Smoller B R, Glusac E J
Department of Pathology, Stanford University Medical Center, CA 94305.
J Cutan Pathol. 1994 Apr;21(2):123-8. doi: 10.1111/j.1600-0560.1994.tb00246.x.
Lichen planus is an inflammatory dermatosis which is characterized histologically by an intense lymphocytic infiltrate at the dermal epidermal junction. This frequently results in disruption of the basement membrane zone, occasionally causing clinical blisters. In order to better understand the specific portion of the basement membrane zone which is disrupted by the lymphocytic infiltrate, we examined 7 cases of lichen planus with antibodies directed against anchoring filaments (GB3), the bullous pemphigoid antigen, anchoring fibrils (type VII collagen) and type IV collagen. In lesions without separation at the BMZ, all antibodies were strongly expressed, as in normal skin. In lesions with early separation, there was a focal decrease in GB3 staining, but types VII and IV collagen labelled normally. In lesions resulting in blisters, GB3 staining was essentially absent, and anti-types IV and VII collagen remained, but stained in a disrupted, less discrete pattern. The bullous pemphigoid antigen showed only slight deviation from the normal staining pattern. These findings suggest that the basement membrane zone in lichen planus is disrupted in the lamina lucida region. The lamina densa and sub-lamina densa zones remain intact even in bullous lesions of lichen planus.
扁平苔藓是一种炎症性皮肤病，其组织学特征为真皮表皮交界处有密集的淋巴细胞浸润。这常常导致基底膜带破坏，偶尔引起临床水疱。为了更好地了解基底膜带中被淋巴细胞浸润破坏的特定部分，我们用针对锚定丝（GB3）、大疱性类天疱疮抗原、锚定原纤维（VII型胶原）和IV型胶原的抗体检查了7例扁平苔藓。在基底膜带未分离的病变中，所有抗体均强烈表达，与正常皮肤一样。在早期分离的病变中，GB3染色有局灶性减少，但VII型和IV型胶原染色正常。在导致水疱的病变中，GB3染色基本缺失，抗IV型和VII型胶原仍然存在，但染色呈破坏状，不那么清晰。大疱性类天疱疮抗原仅显示与正常染色模式略有偏差。这些发现表明，扁平苔藓中的基底膜带在透明层区域被破坏。即使在扁平苔藓的水疱性病变中，致密层和致密层下区域仍保持完整。
