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无重症肌无力的胸腺瘤手术切除对并发斑秃可能具有治疗作用:一例报告

Surgical Removal of a Thymoma without Myasthenia Gravis Can Have a Therapeutic Effect on Concurrent Alopecia Areata: A Case Report.

作者信息

Cho Yu-Ri, Kim Jung-Hwan, Kim Ki-Ho

机构信息

Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea.

出版信息

Ann Dermatol. 2022 Aug;34(4):287-290. doi: 10.5021/ad.20.087.

Abstract

Alopecia areata is a chronic organ-specific autoimmune disease and it could be associated with other autoimmune diseases. We, herein, report a case of alopecia areata in a patient with a thymoma without myasthenia gravis. Multiple hairless patches rapidly developed 6 weeks before the first visit on the patient who had been newly diagnosed with thymoma 2 weeks before the hairless patches occurred, and thymectomy was done 2 weeks before visiting dermatologic department. She had no symptoms associated with myasthenia gravis, and there were no abnormal findings on neurologic exams and acetylcholine receptor autoantibody was not detected in serum. Scalp biopsy showed numerous lymphocytic inflammations around hair follicles and in immunohistochemical staining, the aggregation of CD4+ and CD8+ T cells was observed around hair follicles and FoxP3+ T lymphocytes were rarely observed around hair follicles. The patient refused any treatment and her hairless patches were completely recovered 3 months after thymectomy, without being recurred 3 years after thymectomy. On the basis of both clinical manifestations and histologic findings, we concluded that alopecia areata in the patient had developed in association with thymoma and was recovered rapidly after thymectomy.

摘要

斑秃是一种慢性器官特异性自身免疫性疾病,可能与其他自身免疫性疾病相关。在此,我们报告一例无重症肌无力的胸腺瘤患者并发斑秃的病例。在首次就诊前6周,该患者(在出现斑秃前2周新诊断为胸腺瘤)迅速出现多个无毛斑,在就诊皮肤科前2周进行了胸腺切除术。她没有重症肌无力相关症状,神经系统检查无异常发现,血清中未检测到乙酰胆碱受体自身抗体。头皮活检显示毛囊周围有大量淋巴细胞炎症,免疫组化染色显示毛囊周围观察到CD4 +和CD8 + T细胞聚集,而毛囊周围很少观察到FoxP3 + T淋巴细胞。患者拒绝任何治疗,胸腺切除术后3个月其无毛斑完全恢复,胸腺切除术后3年未复发。基于临床表现和组织学发现,我们得出结论,该患者的斑秃与胸腺瘤相关,并在胸腺切除术后迅速恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cac7/9365659/b0361c38fb8f/ad-34-287-g001.jpg

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