Honda Y, Egawa K, Baba Y, Ono T
Department of Dermatology, Kumamoto University School of Medicine, Japan.
Arch Dermatol Res. 1996 Mar;288(3):133-9.
The fine structure of sweat duct milia and the pathomechanism in their aetiology are still unknown. To examine the relationship and connection of milia to the sweat ducts as well as to the overlying epidermis, nine sweat duct milia, six incomplete and three complete, were studied by three-dimensional reconstruction (3DR) analysis based on photomicrographs obtained after histological and immunohistochemical staining with antibodies against carcinoembryonic antigen (CEA), cancer antigen (CA 50) and human cytokeratin 19 (CK 19). In both incomplete and complete milia, an eccrine duct expressing the antigens penetrated into the cyst wall at the centre of its base, formed a circular path within the wall, and opened into the inner cavity. The eccrine duct was mature in eight milia and immature in one. In the cyst wall, CA 50 and CK 19 were detected throughout the entire cyst except for the most apical portion of incomplete milia, where the cyst wall fused with the overlying epidermis which did not express any of the antigens. CEA was distributed mainly in the basal half of the milia. The finding that the path of the eccrine duct within the cyst wall is circular conflicts with the currently accepted concept of simple penetration of the eccrine duct into the wall, suggesting an acrosyringeal origin of the milia. An incomplete milium is the result of fusion between cells derived from an eccrine duct and those derived from the surrounding epidermis, while the formation of a complete milium does not involve this fusion.
汗腺粟丘疹的精细结构及其病因的发病机制仍不清楚。为了研究粟丘疹与汗腺导管以及上方表皮之间的关系和联系，我们对9个汗腺粟丘疹进行了研究，其中6个不完整，3个完整，通过基于组织学和免疫组织化学染色后获得的显微照片进行三维重建（3DR）分析，使用抗癌胚抗原（CEA）、癌抗原（CA 50）和人细胞角蛋白19（CK 19）的抗体。在不完整和完整的粟丘疹中，一条表达这些抗原的外分泌腺导管在其底部中心穿透囊肿壁，在壁内形成一个环形路径，并通向内腔。8个粟丘疹中的外分泌腺导管成熟，1个不成熟。在囊肿壁中，除了不完整粟丘疹最顶端部分（此处囊肿壁与不表达任何抗原的上方表皮融合）外，整个囊肿都检测到CA 50和CK 19。CEA主要分布在粟丘疹的下半部分。外分泌腺导管在囊肿壁内的路径是环形的这一发现与目前公认的外分泌腺导管简单穿透壁的概念相冲突，提示粟丘疹起源于顶泌汗腺。不完整粟丘疹是由外分泌腺导管来源的细胞与周围表皮来源的细胞融合的结果，而完整粟丘疹的形成不涉及这种融合。
