McGrae J D
Arch Dermatol. 1986 Jan;122(1):43-7. doi: 10.1001/archderm.122.1.43.
Two cases of actinic granuloma are described with emphasis on distinctive clinical and histopathologic features, including immunoperoxidase staining for lysozyme and immunophenotyping of mononuclear leukocytes. Actinic granuloma presents in chronically sun-damaged skin as normally colored to erythematous papules that coalesce to form centrifugally enlarging annular patterns. By light microscopy, a granulomatous infiltrate of giant cells and histiocytes is seen to be intimately related to the presence of elastotic fibers in the upper dermis. Selective localization of lysozyme in the giant cells of the granuloma is apparent by a tertiary antibody immunoperoxidase technique. Determination of mononuclear leukocyte subsets with monoclonal antibodies reveals a predominance of helper T cells in the lymphocytic infiltrate associated with the granuloma. It is postulated that actinic granuloma represents a cell-mediated immune response to weakly antigenic determinants on actinically altered elastotic fibers.
本文描述了两例光化性肉芽肿病例，重点强调了其独特的临床和组织病理学特征，包括溶菌酶免疫过氧化物酶染色和单核白细胞免疫表型分析。光化性肉芽肿出现在长期受阳光损伤的皮肤中，表现为颜色正常至红斑丘疹，融合形成离心性扩大的环状形态。通过光学显微镜观察，可见巨细胞和组织细胞的肉芽肿性浸润与真皮上层弹性纤维的存在密切相关。通过三级抗体免疫过氧化物酶技术可明显观察到溶菌酶在肉芽肿巨细胞中的选择性定位。用单克隆抗体测定单核白细胞亚群显示，与肉芽肿相关的淋巴细胞浸润中辅助性T细胞占优势。据推测，光化性肉芽肿代表了对光化性改变的弹性纤维上弱抗原决定簇的细胞介导免疫反应。
