Cooney T, Doyle C T, Buckley D, Whelton M J
J Clin Pathol. 1977 Oct;30(10):976-80. doi: 10.1136/jcp.30.10.976.
We reviewed 18 patients with a clinical diagnosis of dermatitis herpetiformis who were being treated with dapsone and were on an unrestricted diet. Diagnosis was confirmed by finding IgA deposits in the dermal papillae of unaffected skin. Dapsone was discontinued and biopsy of affected skin was carried out when the typical rash reappeared. The biopsy findings were graded according to the severity of the histological changes. Small bowel tissue from each patient was examined and graded by stereo- and routine microscopy. Thirteen specimens (72%) were stereomicroscopically abnormal; all 18 showed villous atrophy, either partial or subtotal; and in 13 (72%) the interepithelial lymphocyte count was increased. No correlation was found between the histological severity of the skin and the small bowel lesions. Seemingly the severity of the skin rash in dermatitis herpetiformis is no guide to the degree of small bowel abnormality.
我们回顾性研究了18例临床诊断为疱疹样皮炎且正在接受氨苯砜治疗、饮食不受限制的患者。通过在未受累皮肤的真皮乳头中发现IgA沉积物来确诊。当典型皮疹再次出现时，停用氨苯砜并对受累皮肤进行活检。根据组织学变化的严重程度对活检结果进行分级。对每位患者的小肠组织进行立体显微镜和常规显微镜检查并分级。13份标本（72%）在立体显微镜下异常；所有18份标本均显示绒毛萎缩，部分或全部萎缩；13份标本（72%）上皮间淋巴细胞计数增加。未发现皮肤和小肠病变的组织学严重程度之间存在相关性。似乎疱疹样皮炎皮疹的严重程度并不能指导小肠异常的程度。
