Jemec G B, Hansen U
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
J Am Acad Dermatol. 1996 Jun;34(6):994-9. doi: 10.1016/s0190-9622(96)90277-7.
Hidradenitis suppurativa is traditionally classified as a disease of the apocrine gland. However, different histologic descriptions exist.
Our purpose was to describe prospectively the histopathologic characteristics of hidradenitis.
We systematically described and classified 60 consecutive biopsy specimens from patients with hidradenitis and compared them with 33 specimens from clinically noninvolved regional controls.
A heterogeneous histologic picture was found. Apocrine glands were involved in a minority of the 60 specimens, 17 showed poral occlusion, 17 simple folliculitis without poral occlusion, 9 sinus tracts, 6 epithelial cyst, 5 abscess, 3 apocrinitis, 2 diffuse dermal inflammation, and 1 pyogenic granuloma and scarring. Secondary involvement of apocrine glands was found in 12% of all specimens, and secondary involvement of eccrine glands was found in 25%. Sinus tracts were found significantly more often in the presence of poral occlusion or epithelial cysts. Control specimens frequently revealed changes compatible with early stages of follicular involvement. Apocrine glands were observed significantly more often in the axillae than in the groin.
The clinical picture of hidradenitis suppurativa covers a broad histologic spectrum. This may help explain the therapeutic problems posed by this disease. The disease appears to be predominantly follicular, and apocrine glands appear to be primarily involved in only a minority of axillary lesions.
化脓性汗腺炎传统上被归类为顶泌汗腺疾病。然而，存在不同的组织学描述。
我们的目的是前瞻性地描述化脓性汗腺炎的组织病理学特征。
我们系统地描述并分类了60例化脓性汗腺炎患者的连续活检标本，并将其与33例来自临床未受累区域对照的标本进行比较。
发现了异质性的组织学表现。60例标本中少数有顶泌汗腺受累，17例显示毛孔堵塞，17例为无毛孔堵塞的单纯毛囊炎，9例为窦道，6例为上皮囊肿，5例为脓肿，3例为顶泌汗腺炎，2例为弥漫性真皮炎症，1例为化脓性肉芽肿和瘢痕形成。在所有标本中，12%发现顶泌汗腺继发性受累，25%发现小汗腺继发性受累。在存在毛孔堵塞或上皮囊肿的情况下，窦道明显更常见。对照标本经常显示与毛囊受累早期阶段相符的变化。腋窝中顶泌汗腺的观察频率明显高于腹股沟。
化脓性汗腺炎的临床表现涵盖广泛的组织学谱。这可能有助于解释该疾病所带来的治疗问题。该疾病似乎主要是毛囊性的，顶泌汗腺似乎仅在少数腋窝病变中主要受累。
