直接免疫荧光检查显示免疫反应物在表皮内弥漫性沉积：表皮坏死松解早期诊断的线索
Diffuse intraepidermal deposition of immunoreactants on direct immunofluorescence: a clue to the early diagnosis of epidermal necrolysis.
作者信息
King T, Helm T N, Valenzuela R, Bergfeld W F
机构信息
Department of Dermatopathology, Cleveland Clinic Foundation, Ohio 44195.
出版信息
Int J Dermatol. 1994 Sep;33(9):634-6. doi: 10.1111/j.1365-4362.1994.tb02922.x.
BACKGROUND
Toxic epidermal necrolysis is a distinctive disorder that is readily identified clinically and histologically in advanced cases. Early on, however, toxic epidermal necrolysis may be difficult to identify. Some consider fixed drug eruption a limited form of toxic epidermal necrolysis.
METHODS
Direct immunofluorescence was performed on biopsy material of erythematous skin lesions.
RESULTS
Diffuse deposition of immunoreactants in the midmalpighian layer was noted. This finding has not been encountered in other disorders studied in our immunopathology laboratory.
CONCLUSIONS
Diffuse immunoreactant deposition in the mid-epidermis should suggest a diagnosis of epidermal necrolysis either from toxic epidermal necrolysis or fixed drug eruption. Additional cases will need to be assessed to document the usefulness of this pattern for prospective diagnosis.
背景
中毒性表皮坏死松解症是一种独特的疾病，在晚期病例中可通过临床和组织学方法轻易识别。然而，在早期，中毒性表皮坏死松解症可能难以识别。一些人认为固定性药疹是中毒性表皮坏死松解症的一种局限形式。
方法
对红斑性皮肤病变的活检材料进行直接免疫荧光检查。
结果
发现免疫反应物在表皮中层弥漫性沉积。这一发现尚未在我们免疫病理学实验室研究的其他疾病中遇到。
结论
表皮中层弥漫性免疫反应物沉积提示可能为中毒性表皮坏死松解症或固定性药疹所致的表皮坏死松解症。需要评估更多病例以证明这种模式对前瞻性诊断的实用性。
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