Lanoue Julien, Yanofsky Valerie R, Mercer Steven E, Phelps Robert G
*Icahn School of Medicine at Mount Sinai, New York, NY; †Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; and ‡Division of Dermatopathology, Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY.
Am J Dermatopathol. 2016 May;38(5):353-8. doi: 10.1097/DAD.0000000000000503.
Cytokeratins are a major component of colloid bodies that are essentially diagnostic of lichen planopilaris (LPP). Here, the authors assess the ability of the cytokeratin 903 antibody (CK-903) to stain colloid bodies and differentiate LPP from other histologically similar appearing primary cicatricial alopecias. A retrospective review of all specimens submitted to the dermatopathology department over a 2-year window identified 18 cases of LPP and 20 cases of histologically similar appearing entities (discoid lupus erythematosus or central centrifugal cicatricial alopecia) through a combination of H&E, elastic van gieson, and periodic acid-schiff stains. All 38 samples were then prospectively stained with CK-903. Colloid bodies were identifiable in 3 of the 18 LPP cases based on H&E alone but were seen in 9 of 18 cases when CK-903 was used. There were no cases where colloid bodies were seen on H&E but not subsequently identified with CK-903. Additionally, there was no CK-903 staining in any of the 20 cases of similar appearing entities except 1 case of discoid lupus erythematosus, which is known to occasionally show colloid bodies. The authors conclude that CK-903 is a useful adjunctive tool that will allow for a quicker, less costly, and more accurate diagnosis of LPP given its ability identify colloid bodies even in the setting of significant inflammation and fibrosis and its advantages over direct immunofluorescence of low cost, short preparation time, and lack of need for a specialized fluorescent microscope.
细胞角蛋白是胶样小体的主要成分，而胶样小体本质上是扁平苔藓样毛发角化病（LPP）的诊断依据。在此，作者评估细胞角蛋白903抗体（CK - 903）对胶样小体进行染色以及将LPP与其他组织学表现相似的原发性瘢痕性脱发相鉴别的能力。对皮肤科病理科在两年时间内接收的所有标本进行回顾性分析，通过苏木精 - 伊红染色（H&E）、弹性万吉森染色和过碘酸 - 希夫染色，确定了18例LPP病例和20例组织学表现相似的疾病（盘状红斑狼疮或中心离心性瘢痕性脱发）。然后对所有38个样本进行前瞻性CK - 903染色。仅基于H&E染色，在18例LPP病例中有3例可识别出胶样小体，但使用CK - 903时，18例中有9例可见胶样小体。不存在H&E染色可见胶样小体但随后CK - 903染色未识别出的情况。此外，在20例相似表现的疾病中，除1例已知偶尔出现胶样小体的盘状红斑狼疮外，其余病例均未出现CK - 903染色。作者得出结论，CK - 903是一种有用的辅助工具，鉴于其即使在存在显著炎症和纤维化的情况下也能识别胶样小体，以及与直接免疫荧光相比具有成本低、制备时间短且无需专门荧光显微镜的优势，它能够实现对LPP更快、成本更低且更准确的诊断。
