Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI; and.
Department of Dermatology, Brown Dermatology, Providence, RI.
Am J Dermatopathol. 2021 Mar 1;43(3):225-227. doi: 10.1097/DAD.0000000000001832.
Elastophagocytosis is a characteristic finding of granulomatous and elastolytic disorders. It is defined by phagocytosed elastic fibers within histiocytes, multinucleated giant cells, or both. This finding has also been associated with certain medications, malignancies, inflammatory conditions, and infectious disorders. Although Drs Ragaz and Ackerman reported elastophagocytosis in a secondary syphilis lesion in a review of actinic granuloma in 1979, more recent publications have not recognized this finding. We present a case of elastophagocytosis within a lesion of secondary syphilis in a 65-year-old man. Biopsy from his left forearm demonstrated features of secondary syphilis including subtle vacuolar alteration with mild superficial and mid perivascular lymphoplasmacytic inflammation. There were interstitial giant cells with phagocytosed elastic fibers within the superficial dermis. Spirochete immunostain was positive with confirmatory Treponema pallidum IgG antibody and RPR titer. In this report, we present a unique case of secondary syphilis.
弹性物质吞噬作用是肉芽肿性和弹性溶解障碍的特征性表现。其定义为组织细胞、多核巨细胞或两者吞噬的弹性纤维。这一发现也与某些药物、恶性肿瘤、炎症性疾病和感染性疾病有关。虽然 Ragaz 和 Ackerman 博士在 1979 年对光化性肉芽肿的回顾中报道了二期梅毒病变中的弹性物质吞噬作用，但最近的出版物并没有认识到这一发现。我们报告了一例 65 岁男性二期梅毒皮损中的弹性物质吞噬作用。来自他左前臂的活检显示出二期梅毒的特征，包括轻微的空泡样改变，伴有轻度浅表和中血管周围淋巴浆细胞炎症。在真皮浅层有吞噬弹性纤维的间质巨细胞。螺旋体免疫染色阳性，梅毒螺旋体 IgG 抗体和 RPR 滴度均为阳性。在本报告中，我们呈现了一例独特的二期梅毒病例。
