Soter N A, Mihm M C, Gigli I, Dvorak H F, Austen K F
J Invest Dermatol. 1976 Jun;66(6):344-50. doi: 10.1111/1523-1747.ep12482901.
Two distinct cellular patterns of necrotizing angiitis involving venules in skin of patients with clinically identical cutaneous lesions were appreciated by the 1 -mum-thick section technique. In those individuals with serum hypocomplementemia, there was a perivenular inflitrate composed predominantly of neutrophils with fibrin deposition and nuclear debris. In patients with normal serum complement levels, in addition to an infiltrate of neutrophils and fibrin deposition, perivenular lymphocytes in various stages of activation were prominent. In both patterns the venules and not the arterioles were affected, mast cells exhibited various degrees of hypogranulation, and basophils and eosinophils were recognized only rarely. Lesions of different clinical age obtained from one hypocomplelmentemic patient and one normocomplementemic patient exhibited consistent cellular patterns, as did a single crop of lesions biopsied twice, 24 hr apart, in a patient with hypocomplementemia. No patient with hypocomplementemia became normocomplementemic or vice versa with persistence of lesions.
采用1微米厚切片技术观察到，临床皮肤病变相同的患者皮肤小静脉坏死性血管炎存在两种不同的细胞模式。在血清补体水平降低的个体中，静脉周围浸润主要由中性粒细胞组成，伴有纤维蛋白沉积和核碎片。在血清补体水平正常的患者中，除了中性粒细胞浸润和纤维蛋白沉积外，不同活化阶段的静脉周围淋巴细胞也很突出。在这两种模式中，受影响的都是小静脉而非小动脉，肥大细胞呈现不同程度的颗粒减少，仅偶尔能识别出嗜碱性粒细胞和嗜酸性粒细胞。从一名补体水平降低的患者和一名补体水平正常的患者身上获取的不同临床病程的病变呈现出一致的细胞模式，一名补体水平降低的患者相隔24小时两次活检的同一批病变也是如此。没有补体水平降低的患者随着病变持续而变为补体水平正常，反之亦然。
