Hashimoto K, Tye M J
Department of Dermatology and Syphilology Wayne State University School of Medicine, Detroit, MI 48201.
J Cutan Pathol. 1994 Dec;21(6):533-40. doi: 10.1111/j.1600-0560.1994.tb00724.x.
We encountered a patient who complained of many small papules on the neck, shoulders, upper chest and upper back. Biopsy specimens showed complete loss of elastic fibers in the upper dermis including papillary dermis, whereas those of the mid dermis were intact. Electron microscopy revealed that assembly of component fibrils of elastic fibers was loose, and electron dense substance was aggregated in the spaces between these loosely bound subunit fibrils or along the periphery of abnormal fibers. Dermal phagocytes engulfed abnormal as well as normal elastic fibers. Upper dermal elastolysis is a clinical and histopathological entity different from mid-dermal elastolysis. Ultrastructural changes of the former are essentially similar to those of the latter but much more severe. It is suggested that activated elastophagocytosis of dermal phagocytes may play a role in this disease.
我们遇到一位患者，其颈部、肩部、上胸部和上背部出现许多小丘疹。活检标本显示，包括乳头层真皮在内的真皮上层弹性纤维完全缺失，而真皮中层的弹性纤维完好无损。电子显微镜检查显示，弹性纤维的组成原纤维组装松散，电子致密物质聚集在这些松散结合的亚单位原纤维之间的间隙或异常纤维的周边。真皮吞噬细胞吞噬异常和正常的弹性纤维。真皮上层弹性纤维溶解是一种与真皮中层弹性纤维溶解不同的临床和组织病理学实体。前者的超微结构变化与后者基本相似，但更为严重。提示真皮吞噬细胞的活化弹性纤维吞噬作用可能在该疾病中起作用。
