Kossard S, Collins A, McCrossin I
J Am Acad Dermatol. 1987 May;16(5 Pt 1):1007-14. doi: 10.1016/s0190-9622(87)80408-5.
Skin biopsy specimens from four patients who had recurrent bouts of lesions conforming to the clinical description of acne necrotica were studied. The pathologic findings were dominated by lymphocytic inflammation around centrally placed follicles evolving to follicular necrosis that extended to the perifollicular epidermis and dermis. Early lesions showed the development of multiple individual necrotic keratinocytes within the follicular sheath and adjacent epidermis with lymphocytic exocytosis. Later lesions showed more intense necrosis and scale crust obscuring the central target but were still dominated by a peripheral lymphocytic infiltrate. The early pathologic findings of acne necrotica (varioliformis) are represented by a necrotizing lymphocytic folliculitis and differ from the pattern seen in association with nonspecific excoriations, acute bacterial folliculitis, classic comedogenic acne, or acnitis.
对四名患有反复发作性皮损（符合坏死性痤疮临床描述）患者的皮肤活检标本进行了研究。病理结果主要表现为围绕位于中心的毛囊的淋巴细胞性炎症，逐渐发展为毛囊坏死，并扩展至毛囊周围的表皮和真皮。早期病变显示在毛囊鞘和相邻表皮内出现多个单个坏死角质形成细胞，并伴有淋巴细胞外渗。后期病变显示坏死更严重，结痂鳞屑掩盖了中央靶点，但仍以周围淋巴细胞浸润为主。坏死性痤疮（痘疮样）的早期病理表现为坏死性淋巴细胞性毛囊炎，与非特异性擦伤、急性细菌性毛囊炎、典型粉刺性痤疮或毛囊发炎所见模式不同。
