Boer J, Weltevreden E F
Department of Dermatology, Deventer Hospital, The Netherlands.
Br J Dermatol. 1996 Nov;135(5):721-5.
The pathogenesis of hidradenitis suppurativa (HS) has given rise to controversy about whether the central pathogenetic feature is an apocrine follicular occlusion (with subsequent bacterial infection) or it is a folliculitis with secondary involvement of both apocrine and eccrine sweat glands. Most previous concepts have focused on apocrine gland involvement. A prospective study of 27 consecutive patients (39 biopsies) was performed to investigate the immune-histological findings in early, newly formed lesions. Most of them were examined within 3 days of clinical onset. Histopathological findings showed that the initial lesion is an occluding spongiform infundibulo-folliculitis. Furthermore, it was found that T cells predominated in the lymphocytic cell population. A high percentage of HLA-DR positive lymphocytes was found in an inverse relationship with Leu-8 positive lymphocytes. Additionally, a sharp decline in the T-helper/suppressor ratio was observed after the initiation. These results reveal that the primary event in HS is an infundibulofolliculitis with secondary involvement of apocrine glands. Acne inversa would be a more appropriate name.
化脓性汗腺炎（HS）的发病机制引发了争议，即其核心致病特征是顶泌汗腺毛囊阻塞（随后继发细菌感染），还是一种累及顶泌汗腺和小汗腺的继发性毛囊炎症。以往大多数观点都聚焦于顶泌汗腺受累。我们对27例连续患者（39次活检）进行了一项前瞻性研究，以调查早期新形成病变的免疫组织学表现。其中大多数患者在临床发病3天内接受了检查。组织病理学结果显示，初始病变为闭塞性海绵状漏斗部毛囊炎。此外，发现淋巴细胞群体中T细胞占主导。还发现HLA - DR阳性淋巴细胞的高比例与Leu - 8阳性淋巴细胞呈负相关。此外，发病后观察到辅助性T细胞/抑制性T细胞比例急剧下降。这些结果表明，HS的主要事件是漏斗部毛囊炎继发顶泌汗腺受累。“反向痤疮”可能是一个更合适的名称。
