George P M, Hood A F, Rest E B
Department of Dermatology, University of Minnesota, Minneapolis, USA.
Pediatr Dermatol. 1996 Jul-Aug;13(4):269-73. doi: 10.1111/j.1525-1470.1996.tb01236.x.
The histopathology and immunofluorescence of discoid lupus erythematosus (DLE) are well documented in adults, but in children they have not been studied systematically. We reviewed nine skin biopsy specimens from six children with DLE. Only three specimens showed the well-developed epidermal changes seen in lesions of adults with DLE, and in the other six, these changes were either mild or absent. All nine specimens showed some degree of vacuolar alteration of the basal layer, ranging from focal and mild to severe. They all had a moderate to heavy lymphocytic dermal infiltrate in a perivascular and periadnexal distribution. Direct immunofluorescence performed on five specimens of lesional skin was weakly positive for IgM or IgG in three cases, negative in one, and strongly positive for IgM, IgG, IgA, and C3 in one. This study indicates that the range of histologic and immunofluorescence features in children with DLE is similar to that in adults. The histologic findings are distinctive enough to be useful in establishing the diagnosis, although clinicopathologic correlation is required.
盘状红斑狼疮（DLE）在成人中的组织病理学和免疫荧光表现已有充分记录，但在儿童中尚未进行系统研究。我们回顾了6例儿童DLE患者的9份皮肤活检标本。只有3份标本显示出成人DLE病变中典型的表皮改变，另外6份标本中的这些改变要么轻微，要么没有。所有9份标本均显示出基底细胞层不同程度的空泡样改变，从局灶性轻度到重度不等。它们均在血管周围和附件周围有中度至重度淋巴细胞浸润。对5份皮损标本进行直接免疫荧光检测，3例IgM或IgG弱阳性，1例阴性，1例IgM、IgG、IgA和C3强阳性。本研究表明，儿童DLE的组织学和免疫荧光特征范围与成人相似。尽管需要临床病理相关性分析，但组织学发现具有足够的特异性，有助于诊断。
