Schirren C G, Jansen T, Lindner A, Kind P, Plewig G
Department of Dermatology, Ludwig-Maximilians-University, Munich, Germany.
Am J Dermatopathol. 1996 Jun;18(3):296-301. doi: 10.1097/00000372-199606000-00010.
We report a 43-year-old woman with sebaceous gland hyperplasia that occurred in a diffuse pattern of aggregated papular lesions involving her entire face, neck, and upper chest. Comedones, pustules, and inflammatory papules were absent. The eruption was accompanied by marked seborrhea. Histopathological examination showed enlargement of sebaceous acini, an increased number of immature sebocytes in foci, and a dilated follicular infundibulum. Immunohistochemical investigation showed cytokeratin 14 (CK 14) expression in the keratinocytes of the infundibulum, the isthmus, and sebaceous duct and in the mature and immature sebocytes; CK 17 expression in the keratinocytes of the sebaceous duct; CK 1 expression in the keratinocytes of the infundibulum; and an enhanced expression of the proliferation cell antigen Ki-67 (MiB1) in the immature sebocytes. With CK 18 and CK 19, no staining was observed. Oral therapy with isotretinoin (13-cis-retinoic acid) resulted in remarkable improvement in < or = 3 months. Histopathological and immunohistochemical examination after therapy showed markedly reduced sebaceous glands, a decrease in the staining of MiB1-positive immature sebocytes, and enhanced expression of CK 19 in immature sebocytes and sebaceous duct cells. Diffuse sebaceous gland hyperplasia is a rare variant of seboglandular proliferative disorders that is distinct from the well-known circumscribed type.
我们报告了一名43岁女性，其患有皮脂腺增生，表现为弥漫性聚集性丘疹病变，累及整个面部、颈部和上胸部。无粉刺、脓疱和炎性丘疹。皮疹伴有明显的皮脂溢出。组织病理学检查显示皮脂腺腺泡增大，灶性未成熟皮脂腺细胞数量增加，毛囊漏斗部扩张。免疫组织化学研究显示，细胞角蛋白14（CK 14）在漏斗部、峡部和皮脂腺导管的角质形成细胞以及成熟和未成熟皮脂腺细胞中表达；CK 17在皮脂腺导管的角质形成细胞中表达；CK 1在漏斗部的角质形成细胞中表达；增殖细胞抗原Ki-67（MiB1）在未成熟皮脂腺细胞中表达增强。未观察到CK 18和CK 19染色。口服异维A酸（13-顺式维甲酸）治疗在3个月内导致显著改善。治疗后的组织病理学和免疫组织化学检查显示皮脂腺明显减少，MiB1阳性未成熟皮脂腺细胞染色减少，未成熟皮脂腺细胞和皮脂腺导管细胞中CK 19表达增强。弥漫性皮脂腺增生是皮脂腺增生性疾病的一种罕见变异型，与众所周知的局限性类型不同。
