黑素细胞和噬黑素细胞在瑞尔黑变病中的结构与分布

The Structure and Distribution of Melanocytes and Melanophages in Riehl's Melanosis

目的探讨瑞尔黑变病的黑素细胞和噬黑素细胞的组织病理特点。方法收集瑞尔黑变病皮损标本50例,正常皮肤标本20例,所有病理切片标本均进行Fontana-Masson染色、多巴染色、CD68染色、C-Kit(CD117)染色,用图像分析软件Image-proplus6.0分析各组标本中平均光密度值。并通过透射电镜观察4例黑变病皮损的超微结构。结果①特殊染色:Fontana-Masson染色、多巴染色中黑变病组平均光密度值均高于正常组。②电镜:角质形成细胞内的黑素颗粒比正常皮肤中的少,基底层中黑素细胞的大小、形态与正常皮肤相比无明显变化,但基底层黑素细胞内线粒体、高尔基体、粗面内质网丰富,Ⅲ,Ⅳ期黑素小体明显增加;真皮浅层可见较多噬黑素细胞,其内有大量的被溶酶体吞噬的黑素颗粒,呈团块状分布。③免疫组化:黑变病组真皮内存在CD68阳性细胞;C-Kit在黑变病组表达较正常组高。结论瑞尔黑变病皮肤中黑素细胞合成黑素的功能活跃;真皮浅层内含有大量的噬黑素细胞;C-Kit受体在黑变病色素沉着中可能起到调控作用。

Objective To study the structure and distribution of melanocytes and melanophages in Riehl＇s Melanosis.Methods Fifty cases of Riehl＇s Melanosis and 20 normal were chosen,all of them were dealed with Fontana-Masson,DOPA,CD68,C-Kit（CD117）staining the melanocytes.Every case＇s mean density was analyzed by Image-pro plus 6.0（a image analysis software）.4 cases of Riehl＇s Melanosis and 1 case of normal skins＇ ultramicrostructure through electron microscope were observed.Results ①Specific staining：the mean density of Fontana-Masson staining and DOPA staining＇s in the patients with Riehl＇s Melanosis were higner than that of normal.②Electron microscope：the melanin granules in keratinocyte of Riehl＇s Melanosis were less than that of normal,the melanocytes＇size and morphology of Riehl＇s Melanosis were no significant change comparing with that of normal,the mitochondria,Golgi apparatus,rough endoplasmic reticulum were abundant in the melanocytes,the melanosomes of Ⅲ and Ⅳ stages increase.There were plenty of microphages in dermis superficial layer,which having lots of melanin granule phagocytized by cytolysosome,distributing as agglomerate.③Immunohistochemitry staining：There were plentiful of CD68 positive cells in the dermis of Riehl＇s Melanosis;the C-Kit positive melanocytes of Riehl＇s Melanosis were more than that of normal skin.Conclusion The melanocytes＇ fuction in Riehl＇s Melanosis which can produce melanin is active.There are lots of macrophages in the dermis superficial layer of Riehl＇s Melanosis.C-Kit receptor may play an certain role in regulating pigmentation of Riehl＇s Melanosis.