Attanoos R L, Appleton M A, Douglas-Jones A G
Department of Histopathology, University Hospital of Wales, Health Park, Cardiff, U.K.
Br J Dermatol. 1995 Aug;133(2):254-8. doi: 10.1111/j.1365-2133.1995.tb02624.x.
We undertook a retrospective pathological study of 118 skin resection specimens from 101 patients with hidradenitis suppurativa. Follicular occlusion was identified in all the specimens, regardless of disease duration (1 month to 18 years), but was not noted in the axillary and inguinal skin of controls. We therefore regard follicular occlusion as an early and important feature in the pathogenesis of the disease. The presence of apoeccrine glands in axillary skin provided an in vivo model to directly observe the effects of follicular occlusion on follicle inflammation and apocrine gland destruction. In the majority of cases, active folliculitis was associated with apocrinitis and apocrine destruction, whereas apoeccrine glands, which drain directly on to the epidermal surface, appeared intact and non-inflamed. These observations provide direct evidence in an in vivo model that follicular occlusion by keratinous material, with subsequent active folliculitis and secondary destruction of the skin adnexae and subcutis, occur as an integral step in the pathogenesis of hidradenitis suppurativa.
我们对101例化脓性汗腺炎患者的118份皮肤切除标本进行了回顾性病理研究。在所有标本中均发现了毛囊闭塞，无论病程长短（1个月至18年），但在对照组的腋窝和腹股沟皮肤中未发现。因此，我们认为毛囊闭塞是该疾病发病机制中的一个早期且重要的特征。腋窝皮肤中顶泌汗腺的存在提供了一个体内模型，可直接观察毛囊闭塞对毛囊炎症和顶泌腺破坏的影响。在大多数病例中，活动性毛囊炎与顶泌腺炎和顶泌腺破坏有关，而直接引流至表皮表面的顶泌汗腺似乎完好无损且未发炎。这些观察结果在体内模型中提供了直接证据，表明角质物质导致毛囊闭塞，随后发生活动性毛囊炎以及皮肤附属器和皮下组织的继发性破坏，是化脓性汗腺炎发病机制中不可或缺的一步。
