Nishioka K, Ogasawara M, Kurata K, Asagami C
Department of Dermatology, Yamaguchi University School of Medicine, Japan.
Contact Dermatitis. 1993 Jan;28(1):3-5. doi: 10.1111/j.1600-0536.1993.tb03315.x.
We report of a 62-year-old male patient with a dull red itchy nodule on the induction area of allergic contact dermatitis to squaric acid dibutylester, which had been used for the therapy of alopecia universalis. The excised biopsy specimen showed dense infiltration of lymphoid cells in the dermis and subcutaneous tissue, associated with the formation of lymphoid follicles. Immunohistologic analysis of the infiltrates indicated mixed proliferation of T- and B-cells. A biopsy specimen from the challenge area showed spongiosis in the epidermis and lymphoid cell infiltration in the upper dermis, while the infiltrates consisted mainly of T-cells. The following points are discussed: (i) the lesion had an iatrogenic origin and the causative agent was quite evident; (ii) the route of allergen application was only through the epidermis and not directly in the dermis; (iii) lymphoid cell infiltrates of the induction and challenge areas were different.
我们报告了一名62岁男性患者，在曾用于全秃治疗的二丁基酒石酸酯过敏性接触性皮炎的诱发区域出现暗红色瘙痒性结节。切除的活检标本显示真皮和皮下组织中有密集的淋巴细胞浸润，并伴有淋巴滤泡形成。对浸润物的免疫组织学分析表明T细胞和B细胞混合增殖。来自激发区域的活检标本显示表皮有海绵形成，真皮上层有淋巴细胞浸润，而浸润物主要由T细胞组成。讨论了以下几点：（i）病变有医源性起源且致病因素相当明显；（ii）变应原的应用途径仅通过表皮而非直接进入真皮；（iii）诱发区域和激发区域的淋巴细胞浸润不同。
