Ragaz A, Ackerman A B
Am J Dermatopathol. 1981 Spring;3(1):5-25. doi: 10.1097/00000372-198100310-00002.
Two hundred specimens from lesions of lichen planus were studied by conventional light microscopy in order to assess their evolution, maturation, and regression. The most important finding was that Langerhans' cells appear in increased numbers in the epidermis very early in the disease, even preceding the experience of lymphocytes there and then that the appearance of lymphocytes is followed by destruction of keratinocytes in the lower portion of the epidermis and by general epidermal hyperplasia, including hypergranulosis and hyperkeratosis. Wedge-shaped hypergranulosis develops around intraepidermal adnexal structures, namely, acrosyringia and acrotrichia. Finally, long-enduring inflammatory-cell infiltration in the papillary dermis was found to result in eventual fibrosis there, an evidence of resolution. With time the inflammatory-cell infiltrate disappears and the epidermis regains its normal configuration. Bullous lichen planus, hypertrophic lichen planus, atrophic lichens planus, and lichen planopilaris are variants of the same pathological process, modified by intensity and location of process.
为了评估扁平苔藓病变的演变、成熟和消退情况，对200份扁平苔藓病变标本进行了传统光学显微镜检查。最重要的发现是，在疾病早期，表皮内朗格汉斯细胞数量就会增加，甚至早于淋巴细胞的出现，随后淋巴细胞出现，接着表皮下部角质形成细胞被破坏，同时出现包括颗粒层增厚和角化过度在内的表皮普遍增生。楔形颗粒层增厚围绕表皮内附属结构，即顶泌汗腺导管和毳毛发生。最后发现，乳头层真皮中持久的炎性细胞浸润最终导致那里出现纤维化，这是病变消退的证据。随着时间推移，炎性细胞浸润消失，表皮恢复正常形态。大疱性扁平苔藓、肥厚性扁平苔藓、萎缩性扁平苔藓和毛发扁平苔藓是同一病理过程的不同变体，因病变强度和部位不同而有所改变。
