郎格罕细胞与白癜风

郎格罕细胞与白癜风普雄明综述石得仁审校（新疆维吾尔自治区人民医院皮肤科，乌鲁木齐，８３０００１）朗格罕细胞（Ｌａｎｇｅｒｈａｎｓ’Ｃｅｌｌｓ，ＬＣ）为表皮的免疫细胞，具有摄取和递呈抗原等重要的免疫学功能￣［１，２］，近年来ＬＣ与白癜风的关系颇受人们重...     

白癜风患者表皮内郎格罕细胞观察

用改良的Ｊｕｈｌｉｎ－ＳｈｅｌｌｅｙＡＴＰ酶细胞化学染色法检查了１３例白癜风（进展期）患者的白斑、白斑边缘区及对侧相应正常皮肤中郎格罕细胞情况，结果白斑部位表皮郎格罕细胞数目较对应正常皮肤表皮变化不大，而白斑边缘部皮肤郎格罕细胞数目较正常皮肤显著增多（Ｐ＜０．００５）。在白斑及白斑边缘区还可见到印格罕细胞的形态学变化：胞体变大、深染、胞突消失以及细胞积聚现象，在白斑边缘部尤其明显。本研究显示郎格罕细胞数目和形态学的变化与病情活动有关。提示郎格罕细胞在白癜风发病机制中起一定的作用。     

郎格罕细胞与HIV感染

郎格罕细胞是ＨＩＶ感染的靶细胞，细胞内可以检测到前病毒ＤＮＡ及ＲＮＡ，生殖道粘膜的郎格罕细胞可能是性接触所致ＨＩＶ感染的最早的靶细胞之一，郎格罕细胞既可以从Ｔ淋获得感染，又可以针感染传递给Ｔ淋巴细胞，感染ＨＩＶ的郎格罕细胞抗原递呈能力无明显改变。     

冷冻对郎格罕细胞的影响

用ATPasw和OKT_6—ABC染色法观察冷冻对正常皮肤郎格罕细胞的影响。结果:ATPase染色有明显影响,但OKT_6—ABC染色无影响。     

正常表皮内郎格罕细胞的表面标志

郎格罕细胞(LC)来源于骨髓和脾脏^[1],有抗原提呈和同种异基因刺激作用,在许多皮肤病的发病机理中有重要的意义.     

郎格罕细胞与HIV感染

郎格罕细胞是HIV感染的靶细胞,细胞内可以检测到前病毒DNA及RNA。生殖道粘膜的郎格罕细胞可能是性接触所致HIV感染的最早的靶细胞之一。郎格罕细胞既可以从T淋巴细胞获得感染,又可以将感染传递给T淋巴细胞。感染HIV的郎格罕细胞抗原递呈能力无明显改变。     

郎格罕细胞组织增生症

郎格罕细胞组织增生症王健美（华北煤炭医学院附属医院皮肤科唐山０６３００１）唐曙（上海第二医科大学附属新华医院皮肤科）郎格罕细胞组织细胞增生症（Ｌａｎｇｅｒｈａｎｓｃｅｌｌｈｉｓｔｉｏｃｙｔｏｓｉｓ，ＬＣＨ）是一组以郎格罕细胞增生为主的疾病，小儿多见。...     

尖锐湿疣患者郎格罕细胞观察

用ＯＫＴ６单抗及ＡＢＣ法观察了１８例尖锐湿疣患者包皮病损中郎格罕细胞（ＬＣ）的数量、分布及形态，并与正常对照组及疣旁“正常”皮肤中的ＬＣ进行了比较。结果表明，皮损表皮中ＬＣ密度明。减少，与对照组和疣旁“正常”皮肤相比，Ｐ＜０．００１，并有胞突缩短、减少或消失等改变。ＬＣ减少可能使ＨＰＶ抗原不易提是给真皮中的免疫活性细胞，以致病损长期存在，不易消退。     

表现为结节性损害的老年皮肤朗格汉斯细胞组织细胞增生症1例

患者男,63岁。头皮、额部、双耳前至面颊部、两下颌部和胸背部暗红色浸润性丘疹、结节、斑块6年余,伴严重瘙痒。浅表淋巴结和胸部CT和腹部彩超均未见异常。皮损组织病理示:真皮大量单个核细胞弥漫浸润,部分细胞体积较大,胞质淡,核椭圆形,可见核沟。免疫组织化学检查示:CD1a及S-100染色阳性。诊断:皮肤朗格汉斯细胞组织细胞增生症。     

Apoptotic Cell Death of Neutrophils in Development of Skin Lesions of Patients with Anaphylactoid Purpura

The participation of apoptotic cell death of neutrophils in the development of skin lesions of patients with anaphylactoid purpura was examined by the in situ specific labeling of fragmented DNA. In the early stage of the skin lesions, there were few positively stained nuclei in infiltrating cells. The number of positive cells increased markedly in the fully developed stage of the lesions. A number of neutrophils were stained positively. Finally, a few fragmented nuclei were still positive in the late stage of the lesions. It was therefore suggested that fragmentation of neutrophils in the skin lesions from the patients might be due to apoptosis. Inducible nitric oxide synthase and nitrotyrosine were detected in infiltrates, and interleukin-8 was also detected in vascular endothelial cells in those skin lesions. The roles of nitric oxide and interleukin-8 in the apoptosis of neutrophils are discussed.     

Immunohistochemical Study of Cellular Events in Lesional Skin during Common Virus Infections

Determination was made of epidermal Langerhans cell (LC) distribution and infiltrating cellular events in lesional skin during varicella zoster virus (VZV) infection, and the results were compared with those for herpes simplex (HS), measles, and rubella by immunohistochemical staining with cell surface markers. CD1 a positive epidermal LCs increased in number, particularly in measles and rubella. The number of LCs was within the normal range or slightly increased in the epidermis of VZV infection. In herpes zoster (HZ) and varicella, HLA-DR positive epidermal cells were present in the basal part of the epidermis. In measles, HLA-DR positive cells aggregated in papular lesions. In measles and rubella, the number of HLA-DQ positive epidermal cells appeared to increase. In HS cases, CD11b (OKM1) positivity of the upper epidermal keratinocytes was quite pronounced, but not in the basal layer. CD8 positive suppressor/cytotoxic cells extensively infiltrated the dermis of HZ and varicella. Dermal infiltrates were identified as CD8 positive cell dominant in measles, HZ, and varicella. These results provide a partial explanation as to why cellular events in skin lesions act immunosuppressively.     

朗格汉斯细胞组织细胞增生症皮肤损害临床分析

目的:分析朗格汉斯细胞组织细胞增生症(LCH)的临床特点.方法:回顾性分析近10余年国内文献报道的918例诊断LCH的临床资料.结果:918例LCH中皮肤受累510例,占55.5%,以皮疹为首发症状的106例,占11.55%.临床上以湿疹样、脂溢性皮炎样或紫癜样皮疹多见.所有病例均合并其他系统损害,以发热(52.07%),肝肿大(52.29%)、脾肿大(48.26%)、骨损害(38.78%)、肺部损害(36.16%)最为常见.在918例LCH中,男593例,女317例,性别不详8例,最小出生4h,最大65岁,1岁以下占19.17%.皮肤活检151例.结论:皮肤是LCH常累及器官,对于1岁以下的小儿出现不典型湿疹样、脂溢性皮炎样或紫癜样皮疹应警惕LCH的可能,应进一步完善各项检查以明确诊断.     

Staphylococcus aureus Colonization in Acute and Chronic Skin Lesions of Patients with Atopic Dermatitis

Background

Staphylococcus aureus (SA) has peculiar abilities to colonize the skin in atopic dermatitis (AD) patients.

Objective

We sought to determine the colonization rates of SA in acute and chronic skin lesions of AD patients, to find any difference in colonization rates according to age and to find the influences of total immunoglobulin E (IgE) and eosinophil counts to the colonization of SA.

Methods

We evaluated the total IgE level and eosinophil counts, and cultured SA from the skin lesions of 687 AD patients (131 acute and 556 chronic skin lesions) and 247 control urticaria patients (July 2009 to November 2010; Samsung Medical Center Dermatology Clinic, Seoul, Korea).

Results

The SA colonization rates were 74%, 38% and 3% in acute, chronic skin lesions and control skin, respectively, and they were increased with age in AD patients. The colonization rate in chronic skin lesions was higher in the high IgE/eosinophilia groups as compared to the normal IgE/eosinophil groups.

Conclusion

The SA colonization rate was higher in AD patients and especially in acute lesions, and had a tendency to increase with age. As the colonization rates were only higher in the high IgE/eosinophilia groups of chronic skin lesions, we suggested that SA may invade the skin through barrier defects in acute skin lesions, but the colonization in chronic lesions may be orchestrated through many different factors.     

白癜风患者皮损中CD4~+,CD8~+T淋巴细胞及朗格汉斯细胞的检测

目的探讨白癜风患者皮损中CD4+,CD8+T淋巴细胞、朗格汉斯细胞(LC)及黑素细胞(MC)在白癜风发病中的作用。方法采用Envision免疫组化染色法,对12例白癜风进展期患者和9例稳定期患者皮损处CD4+,CD8+T淋巴细胞、LC及MC进行检测,并与10例正常人皮肤进行对照。结果白癜风患者皮损中CD4+,CD8+T淋巴细胞、LC表达较对照组显著增多(P<0.01),而MC表达较对照组显著减少(P<0.01)。结论白癜风患者皮损中LC,CD4+,CD8+T淋巴细胞异常表达可能参与白癜风的发病,其作用模式可能是LC抗原递呈,CD4+,CD8+T淋巴细胞浸润破坏或攻击MC,从而引起白癜风患者表皮基底层的MC减少或消失,导致白癜风的发生。     

朗格汉斯细胞表达与尖锐湿疣发病的相关性研究

目的：探讨朗格汉斯细胞（LC）的表达与尖锐湿疣（CA）发病的相关性。方法：采用免疫组化法对28例CA皮损和10例正常皮肤组织进行CD1a^＋LC染色;应用图像分析技术对CD1a^＋LC进行定量分析。结果：CA皮损中CD1a^＋LC数目明显减少,分布不规则,形态不典型,结构不完整,树突状突起明显减少、缩短或消失;CA组CD1a^＋LC数目较对照组明显减少（P〈0.05）。经图像分析显示CA组平均CD1a^＋LC含量明显低于对照组（P〈0.05）。结论：尖锐湿疣中CD1a^＋LC的形态和数量变化可能与其发病密切相关。     

A Case of Pseudovascular Adenoid Squamous Cell Carcinoma of the Skin with Spindle Cell Pattern

We report a case of pseudovascular adenoid squamous cell carcinoma which was in the form of a dome-shaped, cherry red tumor on the right cheek of an 86-year-old Japanese woman. Histologically, two types of atypical cells were identified; round cells in the upper part and spindle cells in the lower part. In the upper part, inter-anastomosing sinusoid-like pseudolumina were observed between the cords of the tumor cells. Immunohistochemically, the tumor cells did not express Factor VIII-related and CD34 antigens or bind Ulex europaes I agglutinin, except for only one anti-cytokeratin antibody. Ultrastructurally, the tumor cells contained tonofilaments and desmosomes and represented acantholysis. From the electron microscopy, possible role of capillary hyperpermeability on the acantholytic process of the neoplastic cells was suggested.     

以皮肤损害为首发表现的结外鼻型NK/T细胞淋巴瘤1例及文献复习

目的:报道1例皮肤结外鼻型NK/T细胞淋巴瘤,分析其临床表现、组织病理特点及治疗和预后,以提高皮肤科临床医生对本病的诊治水平.方法:通过临床表现、组织病理分析,结合免疫组化染色、EB病毒原位杂交确诊.结果:颈后皮损组织病理示真皮浅中层血管附属器周围几大灶淋巴样细胞浸润,细胞核大,胞浆透明,异型性明显.瘤细胞表达CD2、CD3、CD5、CD7、CD8、GranzymeB、Ki-67,而不表达CD56,EB病毒( + ).诊断为皮肤的结外鼻型NK/T细胞淋巴瘤.结论:结外鼻型NK/T细胞淋巴瘤具有独特的组织病理及免疫组化特征,恶性度高、易误诊、预后差.     

湿疹与特应性皮炎皮损处细菌学研究

目的 探讨湿疹和特应性皮炎(AD)皮损处的细菌学特点及金黄色葡萄球菌(金葡菌)在湿疹及AD发病中的作用。方法 多中心随机双盲对207例湿疹患者和119例AD患者皮损及非皮损处取材做细菌培养,并对所分离到的金葡菌进行常规药敏试验和噬菌体分型。结果 207例湿疹患者皮损处的细菌检出阳性率、金葡菌的比例及定植均明显高于非皮损处,差异有显著性(P<0.01)。119例AD患者皮损处的细菌检出阳性率及金葡菌的定植明显高于非皮损处,差异有显著性。对分离到的141株金葡菌进行噬菌体分型。Ⅰ组占6.3%,Ⅱ组占7.0%,Ⅲ组占3.5%,Ⅴ组占0.7%,杂组占1.4%,不能分型占56%,MRSA分型噬菌体26株混合组占6.3%。药敏试验结果表明在常用的6种外用抗菌药物中莫匹罗星对金葡菌和表皮葡萄球菌的抗菌活性最强,其MIC范围、MIC₉₀和MIC₅₀是6种抗菌药物中最低的。且莫匹罗星对金葡菌及其中的各噬菌体分型和表皮葡萄球菌中的耐甲氧西林和耐甲氧西林凝固酶阴性菌株也有较好的抑菌能力。结论 湿疹和AD的发病与细菌感染密切相关,其中金葡菌是最重要的细菌,对湿疹和AD患者外用药治疗合并使用外用抗菌药物是必要的,根据对金葡菌抗菌活性的测定,莫匹罗星的效果较好。