Walker Daniel, Susa Joseph S, Currimbhoy Sharif, Jacobe Heidi
Department of Dermatology, University of Arkansas, Fayetteville, Arkansas.
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
J Am Acad Dermatol. 2017 Jun;76(6):1124-1130. doi: 10.1016/j.jaad.2016.12.020. Epub 2017 Mar 9.
Histopathological features in morphea (localized scleroderma) and their clinical correlates are poorly described.
We sought to systematically describe histologic changes of morphea in a large, well-annotated cohort and determine the association between histopathology and clinical features.
This was a cross-sectional study of 83 patients enrolled in the Morphea in Adults and Children cohort. The main outcome measure was the association of microanatomical location and degree of sclerosis and inflammation seen on histologic samples with patient-reported symptoms and physician-based measures of severity.
Pattern of sclerosis was associated with morphea subtype, the presence of patient-reported symptoms, and functional limitation. A bottom-heavy pattern of sclerosis was associated with pain and tightness (P = .0039 and .001, respectively). These symptoms were not associated with a top-heavy pattern. Severe inflammation may be associated with pain and functional limitation (P = .073 for both).
Small sample size limits ability to detect associations, particularly in subgroups.
Histopathological examination of morphea may assist in identifying patients who may require additional monitoring and treatment. Features such as patterns of sclerosis and severity of inflammation should be included in pathology reports to help aid in clinical management.
硬斑病（局限性硬皮病）的组织病理学特征及其临床相关性描述较少。
我们试图在一个大量且注释完善的队列中系统描述硬斑病的组织学变化，并确定组织病理学与临床特征之间的关联。
这是一项对纳入成人和儿童硬斑病队列的83例患者进行的横断面研究。主要结局指标是组织学样本上观察到的微观解剖位置、硬化程度和炎症程度与患者报告的症状以及医生评估的严重程度之间的关联。
硬化模式与硬斑病亚型、患者报告的症状以及功能受限有关。底部较重的硬化模式与疼痛和紧绷感相关（分别为P = 0.0039和0.001）。这些症状与顶部较重的模式无关。严重炎症可能与疼痛和功能受限有关（两者均为P = 0.073）。
样本量小限制了检测关联的能力，尤其是在亚组中。
硬斑病的组织病理学检查可能有助于识别可能需要额外监测和治疗的患者。病理报告应包括硬化模式和炎症严重程度等特征，以帮助临床管理。
