University of Pennsylvania, Philadelphia, PA.
Vet Pathol. 2023 Nov;60(6):783-795. doi: 10.1177/03009858231189298. Epub 2023 Jul 29.
Allergic dermatoses are common in people and domestic animals. Resultant lesions are routinely biopsied and submitted for histological examination to confirm a diagnosis or rule out diseases with overlapping or atypical clinical features. Diagnostic pathologists and clinicians are often faced with the difficult task of determining whether an allergic reaction pattern is present on both the microscopic and macroscopic levels and correlating histopathologic findings with clinical and historical data to achieve a precise clinical diagnosis. The bulk of the current veterinary literature on allergic dermatoses focuses on atopic dermatitis in dogs, distantly followed by cats, horses, and other animals. The objectives of this review are to demonstrate the key histopathologic and clinical diagnostic features of the various allergy-mediated reaction patterns, and to provide diagnosticians with a practical guide for clinicopathological correlations. Current concepts in the pathophysiology of immediate hypersensitivity reactions, with a focus on atopic dermatitis, are discussed. Points of potential histopathologic overlap between the "classic" allergic reaction pattern and less common inflammatory, predominately eosinophilic, conditions that may mimic this pattern will be discussed with the goal of highlighting the critical need for collaboration between pathologists and clinicians in furthering patient care.
变应性皮肤病在人和家畜中都很常见。通常会对由此产生的病变进行活检,并提交给组织病理学检查,以确认诊断或排除具有重叠或非典型临床特征的疾病。诊断病理学家和临床医生经常面临着一项艰巨的任务,即确定微观和宏观层面上是否存在过敏反应模式,并将组织病理学发现与临床和历史数据相关联,以做出准确的临床诊断。目前兽医文献中大量关于变应性皮肤病的内容主要集中在犬特应性皮炎上,其次是猫、马和其他动物。本文的目的是展示各种过敏介导的反应模式的关键组织病理学和临床诊断特征,并为诊断人员提供临床病理相关性的实用指南。本文还讨论了即刻过敏反应的病理生理学的最新概念,重点是特应性皮炎。将讨论“经典”过敏反应模式与不太常见的、以嗜酸性粒细胞为主的炎症性疾病之间潜在的组织病理学重叠,目的是强调病理学家和临床医生之间进一步合作以改善患者护理的重要性。