Papi M, Didona B, Chinni L M, Gobello T, Mazzanti C, De Pità O, Cavalieri R
Istituto Dermopatico Immacolata--I.R.C.C.S., Rome, Italy.
J Dermatol. 1997 Sep;24(9):583-6. doi: 10.1111/j.1346-8138.1997.tb02297.x.
A male with pyoderma gangrenosum is reported. The clinical and histological features were typical. The initial lesions resolved with characteristic cribriform scars. A few days after the complete recovery, he developed several necrotizing focal lesions localized to the scarred areas. A further histological examination revealed a granulation tissue rich in neutrophils and signs of necrotizing vasculitis. We found a high titer of circulating perinuclear antineutrophil antibodies (p-ANCA), which are a serological marker for various systemic diseases. An immunological circulating factor has been repeatedly suggested to be the "primum movens" of pyoderma gangrenosum. We discuss the unusual clinical presentation interpreted as a Koebner phenomenon and the possible role of immune factors in enhancing circulating-endothelial cell interactions in relation to the pathogenesis of pyoderma gangrenosum.
报告了一名患有坏疽性脓皮病的男性患者。其临床和组织学特征典型。初始皮损消退后留下特征性筛状瘢痕。完全康复几天后，他在瘢痕部位出现了几处坏死性局灶性皮损。进一步的组织学检查显示有富含中性粒细胞的肉芽组织以及坏死性血管炎的迹象。我们发现其循环中核周抗中性粒细胞抗体（p-ANCA）滴度很高，这是多种全身性疾病的血清学标志物。免疫循环因子一直被反复认为是坏疽性脓皮病的“原动力”。我们讨论了这种被解释为同形反应的不寻常临床表现以及免疫因子在坏疽性脓皮病发病机制中增强循环内皮细胞相互作用方面可能发挥的作用。
