Tsutsumi Reiko, Sugita Kazunari, Abe Yuko, Hozumi Yutaka, Suzuki Tamio, Yamada Nanako, Yoshida Yuichi, Yamamoto Osamu
Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan.
Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan.
J Cutan Pathol. 2019 Feb;46(2):123-129. doi: 10.1111/cup.13396. Epub 2018 Dec 18.
Rhododendrol (rhododenol), an inhibitor of tyrosinase activity, is used as a skin-whitening component. Many cases of leukoderma after the application have been reported, termed rhododenol-induced leukoderma (RIL). The aim of this study was to clarify the pathogenesis of RIL morphologically through comparison with vitiligo.
We examined 14 cases of RIL and 15 cases of vitiligo using routine histopathology and immunohistochemistry. Thirteen cases of RIL, six cases of vitiligo and specimens of the RIL mouse model were evaluated by electron microscopy.
There were common findings in RIL and vitiligo at the light-microscopic level: (a) vacuolar changes in the dermo-epidermal junction, (b) melanophages in the papillary dermis, (c) perifollicular lymphocyte infiltration, (d) loss or decrease of basal melanin pigment and (e) decrease of melanocytes in the lesions. The ultrastructural observations showed specific findings of RIL: (a) remaining melanocytes in depigmented lesions, (b) inhomogeneous melanization in melanocytes and (c) degenerated melanosomes in melanocytes. Some of the findings were observed in a RIL mouse model. Furthermore, it is notable that cell organelles of melanocytes were intact in our RIL cases.
Morphological changes of RIL targeting melanosomes in melanocytes without degeneration of organelles reflect the reversible clinical course of most cases.
杜鹃花醇是一种酪氨酸酶活性抑制剂，用作皮肤美白成分。已有许多应用后发生白斑病的病例报道，称为杜鹃花醇诱导的白斑病（RIL）。本研究的目的是通过与白癜风比较，从形态学上阐明RIL的发病机制。
我们使用常规组织病理学和免疫组织化学检查了14例RIL和15例白癜风。通过电子显微镜对13例RIL、6例白癜风和RIL小鼠模型的标本进行了评估。
RIL和白癜风在光镜水平有共同表现：（a）真皮-表皮交界处的空泡改变；（b）乳头真皮中的噬黑素细胞；（c）毛囊周围淋巴细胞浸润；（d）基底黑色素沉着缺失或减少；（e）病变中黑素细胞减少。超微结构观察显示了RIL的特异性表现：（a）色素脱失病变中残留的黑素细胞；（b）黑素细胞内黑色素化不均匀；（c）黑素细胞中退化的黑素小体。在RIL小鼠模型中观察到了一些结果。此外，值得注意的是，在我们的RIL病例中黑素细胞的细胞器是完整的。
RIL针对黑素细胞中黑素小体的形态学变化，且细胞器未退化，反映了大多数病例的可逆临床过程。
