Fening Katherine, Parekh Vishwas, McKay Kristopher
Division of Dermatopathology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Cutan Pathol. 2016 Aug;43(8):643-8. doi: 10.1111/cup.12725. Epub 2016 Jun 3.
Distinguishing types of lymphocytic scarring alopecia is often difficult because of the overlapping features. Recently, the presence of plasmacytoid dendritic cells (PDCs) in cutaneous lupus erythematosus (LE) was demonstrated and further shown to help distinguish lupus from other dermatoses.1-6 This study aims to determine if the presence and distribution of PDCs can aid in the diagnosis of scarring alopecia.
Cases of scarring alopecia due to chronic cutaneous lupus erythematosus (CCLE), lichen planopilaris (LPP) and central centrifugal cicatricial alopecia (CCCA) were examined histopathologically. A total of 45 total biopsies were evaluated and CD123 immunohistochemistry was performed on all samples. The relative percentage of PDCs, the presence of clusters and the distribution of CD123+ cells were noted.
PDCs comprised a greater percentage of the infiltrate and were arranged in clusters in cases of CCLE vs. LPP or CCCA. In CCLE, the location of PDCs was perivascular, perifollicular, perieccrine and/or at the follicular junction. In LPP and CCCA, PDCs were mainly arranged as single, interstitial cells.
Our findings suggest that the presence and arrangement of CD123+ PDCs may assist in the diagnosis of scarring alopecia. We anticipate this will be of value in diagnosing challenging cases of highly inflammatory scarring alopecia.
由于淋巴细胞性瘢痕性秃发的特征相互重叠，区分其类型往往很困难。最近，已证实在皮肤红斑狼疮（LE）中存在浆细胞样树突状细胞（PDC），并进一步表明其有助于将狼疮与其他皮肤病区分开来。1-6本研究旨在确定PDC的存在和分布是否有助于瘢痕性秃发的诊断。
对慢性皮肤红斑狼疮（CCLE）、扁平苔藓性秃发（LPP）和中心离心性瘢痕性秃发（CCCA）导致的瘢痕性秃发病例进行组织病理学检查。共评估了45份活检样本，并对所有样本进行了CD123免疫组织化学检测。记录PDC的相对百分比、簇的存在情况以及CD123+细胞的分布。
与LPP或CCCA相比，CCLE病例中PDC在浸润细胞中所占百分比更高，且呈簇状排列。在CCLE中，PDC位于血管周围、毛囊周围、汗腺周围和/或毛囊交界处。在LPP和CCCA中，PDC主要呈单个间质细胞排列。
我们的研究结果表明，CD123+ PDC的存在和排列可能有助于瘢痕性秃发的诊断。我们预计这将对诊断具有挑战性的高度炎症性瘢痕性秃发病例有价值。
