Sweat gland abnormalities in lichenoid dermatosis.
ABSTRACT Lichenoid dermatosis is a pattern description of a variety of cutaneous lesions which primarily affect the dermoepidermal junction. Involvement of skin appendages has been restricted to hair follicles in lichen planopilaris and discoid lupus erythematosus. Sweat gland involvement has not been described in the four common members of this group, namely, lichen planus, discoid lupus erythematosus, fixed drug eruptions and erythema multiforme, although structural abnormalities have been reported in graft-versus-host disease. In a detailed morphological study of 59 cases, including lichen planus (12), discoid lupus erythematosus (18), fixed drug eruption (14) and erythema multiforme (15), 78% (47/59) showed sweat, gland abnormalities. The abnormalities included vacuolation of cell cytoplasm, with and without lymphocytic infiltration, apoptosis of basal cells and basal cell hyperplasia of the excretory ducts which predominantly affected the portion of the duct adjoining the acrosyringium. The portion of the duct close to the secretory gland was only involved in continuity and the secretory glands were unaffected. These abnormalities of the sweat gland mostly constitute primary involvement by the disease process in contrast to structural abnormalities secondary to fibrosis.
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ABSTRACT: Toxic epidermal necrolysis (TEN) is a rare dermatological emergency which is caused by drugs and results in a high morbidity and a mortality rate of 20-30%. Ten confirmed cases of TEN were retrieved and the sweat glands were examined. Abnormalities of the sweat duct were found in all the cases and included basal vaculopathy, increased lymphocytic infiltration, basal apoptosis, basal cell hyperplasia and necrosis of the duct. Destruction and loss of the distal duct was present in 40% of the cases and was accompanied by dilatation of the proximal duct. In all cases, the proximal duct was involved to a lesser degree and in continuity with the distal duct, supporting the possibility of cytokine action. The secretory gland was normal. The presence of a significant reduction of sweat ducts in a disease process that involves 30-100% of the total body surface area is of clinical importance.Journal of Cutaneous Pathology 09/1995; 22(4):359-64. · 1.77 Impact Factor
- Journal of the American Academy of Dermatology 09/2014; 71(3):e99–e101. · 4.91 Impact Factor
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ABSTRACT: Cutaneous lesions of lupus erythematosus (LE) show a broad spectrum of clinicopathologic features. Histopathologically, besides typical patterns such as interface dermatitis, perivascular lymphocytic infiltrate and dermal mucin deposits, an involvement of the eccrine structures, especially the acrosyringium, may be observed. We describe the case of a 21-year-old woman with a 4-year history of systemic LE, who presented with a 'butterfly' rash over the cheeks as well as erythematous macules on the arms and décolleté. Biopsy from one lesion on the arm revealed interface changes, necrotic keratinocytes and exocytosis of lymphocytes restricted only to the regions of the acrosyringia. The epidermis between affected acrosyringia was normal with no hints of interface dermatitis. The eccrine glands and coils were not affected. In the dermis there were only sparse inflammatory infiltrates. Differential diagnoses such as erythema multiforme, drug eruption and lichen planus could be ruled out because of histopathologic features and clinical presentation. This is an example of a peculiar histopathological variant of cutaneous LE, characterized by exclusive involvement of the acrosyringia. The histopathologic features represent a pitfall in the diagnosis and can be correctly interpreted only upon correlation with clinical data.Journal of Cutaneous Pathology 04/2009; 37(1):91-3. · 1.77 Impact Factor