Pitney Lucy K, O'Brien Blake, Pitney Michael J
Queensland Institute of Dermatology, Greenslopes Hospital, Greenslopes, Brisbane, Queensland, Australia.
Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia.
Australas J Dermatol. 2018 Feb;59(1):e53-e58. doi: 10.1111/ajd.12592. Epub 2017 Feb 27.
Acne necrotica is a disorder of adults of obscure aetiology, featuring repeated cropping of inflammatory papulonodules which rapidly necrotise, leaving varying degrees of superficial scarring with pathological features in early lesions of a necrotising lymphocytic folliculitis. A perceived diminishing interest in this entity in recent years prompted a prospective study of patients presenting to a dermatology practice over a 3-year period to reassess the prevalence of this disorder in general dermatological patients, leading to the identification of 47 patients (35 female) with features of acne necrotica, with histopathology undertaken in atypical cases. We identified the importance of the recognition of primary lesions (1-2 mm umbilicated erythematous papules), often difficult to find in excoriated areas, as being paramount in the diagnosis both clinically and histologically in our study, which reveals a significantly more prevalent and clinically diverse disorder than featured in previous textbook and academic journal descriptions.
坏死性痤疮是一种病因不明的成人疾病，其特征为炎症性丘疹结节反复出现，且迅速坏死，留下不同程度的浅表瘢痕，早期病变具有坏死性淋巴细胞性毛囊炎的病理特征。近年来，人们感觉对该疾病的关注度有所下降，这促使我们对一家皮肤科诊所3年内接诊的患者进行了一项前瞻性研究，以重新评估该疾病在普通皮肤科患者中的患病率，结果发现了47例具有坏死性痤疮特征的患者（35例女性），并对非典型病例进行了组织病理学检查。我们认识到原发性皮损（1-2毫米脐凹状红斑丘疹）的识别很重要，在我们的研究中，这种皮损在糜烂区域通常很难找到，但在临床和组织学诊断中至关重要，研究表明该疾病比以往教科书和学术期刊描述的更为普遍，临床症状也更多样。
