Bielsa I, Herrero C, Collado A, Cobos A, Palou J, Mascaró J M
Department of Dermatology, Hospital Clínico, Faculty of Medicine, Barcelona, Spain.
Arch Dermatol. 1994 Jan;130(1):54-8.
The possible distinction between different types of cutaneous lupus erythematosus (CLE) based on histologic features has been largely debated. This study describes the histopathologic features of three distinct subsets of CLE: chronic, annular-subacute, and papulosquamous-subacute. Biopsy specimens from 92 patients with CLE were examined without the clinical diagnosis being known by the examiners. Of them, 36 clinically demonstrated chronic CLE; 32, annular-subacute CLE; and 24, papulosquamous-subacute CLE.
In chronic CLE, the dermal changes (basement membrane thickening, dermal colloid bodies, pilosebaceous atrophy, and periappendageal infiltrate) were more frequent, while in annular-subacute CLE, a more severe vacuolation of the basal layer and a greater number of epidermal colloid bodies were seen. In addition, pilosebaceous atrophy and more severe epidermal damage were almost exclusive to chronic CLE and annular-subacute CLE, respectively.
Although some histologic differences between chronic and annular-subacute CLE exist, histopathologic diagnosis of the CLE subsets can only be accurately established when pilosebaceous atrophy or necrosis of all epidermal layers is observed.
基于组织学特征对不同类型皮肤红斑狼疮（CLE）进行区分的可能性一直存在很大争议。本研究描述了CLE三个不同亚组的组织病理学特征：慢性型、环状亚急性型和丘疹鳞屑亚急性型。对92例CLE患者的活检标本进行了检查，检查人员在不知临床诊断的情况下进行观察。其中，36例临床诊断为慢性CLE；32例为环状亚急性CLE；24例为丘疹鳞屑亚急性CLE。
在慢性CLE中，真皮改变（基底膜增厚、真皮胶样小体、毛囊皮脂腺萎缩和附属器周围浸润）更为常见，而在环状亚急性CLE中，可见基底细胞层更严重的空泡化和更多数量的表皮胶样小体。此外，毛囊皮脂腺萎缩和更严重的表皮损伤几乎分别是慢性CLE和环状亚急性CLE所特有的。
虽然慢性和环状亚急性CLE之间存在一些组织学差异，但只有在观察到毛囊皮脂腺萎缩或全层表皮坏死时，才能准确建立CLE亚组的组织病理学诊断。
