Akagawa Mai, Hattori Yuki, Mizutani Yoko, Shu En, Miyazaki Tatsuhiko, Seishima Mariko
Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Pathology, Gifu University Hospital, Gifu, Japan.
Case Rep Dermatol. 2020 Mar 20;12(1):52-56. doi: 10.1159/000506670. eCollection 2020 Jan-Apr.
Palisaded neutrophilic and granulomatous dermatitis (PNGD) shows various clinical features and is histologically characterized by palisaded granulomas surrounding degenerated collagen. PNGD is known to be associated with a variety of systemic conditions such as rheumatoid arthritis and systemic lupus erythematosus. Furthermore, PNGD has been reported to be associated with antineutrophilic cytoplasmic antibody-associated vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis. Here, we report a case of PNGD associated with GPA, which showed the infiltration of CD163-positive M2 macrophages in the skin lesion with elevated serum level of soluble CD163 (sCD163). The serum sCD163 level was reduced to normal range after systemic steroid therapy. Thus, M2 macrophages may play a role in the pathomechanisms of PNGD associated with GPA.
栅栏状中性粒细胞和肉芽肿性皮炎（PNGD）具有多种临床特征，其组织学特征为围绕变性胶原的栅栏状肉芽肿。已知PNGD与多种全身性疾病相关，如类风湿性关节炎和系统性红斑狼疮。此外，据报道PNGD与抗中性粒细胞胞浆抗体相关血管炎有关，包括肉芽肿性多血管炎（GPA）和显微镜下多血管炎。在此，我们报告一例与GPA相关的PNGD病例，该病例显示皮肤病变中有CD163阳性M2巨噬细胞浸润，且血清可溶性CD163（sCD163）水平升高。全身类固醇治疗后，血清sCD163水平降至正常范围。因此，M2巨噬细胞可能在与GPA相关的PNGD发病机制中起作用。
