Antley C M, Carrington P R, Mrak R E, Smoller B R
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, USA.
J Cutan Pathol. 1998 Nov;25(10):545-9. doi: 10.1111/j.1600-0560.1998.tb01738.x.
Transient acantholytic dermatosis is often associated with excessive sweating, fever, and bed confinement. The pathogenesis of this disease has been postulated to be poral occlusion of damaged eccrine intraepidermal ducts. Histological and immunohistochemical and ultrastructural studies were performed on 10 biopsies from 10 patients with transient acantholytic dermatosis. Immunoreactions for carcinoembryonic antigen and cytokeratin-7 to identify eccrine duct epithelium were performed on all 11 biopsies. In addition, 5 of the biopsies were immunoreacted for cytokeratin 8. All immunoreactions were reviewed independently by two observers to determine extent of reactivity and whether it correlated with areas of epidermal acantholysis. Among the 11 biopsies, 8 showed acantholysis not associated with eccrine duct outflow tracts. In 2 biopsies the acantholysis was consistently associated with acrosyringea; in one case acantholysis was inconsistently associated with eccrine outflow tracts. Epidermal acantholysis in patients with Grover's disease is associated with the outflow tracts of eccrine ducts in a subgroup of patients. Although leakage of sweat from occluded sweat ducts in acrosyringia may be the mechanism operating in a subgroup of patients with Grover's disease, this does not appear to be the subgroup of patients in whom Grover's disease develops in the setting of being bedridden and/or sweating.
暂时性棘层松解性皮病常与多汗、发热及长期卧床有关。该疾病的发病机制据推测是受损的小汗腺表皮内导管的管口堵塞。对10例暂时性棘层松解性皮病患者的10份活检组织进行了组织学、免疫组织化学及超微结构研究。对所有11份活检组织进行癌胚抗原和细胞角蛋白-7免疫反应以识别小汗腺导管上皮。此外，5份活检组织进行了细胞角蛋白8免疫反应。两名观察者独立复查所有免疫反应，以确定反应程度及其是否与表皮棘层松解区域相关。在11份活检组织中，8份显示棘层松解与小汗腺导管流出道无关。在2份活检组织中，棘层松解始终与顶泌汗腺相关；在1例中，棘层松解与小汗腺流出道的相关性不一致。在一部分患者中，格罗弗病患者的表皮棘层松解与小汗腺导管流出道有关。尽管顶泌汗腺中堵塞的汗腺导管汗液渗漏可能是一部分格罗弗病患者的发病机制，但这似乎并非在长期卧床和/或多汗情况下发生格罗弗病的那部分患者。
