玫瑰糠疹110例组织病理分析

Histopathological features of 110 cases of pityriasis rosea

目的分析玫瑰糠疹的组织病理特点。方法回顾性分析北京大学第一医院皮肤性病科自2000年1月至2021年5月间诊断为玫瑰糠疹患者的临床及组织病理资料。结果110例患者中男59例,女51例;年龄6~79岁,中位年龄32岁。临床类型中一般类型105例,表现为以躯干、四肢近端分布为主、皮损长轴与皮纹走行一致的红色丘疹、斑丘疹,有领圈样脱屑;特殊类型5例,其中表现为多形红斑1例,紫癜型3例,水疱型1例。皮损组织病理:灶性角化不全85例(77.3%),表皮海绵水肿107例(97.3%),局灶性基底细胞水肿106例(96.4%),真皮浅层血管周围炎症细胞浸润95例(86.4%),红细胞外溢20例(18.2%)。结论玫瑰糠疹相对特异性的组织病理特征是轻度基底细胞水肿,需与界面性皮炎而非海绵水肿性皮炎鉴别。

Objective To analyze histopathological features of pityriasis rosea.Methods Clinical and pathological data were collected from 110 patients with pityriasis rosea in Department of Dermatology,Peking University First Hospital between January 2000 and May 2021,and analyzed retrospectively.Results Among the 110 patients,59 were males and 51 were females;their ages ranged from 6 to 79 years,with a median age of 32 years.There were 105 cases of general type of pityriasis rosea,presenting as red papules and maculopapules,whose long axes were parallel to the dermatoglyphs,accompanied by collar-like desquamation distributed mainly on the trunk and proximal extremities;there were 5 cases of special types of pityriasis rosea,including 1 case of erythema multiforme,3 cases of purpuric pityriasis rosea,and 1 case of vesicular pityriasis rosea.Histopathological examination showed focal parakeratosis in 85 cases(77.3%),epidermal spongiosis in 107 cases(97.3%),focal basal cell edema in 106 cases(96.4%),superficial dermal perivascular inflammatory cell infiltration in 95 cases(86.4%),and erythrocyte extravasation in 20 cases(18.2%).Conclusion The relatively specific histopathological feature of pityriasis rosea was mild basal cell edema,and pityriasis rosea should be differentiated from interfacial dermatitis rather than spongiotic dermatitis.