Mowad C M, McGinley K J, Foglia A, Leyden J J
Department of Dermatology, University of Pennsylvania, Philadelphia, USA.
J Am Acad Dermatol. 1995 Nov;33(5 Pt 1):729-33. doi: 10.1016/0190-9622(95)91809-4.
Previous studies have indicated that cutaneous bacteria, particularly coagulase-negative staphylococci, play a role in the pathogenesis of miliaria. An accumulation of periodic acid-Schiff (PAS)-positive material has been described as blocking the sweat duct in miliaria. Furthermore, a PAS-positive extracellular polysaccharide substance (EPS) has been identified as a product of some strains of Staphylococcus epidermidis.
We evaluated the relative ability of various species of coagulase-negative staphylococci to induce miliaria with particular reference to the potential role of EPS.
We inoculated various strains of coagulase-negative staphylococci on the volar forearms of subjects under an occlusive dressing coupled with thermal stimulation. Ability to induce miliaria as well as microbiologic, histologic, and immunostaining features were evaluated.
Miliaria was induced only with strains of S. epidermidis; other species including S. haemolyticus, S. hominis, S. cohnii, S. saprophyticus, and S. simulans were not capable of inducing miliaria. Moreover, only S. epidermidis strains capable of producing EPS were capable of inducing miliaria.
Our data indicate that EPS is the PAS-positive material that obstructs the delivery of sweat to the skin surface in miliaria and therefore demonstrate that the EPS produced by S. epidermidis plays a central role in the pathogenesis of miliaria. Furthermore, in a survey of staphylococcal flora isolated from 68 subjects, EPS-producing strains were found to be common.
既往研究表明，皮肤细菌，尤其是凝固酶阴性葡萄球菌，在痱子的发病机制中起作用。周期性酸-希夫（PAS）阳性物质的积聚被描述为在痱子中阻塞汗腺导管。此外，一种PAS阳性的细胞外多糖物质（EPS）已被鉴定为表皮葡萄球菌某些菌株的产物。
我们评估了各种凝固酶阴性葡萄球菌诱导痱子的相对能力，特别参考了EPS的潜在作用。
我们将各种凝固酶阴性葡萄球菌菌株接种于受试者的掌侧前臂，采用封闭敷料并结合热刺激。评估诱导痱子的能力以及微生物学、组织学和免疫染色特征。
仅表皮葡萄球菌菌株能诱导出痱子；其他菌种，包括溶血葡萄球菌、人葡萄球菌、科氏葡萄球菌、腐生葡萄球菌和模仿葡萄球菌，均不能诱导出痱子。此外，只有能够产生EPS的表皮葡萄球菌菌株能够诱导出痱子。
我们的数据表明，EPS是在痱子中阻碍汗液输送到皮肤表面的PAS阳性物质，因此表明表皮葡萄球菌产生的EPS在痱子的发病机制中起核心作用。此外，在一项对68名受试者分离出的葡萄球菌菌群的调查中，发现产EPS菌株很常见。
