Magro Cynthia, Lipner Shari
Weill Cornell Medicine, New York, NY.
Dermatol Online J. 2020 Apr 15;26(4):13030/qt2157f9g0.
A striking dermatitis referred to by its colloquial designation of sabra dermatitis is associated with glochidia inoculation from the Opuntia cactus commonly known as the prickly pear. We report a 45-year-old woman who had an unexpected encounter with a cactus plant during a trip to Texas. She brushed up against the plant and was aware that she had been inoculated with several spines of the plant. Five days later she developed erythematous papules on the digits accompanied by swelling. The biopsy showed a very striking granulomatous reaction pattern within the dermis. There was a linear pattern of necrobiosis, likely representing a tract of inoculation injury palisaded by histiocytes including multinucleated forms. This necrobiotic tract demonstrated retained glochidia, each measuring roughly 40 to 70 microns in diameter. The nature of the inflammatory response is one that combines features of classic delayed hypersensitivity and an innate foreign body response. The glochidia are capable of eliciting a T cell mediated immune response; it is reasonable to assume that a Th1 cytokine signal is responsible for the unique pattern of inflammation including the secondary influx of neutrophils and relative lack of tissue eosinophilia.
一种俗称萨布拉皮炎的显著性皮炎与来自仙人掌科仙人掌（俗称仙人球）的钩球幼虫接种有关。我们报告一名45岁女性，她在德克萨斯州旅行期间意外接触了一种仙人掌植物。她擦过这种植物，意识到自己被该植物的几根刺扎到了。五天后，她手指上出现了红斑丘疹并伴有肿胀。活检显示真皮内有非常显著的肉芽肿反应模式。存在一种线状渐进性坏死模式，可能代表由包括多核形式在内的组织细胞围成栅栏的接种损伤轨迹。这条渐进性坏死轨迹显示有残留的钩球幼虫，每个直径约为40至70微米。炎症反应的性质是一种结合了经典迟发型超敏反应和先天性异物反应特征的反应。钩球幼虫能够引发T细胞介导的免疫反应；可以合理推测，Th1细胞因子信号负责这种独特的炎症模式，包括中性粒细胞的继发性流入和相对缺乏组织嗜酸性粒细胞。
