Department of Dermatology, University Clinic Münster, Münster, Germany.
Dermatologikum Hamburg, Hamburg, Germany ; and.
Am J Dermatopathol. 2021 Feb 1;43(2):103-111. doi: 10.1097/DAD.0000000000001722.
Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is a clinically very well-defined drug eruption, but the histopathological findings are still considered to be nonspecific.
To characterize the histopathological and immunophenotypical features of SDRIFE.
We performed a retrospective study that identified 11 biopsies from 9 patients with SDRIFE. The histopathological features were analyzed in conjunction with the immunohistochemical findings.
The most common histopathological feature was basal cell vacuolization, which was often associated with necrotic keratinocytes and focal spongiosis. TIA1+ T cells and neutrophils were frequently detected in the epidermis and at the dermoepidermal junction. The dermal inflammatory infiltrate was mixed, consisting of CD3+ T cells, macrophages, granulocytes, low numbers of CD20+ B cells, and plasma cells. A combination of histopathological patterns was observed in 5 cases. The most frequent combined histopathological patterns were interface dermatitis, spongiotic dermatitis, and psoriasiform dermatitis. Other histopathological patterns found in different combinations were pustular dermatitis, perivascular and interstitial neutrophilic dermatitis, and interstitial granulomatous dermatitis. In the other 4 cases, a single histopathological pattern predominated, such as psoriasiform dermatitis, vacuolar interface dermatitis of erythema multiforme-like type, or superficial and deep perivascular and interstitial dermatitis with eosinophils and neutrophils.
SDRIFE is characterized histologically by a vacuolar interface dermatitis induced by cytotoxic T lymphocytes and neutrophilic granulocytes. This pattern may be obscured by accompanying spongiotic, psoriasiform, or pustular features combined with a mixed superficial and sometimes deep dermal infiltrate.
对称性药物相关性间擦疹和屈侧疹（SDRIFE）是一种临床上定义明确的药物疹，但组织病理学表现仍被认为是非特异性的。
描述 SDRIFE 的组织病理学和免疫表型特征。
我们进行了一项回顾性研究，共纳入 9 例 SDRIFE 患者的 11 例活检。结合免疫组化结果分析组织病理学特征。
最常见的组织病理学特征是基底细胞空泡化，常伴有坏死角质形成细胞和局灶性海绵形成。TIA1+T 细胞和中性粒细胞常在上皮和表皮真皮交界处被检测到。真皮炎症浸润为混合性，包括 CD3+T 细胞、巨噬细胞、粒细胞、少量 CD20+B 细胞和浆细胞。5 例观察到混合组织病理学模式。最常见的联合组织病理学模式为界面性皮炎、海绵形成性皮炎和银屑病样性皮炎。在不同组合中发现的其他组织病理学模式包括脓疱性皮炎、血管周围和间质中性粒细胞性皮炎以及间质肉芽肿性皮炎。在另外 4 例中，单一组织病理学模式占主导地位，如银屑病样性皮炎、多形红斑样空泡界面性皮炎或伴有嗜酸性粒细胞和中性粒细胞的浅层和深层血管周围和间质性皮炎。
SDRIFE 的组织病理学特征是由细胞毒性 T 淋巴细胞和中性粒细胞引起的空泡界面性皮炎。这种模式可能会被伴随的海绵形成、银屑病样或脓疱样特征以及混合的浅层和有时深层真皮浸润所掩盖。
