Yanagihara Makoto, Makino Teruhiko, Shimizu Tadamichi, Mochizuki Takashi
Department of Dermatology, Shinseikai Toyama Hospital, Imizu, Toyama, Japan.
Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
J Cutan Pathol. 2018 Jun;45(6):423-427. doi: 10.1111/cup.13131. Epub 2018 Apr 2.
Lichen aureus is a rare, chronic, persistent purpuric dermatosis clinically characterized by striking yellow- to bronze-colored lesions. Histologically, lichen aureus differs from other pigmented purpuric dermatoses in containing dense, band-like infiltrates closely associated with the epidermis. This report describes 2 patients with lichen aureus, a 20-year-old woman with a lesion on her right arm and a 51-year-old man with a lesion on the right side of his groin. Skin biopsy specimens revealed almost identical findings in both patients, including dense band-like infiltrates containing lymphocytes, histiocytes with hemosiderin deposits scattered extravasated red blood cells and nerve alterations at the dermo-epidermal interface. The nerves within the lesions were filled with granules, which stained positive with antibody to microtubule-associated protein 1A/1B-light chain 3, suggesting autophagy within the nerves. These altered nerves were present only in areas of band-like dermal lymphocytic infiltration. Electron microscopy of the lesions showed the accumulation of autophagosomes in Schwann cells.
金黄色苔藓是一种罕见的慢性、持续性紫癜性皮肤病，临床特征为显著的黄色至青铜色皮损。组织学上，金黄色苔藓与其他色素性紫癜性皮肤病不同，其含有与表皮紧密相关的致密带状浸润。本报告描述了2例金黄色苔藓患者，1例为20岁女性，右臂有皮损；另1例为51岁男性，右侧腹股沟有皮损。皮肤活检标本显示，两名患者的 findings 几乎相同, 包括致密带状浸润，其中含有淋巴细胞、有含铁血黄素沉积的组织细胞、散在的外渗红细胞以及真皮 - 表皮交界处的神经改变。皮损内的神经充满颗粒，这些颗粒用微管相关蛋白1A/1B轻链3抗体染色呈阳性，提示神经内存在自噬。这些改变的神经仅存在于带状真皮淋巴细胞浸润区域。皮损的电子显微镜检查显示施万细胞中有自噬体的积累。
