Lancer H A, Bronstein B R, Nakagawa H, Bhan A K, Mihm M C
J Am Acad Dermatol. 1984 May;10(5 Pt 1):760-8. doi: 10.1016/s0190-9622(84)70091-0.
Two patients with the benign type of follicular mucinosis (FM) are presented. Their clinical features and course were characteristic for this subgroup of FM. Light and electron microscopy, direct immunofluorescence, and immunoperoxidase cell marker studies were undertaken to characterize the nature of the disease process. Light microscopy confirmed the follicular outer root sheath and sebaceous gland epithelial degenerative changes. The infiltrating inflammatory cells were morphologically benign. Electron microscopy detailed the cellular associations in the areas of degenerative change. Disattached keratinocytes were closely apposed to significant numbers of macrophages and Langerhans cells. Direct immunofluorescence studies demonstrated primarily complement (C3) and fibrinogen/fibrin in areas of reticular degeneration. Immunoperoxidase studies revealed large numbers of T cells and macrophages and a striking increase in the number of Langerhans cells in the affected follicular epithelium. The findings suggest that cell-mediated immune mechanisms may play a role in the pathogenesis of this disorder.
本文报告了两例良性毛囊黏蛋白病（FM）患者。其临床特征和病程为此亚组FM的典型表现。进行了光镜和电镜检查、直接免疫荧光及免疫过氧化物酶细胞标志物研究，以明确疾病过程的性质。光镜证实毛囊外根鞘和皮脂腺上皮有退行性改变。浸润的炎性细胞形态学表现为良性。电镜详细观察了退行性变区域的细胞关联。脱离的角质形成细胞与大量巨噬细胞和朗格汉斯细胞紧密相邻。直接免疫荧光研究显示，在网状变性区域主要有补体（C3）和纤维蛋白原/纤维蛋白。免疫过氧化物酶研究显示，受累毛囊上皮中有大量T细胞和巨噬细胞，且朗格汉斯细胞数量显著增加。这些发现提示，细胞介导的免疫机制可能在该疾病的发病机制中起作用。
