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扁平苔藓与慢性丙型肝炎关系的临床及组织病理学分析

Clinical and histopathologic analysis of the relationship between lichen planus and chronic hepatitis C.

作者信息

Tanei R, Watanabe K, Nishiyama S

机构信息

Department of Dermatology, School of Medicine, Kitasato University, Kanagawa, Japan.

出版信息

J Dermatol. 1995 May;22(5):316-23. doi: 10.1111/j.1346-8138.1995.tb03395.x.

Abstract

A prospective clinical investigation of 45 patients with lichen planus (LP) demonstrated a significant association between LP and chronic hepatitis C. Anti-hepatitis C virus (HCV) antibodies were found in 17 (37.8%) of the 45 LP patients. This was significantly higher than in the controls. This higher prevalence of anti-HCV antibodies was found equally in both male and female patients in the three types of LP; cutaneous only type, mucous only type, and both cutaneous and mucous type. Most of the patients with positive anti-HCV antibodies had abnormal values of transaminase enzymes and/or a past history of chronic hepatitis. Histological and immunohistological investigations of three cases with LP and chronic hepatitis C demonstrated some morphologic similarities between these two diseases. Histopathologic findings of both LP and chronic hepatitis C were based on a T lymphocytic infiltrate with keratinocyte or hepatocyte damage. The degrees of infiltrating cells positive to UCHL-1, MX-panB, Leu-7, and human leukocyte antigen (HLA)-DR antibodies in the chronic hepatitis C lesions seemed to be similar to those in the LP lesions. These results may support a possible relationship between LP and chronic hepatitis C and the hypothesis that LP may be associated with chronic liver diseases as a result of a cytotoxic attack on the hepatocytes.

摘要

一项对45例扁平苔藓(LP)患者的前瞻性临床研究表明,LP与慢性丙型肝炎之间存在显著关联。在45例LP患者中,有17例(37.8%)检测出抗丙型肝炎病毒(HCV)抗体。这一比例显著高于对照组。在三种类型的LP患者(仅皮肤型、仅黏膜型以及皮肤和黏膜混合型)中,男性和女性患者抗HCV抗体的高患病率相当。大多数抗HCV抗体阳性的患者转氨酶酶值异常和/或有慢性肝炎病史。对3例LP合并慢性丙型肝炎患者进行的组织学和免疫组织学研究表明,这两种疾病在形态学上有一些相似之处。LP和慢性丙型肝炎的组织病理学发现均基于T淋巴细胞浸润以及角质形成细胞或肝细胞损伤。慢性丙型肝炎病变中对UCHL-1、MX-panB、Leu-7和人类白细胞抗原(HLA)-DR抗体呈阳性的浸润细胞程度似乎与LP病变中的相似。这些结果可能支持LP与慢性丙型肝炎之间可能存在的关系,以及LP可能由于对肝细胞的细胞毒性攻击而与慢性肝病相关的假说。

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