Tomasini Carlo
Dermatologic Clinic, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy -
G Ital Dermatol Venereol. 2017 Oct;152(5):500-515. doi: 10.23736/S0392-0488.17.05720-0. Epub 2017 Jul 26.
The term "invisible dermatoses" is often used in two different contexts: 1) dermatoses which are invisible to the clinician, i.e., diseases with no significant clinical features; 2) dermatoses which are invisible to the pathologist. These latter comprise a wide spectrum of entities which present with definite and obvious clinical features, but subtle or hidden histological features and are therefore "invisible" histologically. Diagnosis of such diseases represents a great challenge to both the dermatologist and dermatopathologist. The list of such diseases, originally comprising only few entities, has been gradually expanded over decades and now is a large one. This review focuses on the recently expanded spectrum of such diseases, and offers to the dermatopathologist a strategy for their diagnosis, based mainly on proper awareness, recognition of subtle features, special stains, special investigations such as immunofluorescence and histochemistry and proper clinicopathological correlation.
“隐匿性皮肤病”这一术语常用于两种不同的语境:1)临床医生难以察觉的皮肤病,即无明显临床特征的疾病;2)病理学家难以察觉的皮肤病。后者涵盖了广泛的疾病实体,这些疾病具有明确且明显的临床特征,但组织学特征细微或隐匿,因此在组织学上“难以察觉”。此类疾病的诊断对皮肤科医生和皮肤病理学家而言都是巨大的挑战。这类疾病的清单最初仅有寥寥几种,几十年来逐渐增多,如今已颇为庞大。本综述聚焦于此类疾病近期扩大的范围,并为皮肤病理学家提供一种诊断策略,主要基于正确的认识、对细微特征的识别、特殊染色、免疫荧光和组织化学等特殊检查以及恰当的临床病理关联。