Kumar Parimalam, Thomas Jayakar, Dineshkumar Devaraj
Department of Dermatology, Thanjavur Medical College, Thanjavur, India.
Department of Skin and STD, Sree Balaji Medical College, Chennai, Tamil Nadu, India.
Indian J Dermatol. 2015 Mar-Apr;60(2):213. doi: 10.4103/0019-5154.152575.
Erythroderma in infants is a rare condition of varied etiology. Psoriasis is now emerging as the most common cause of erythroderma in infants. Early diagnosis of the etiological cause much depends upon the histological confirmation, which is essential for an early and appropriate treatment.
It was aimed to study the histological findings in psoriatic erythroderma in infants.
A total of 8 infants up to 1 year of age presenting with erythroderma, clinically suspected to be of psoriatic etiology attending private clinic were included. After detailed history taking and astute clinical exam, all of them were biopsied. In case 6, with a positive family history of psoriasis and asthma in parents, biopsy was taken from two sites. The histological findings of all nine biopsies were studied and analyzed.
Histology of all eight children showed psoriasi form pattern with acanthosis (AC) and dilated papillary capillaries (PC). Spongiform (SF) pattern was seen in the second biopsy (6b) of child with features of both psoriasis and atopy. SF pustule of Kogoj or Munro's abscess was not seen in any of them.
Regular AC and PC dilatation were the consistent histological findings observed in infants with erythrodermic psoriasis. These were the early findings observed in younger infants. Co-existence of psoriasis with atopic dermatitis may indicate a common pathogenic mechanism or an immunogenetic spin-off.
婴儿红皮病病因多样,较为罕见。银屑病现已成为婴儿红皮病最常见的病因。病因的早期诊断很大程度上依赖于组织学确诊,这对于早期和恰当的治疗至关重要。
旨在研究婴儿银屑病性红皮病的组织学表现。
纳入8名1岁以下出现红皮病、临床怀疑为银屑病病因且在私人诊所就诊的婴儿。详细询问病史并进行仔细的临床检查后,对所有婴儿进行活检。病例6的父母有银屑病和哮喘家族史,从两个部位取材活检。对所有9份活检标本的组织学表现进行研究和分析。
所有8名儿童的组织学表现均为银屑病样模式,伴有棘层肥厚(AC)和乳头毛细血管扩张(PC)。在一名同时具有银屑病和特应性皮炎特征的儿童的第二次活检标本(6b)中可见海绵状(SF)模式。所有标本均未见到科戈伊海绵状脓疱或蒙罗微脓肿。
规则的棘层肥厚和毛细血管扩张是婴儿银屑病性红皮病一致的组织学表现。这些是在较小婴儿中观察到的早期表现。银屑病与特应性皮炎并存可能表明存在共同的致病机制或免疫遗传衍生现象。