Smith S B, Harrist T J, Murphy G F, Halperin A J, Newell J B, Fallon J T, Fine J D, Mihm M C
Arch Dermatol. 1984 Mar;120(3):324-8.
Linear IgA bullous dermatosis (LAD), also known as "atypical dermatitis herpetiformis," is a disorder that is distinct from classic dermatitis herpetiformis (DH). In eight patients with DH and six with LAD, quantitative assessment of a variety of histopathologic variables was made. The number of rete tips with neutrophils in basal vacuoles and the length of the epidermal basement membrane zone (BMZ) associated with these findings were greater in LAD than DH. The number of microabscesses of neutrophils in the dermal papillae and the length of epidermal BMZ associated with them were greater in DH than in LAD. By using the number of microabscesses and the number of rete tips with neutrophils in basal vacuoles in a probability model, we found by retrospective analysis that a correct diagnosis could be made for LAD in 75% of biopsy specimens with a probability of 97% and in all cases of DH with a probability of 92%. Using this model, we made no misdiagnoses. This is the first diagnostic probability model in dermatopathology that expresses a confidence level in diagnosis.
线状IgA大疱性皮肤病（LAD），也被称为“非典型疱疹样皮炎”，是一种与经典疱疹样皮炎（DH）不同的疾病。对8例DH患者和6例LAD患者的多种组织病理学变量进行了定量评估。LAD患者中，基底空泡内有中性粒细胞的 rete 尖端数量以及与这些发现相关的表皮基底膜带（BMZ）长度比DH患者更多。DH患者真皮乳头中中性粒细胞微脓肿的数量以及与之相关的表皮BMZ长度比LAD患者更多。通过在概率模型中使用微脓肿数量和基底空泡内有中性粒细胞的 rete 尖端数量，我们通过回顾性分析发现，在75%的活检标本中可以正确诊断LAD，概率为97%，在所有DH病例中诊断概率为92%。使用该模型，我们没有出现误诊情况。这是皮肤病理学中第一个表达诊断置信水平的诊断概率模型。
