皮样肉芽肿内外的水肿以及大的巨细胞的出现是1型反应的主要特征。在麻风结节性红斑中，皮下可见明显的嗜中性粒细胞浸润，可伴有或不伴有血管炎。本文综述了麻风病及其特殊类型的主要组织病理学特征。
