Iwatsuki K, Yamada M, Takigawa M, Inoue K, Matsumoto K
J Am Acad Dermatol. 1987 Jan;16(1 Pt 1):83-8. doi: 10.1016/s0190-9622(87)70007-3.
We report three patients with peculiar nodules of the earlobes that developed a few months after the wearing of pierced-type gold earrings. Biopsy specimens showed dense infiltration of lymphoid cells in the dermis and subcutaneous tissue associated with the formation of lymphoid follicles. The clinical and histologic pictures were similar to those of lymphocytoma cutis. Immunohistologically, the nodular lesions were characterized by the proliferation of T cells, mainly suppressor/cytotoxic T cells, and the presence of histiocytic cells displaying Leu-3a antigens on the surface. Patch tests of aqueous gold compound induced a strong skin reaction. A histologic study of the patch test reaction sites revealed a picture of ordinary allergic contact dermatitis showing that T cells, including both helper and suppressor T cells, invaded the spongiotic epidermis and the papillary dermis. Eosinophils and a few Langerhans cells were also present in the dermal infiltrates. These findings suggest that pierced-type gold earrings induced a long-term dermal response that resulted in producing benign lymphoplasia in the sensitized individuals.
我们报告了三名患者，他们在佩戴穿孔式金耳环几个月后耳垂出现了特殊结节。活检标本显示真皮和皮下组织中有密集的淋巴细胞浸润，并伴有淋巴滤泡形成。临床和组织学表现与皮肤淋巴细胞瘤相似。免疫组织化学显示，结节性病变的特征是T细胞增殖，主要是抑制/细胞毒性T细胞，以及表面显示Leu-3a抗原的组织细胞的存在。金化合物水溶液斑贴试验引起强烈的皮肤反应。对斑贴试验反应部位的组织学研究显示为普通变应性接触性皮炎，表明包括辅助性T细胞和抑制性T细胞在内的T细胞侵入了海绵状表皮和乳头层真皮。真皮浸润中也有嗜酸性粒细胞和一些朗格汉斯细胞。这些发现表明，穿孔式金耳环引起了长期的真皮反应，导致致敏个体产生良性淋巴组织增生。
