Howe K, Foresman P, Griffin T, Johnson W
Department of Dermatology, University of Pennsylvania, Philadelphia, USA.
J Cutan Pathol. 1996 Jun;23(3):270-4. doi: 10.1111/j.1600-0560.1996.tb01478.x.
Two patients developed a papulosquamous eruption in a widespread distribution which progressed with islands of sparing of uninvolved skin characteristic clinically of adult-onset pityriasis rubra pilaris (PRP). Biopsies from both patients showed multiple areas of nonfollicular and follicular suprabasilar and intra-epidermal acantholysis with minimal dyskeratosis. They also showed the usual histologic features of PRP with a thickened orthokeratosis and parakeratosis, a retained and sometimes thickened granular cell layer, and psoriasiform epidermal hyperplasia with a perivascular lymphohistiocytic infiltrate in the superficial dermis. Two previous patients with PRP have been reported with nonfollicular, focal acantholytic dyskeratosis and both were interpreted as most likely representing an incidental finding. We believe the acantholysis in these two cases is related to the disease process, and in our second patient, was helpful in establishing the diagnosis.
两名患者出现广泛分布的丘疹鳞屑性皮疹，皮疹进展过程中出现未受累皮肤岛，临床上具有成人型毛发红糠疹（PRP）的特征。两名患者的活检均显示多个非毛囊性和毛囊性基底上层及表皮内棘层松解区域，伴有轻度角化不良。活检还显示PRP常见的组织学特征，即正角化过度和角化不全增厚、颗粒细胞层保留且有时增厚，以及银屑病样表皮增生，浅层真皮有血管周围淋巴细胞和组织细胞浸润。此前曾报道过两名PRP患者出现非毛囊性、局灶性棘层松解性角化不良，两者均被解释为很可能是偶然发现。我们认为这两例中的棘层松解与疾病过程相关，在我们的第二例患者中，棘层松解有助于确诊。
