寻常型进行期白癜风的超微结构变化

UltrastructuralChangesofProgressiveVitiligoVulgaris

为了在亚细胞水平上了解白癜风的病理过程，进一步探讨其发病机理，用透射电镜观察了１０例寻常型进行期白癜风患者白斑、白斑边缘及远离白斑对应侧正常皮肤的超微结构变化。结果显示：９例白斑区黑素细胞及黑素小体缺乏，１例残留一黑素细胞，但明显退化。白斑边缘显示多种异常，黑素细胞内粗面内质网高度扩张，数量增多。定性及细胞形态计量学研究表明远离白斑处临床正常皮肤已经出现病理改变。本研究表明进行期白癜风白斑边缘超微结构变化最为显著，皮损处表皮三种主要细胞即角朊细胞、黑素细胞及郎格罕细胞均有异常，远离白斑处临床正常皮肤出现结构异常，提示其可能处于临床前状态，细胞形态计量学使电镜的细胞形态定性观察进化到定量研究，值得推广。

Inordertounderstandthepathologicalcourseofvitiligoandexploreitspathogenesisfurther,westudiedultrastructuralcharacteristicsoftencasesofprogressivevitiligowithtransmissionelectronmicroscope.Biopsieswereobtainedfromthecenterandmarginofthelesion,andclinicalynor-malskinonthesymmetricalpartofthebody.Theresultsshowedthatmelanocytesandmelanosomewereabsentinthecenterofthelesioninninecases;aresidualdegeneratedmelanocytewasseeninonecase.Inthemarginofthelesionmanyabnormalitieswereobserved,themostsignificantchangesinmelanocytesweredilatationofroughendoplasmicreticulumanddegenerationofmelanosome;ker-atinocytesalsoshoweddegenerativechanges,Langerhans′celswereactiveandincreasedindensity.Qualitativeandquantitativestudiesshowedthattheclinicalynormalskinhadpathologicalchangesal-ready.Thisreportshowsthatultrastructuralchangesinthemarginofthelesionaremostevident,threetypesofcelsintheepidermisincludingkeratinocytes,melanocytesandLangerhans′celsarede-generated,theclinicalynormalskinfarawayfromthelesionisabnormalandisposiblyundersubclini-calstate.Celmorphometryturnscytologicstudyfromqualitativetoquantitativestudy,itisworthytobeused.