Department of Pathology, Shohada-e-Tajrish Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Exp Dermatol. 2021 Oct;46(7):1248-1254. doi: 10.1111/ced.14670. Epub 2021 May 14.
Facial papules (FPs) are considered to be created by the inflammatory process, which involves facial vellus hairs, in frontal fibrosing alopecia.
To demonstrate the histopathological features of FPs and the composition of the inflammatory infiltrate.
In total, 18 patients with FPs were enrolled in the study after histopathological confirmation of lichen planopilaris. Histopathological evaluation of the specimens was performed by two dermatopathologists. The samples were immunostained with CD4, CD8 and CD123 monoclonal antibodies, and the percentage and proportion of cells stained with these markers were investigated.
A follicular lichenoid reaction and perifollicular fibrosis were present in all cases. Vellus hairs were detected in 83.3% of biopsy specimens (15 cases), all of which were involved by the inflammation. The majority of the follicles (72%) revealed follicular plugs. Reduction and destruction of elastic fibres were visible in the perifollicular (adventitial) and the papillary dermis (100% and 78% of specimens, respectively). Prominent sebaceous glands and dilated ducts were detected in 78% and 72% of samples, respectively. CD4-positive T cells formed 67.72% and CD8-positive T cells 32.28% of the infiltrate, and the mean CD4/CD8 ratio was 2.48. In 13 (72.2%) biopsy specimens < 10% of the infiltrate was positive for CD123 marker.
Perifollicular inflammation, fibrosis and elastic-fibre destruction were constant histopathological features of FPs; furthermore, prominent sebaceous glands were present in the majority of samples. We also observed a CD4-positive predominance in the infiltrate.
面部丘疹（FP）被认为是由炎症过程引起的，该过程涉及额部纤维性脱发中的面部毳毛。
展示 FP 的组织病理学特征和炎症浸润的组成。
共纳入 18 例经组织病理学证实为扁平苔藓样发疹的 FP 患者。由两位皮肤科病理学家对标本进行组织病理学评估。对标本进行 CD4、CD8 和 CD123 单克隆抗体免疫染色，研究这些标记物染色的细胞百分比和比例。
所有病例均存在毛囊苔藓样反应和毛囊周围纤维化。15 例活检标本中均检测到毳毛（83.3%），所有这些毛发均被炎症累及。大多数毛囊（72%）显示出毛囊塞。在毛囊周围（血管周围）和乳头真皮中可见弹性纤维减少和破坏（分别为 100%和 78%的标本）。78%和 72%的标本分别可见显著的皮脂腺和扩张的导管。CD4 阳性 T 细胞占浸润细胞的 67.72%，CD8 阳性 T 细胞占 32.28%，平均 CD4/CD8 比值为 2.48。在 13 例（72.2%）活检标本中，浸润细胞中<10%为 CD123 标志物阳性。
毛囊周围炎症、纤维化和弹性纤维破坏是 FP 的恒定组织病理学特征；此外，大多数样本中均可见显著的皮脂腺。我们还观察到浸润中 CD4 阳性细胞占优势。
