Lavker R M, Leyden J J, McGinley K J
J Invest Dermatol. 1981 Sep;77(3):325-30. doi: 10.1111/1523-1747.ep12482524.
The structural organization and bacteriological profile of follicular casts and early comedones in prepuberal children were investigated. Follicular casts were present in all samples but were not as abundant as usually seen in older individuals with acne. When examined with the light microscope, all casts and comedones were composed of numerous layers of horny cells and sebum, but were devoid of bacteria. Neither follicular casts nor comedones yielded bacteria when cultured. Electron microscopy of the follicular casts revealed the presence of small round, discrete lipid droplets, and alternating dense and less dense lamellar configurations within the horny cells. Some horny cells closest to the sebum-filled lumen contained large lipid masses, resulting in "balloon-shaped" regions. Prepuberal follicular horny cells contained all of the abnormalities usually seen in follicular casts and biopsy material from acne patients, which suggests that these casts are potential comedones. These aberrations occurred in the complete absence of bacteria indicating that bacteria are not essential to the formation of casts or comedones. Furthermore, our findings indicate that bacteria play little if any role in the initial events of pathological keratinization.
对青春期前儿童毛囊角质栓和早期粉刺的结构组织及细菌学特征进行了研究。所有样本中均存在毛囊角质栓，但不如在患有痤疮的年长个体中常见的那样丰富。在光学显微镜下检查时，所有角质栓和粉刺均由多层角质细胞和皮脂组成，但没有细菌。培养时，毛囊角质栓和粉刺均未培养出细菌。毛囊角质栓的电子显微镜检查显示，角质细胞内存在小的圆形、离散的脂滴，以及交替出现的致密和较疏松的层状结构。一些最靠近充满皮脂的管腔的角质细胞含有大量脂质团块，形成“气球状”区域。青春期前毛囊角质细胞具有通常在毛囊角质栓和痤疮患者活检材料中所见的所有异常，这表明这些角质栓是潜在的粉刺。这些异常在完全没有细菌的情况下发生，表明细菌对于角质栓或粉刺的形成并非必不可少。此外，我们的研究结果表明，细菌在病理性角质化的初始事件中几乎不起作用。
