Zheng P, Lavker R M, Kligman A M
Br J Dermatol. 1985 Feb;112(2):185-93. doi: 10.1111/j.1365-2133.1985.tb00082.x.
The histopathology of striae distensae is disputed; different authorities give contradictory accounts of the microscopic changes, especially in elastic fibres. We re-evaluated the problem by taking eight elliptical biopsies across striae. Six were examined by light microscopy with appropriate stains for elastin and collagen. Two were prepared for scanning electronmicroscopy (s.e.m.), using a procedure which removes collagen, enabling the elastic network to be seen in its native form. By light microscopy, striae were sharply demarcated from normal skin, consisting mainly of fine, straight bundles of collagen arranged parallel to the surface. Fine elastic fibres were disposed similarly without fragmentation, fraying or curling. By s.e.m., the elastic network was found to be extraordinarily dense and well developed with many fine, curled fibres in random array. It was evident that the routine stains for elastin greatly underestimated the abundance of elastic fibres, probably because immature fibres contain insufficient protein matrix. The horizontal packing of collagen bundles was confirmed by s.e.m. These findings support the view that striae distensae are scars. There is no evidence that they form by stress-induced rupture of the connective tissue.
膨胀纹的组织病理学存在争议;不同的权威机构对微观变化给出了相互矛盾的描述,尤其是在弹性纤维方面。我们通过在膨胀纹上取八个椭圆形活检组织重新评估了这个问题。六个组织通过光学显微镜检查,使用了针对弹性蛋白和胶原蛋白的适当染色剂。两个组织用于扫描电子显微镜(s.e.m.)检查,采用一种去除胶原蛋白的程序,使弹性网络能够以其天然形式被观察到。通过光学显微镜观察,膨胀纹与正常皮肤界限分明,主要由平行于表面排列的细小、笔直的胶原束组成。细小的弹性纤维排列方式相似,没有断裂、磨损或卷曲。通过扫描电子显微镜观察,发现弹性网络异常致密且发育良好,有许多细小的卷曲纤维呈随机排列。很明显,常规的弹性蛋白染色大大低估了弹性纤维的数量,可能是因为未成熟的纤维所含蛋白质基质不足。扫描电子显微镜证实了胶原束的水平排列。这些发现支持膨胀纹是瘢痕的观点。没有证据表明它们是由结缔组织的应力诱导破裂形成的。