环状弹力纤维溶解性巨细胞肉芽肿1例

患者女,23岁。面部红色萎缩性斑片1年。组织病理检查示真皮弥漫以组织细胞、多核巨细胞为主的肉芽肿性浸润。弹力纤维染色示肉芽肿浸润部位弹力纤维缺失、溶解,部分断裂。诊断:环状弹力纤维溶解性巨细胞肉芽肿。     

环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,45岁,双侧颈部、双手背多发淡红色及皮色扁平丘疹1个月。皮损组织病理示:表皮大致正常,真皮中上层胶原束间可见多量多核巨细胞、淋巴细胞、组织细胞浸润,并可见多核巨细胞吞噬弹性纤维碎片现象,弹力纤维染色示肉芽肿区弹力纤维减少,阿新蓝染色未见明显黏蛋白沉积。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,55岁。面部红色肿块8个月。皮损组织病理示:真皮下部以多核巨细胞为主的肉芽肿性浸润。特殊染色显示:真皮中下部弹力纤维减少、断裂或消失。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

额部环状弹性纤维溶解性巨细胞肉芽肿1例

患者男,58岁。额部反复出现多发性环形红斑13年余。皮损组织病理示:表皮大致正常,真皮浅层较多淋巴细胞灶性浸润,真皮内见两处肉芽肿样病变,由较多多核巨细胞和部分淋巴细胞构成,未见坏死。弹力纤维染色示:多核巨细胞内可见吞噬现象。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

穿通性环状肉芽肿2例

报告２例穿通性环状肉芽肿均为丘疹型，１例临床皮损类似寻常疣。组织病理示真皮上部栅状肉芽肿和穿通管道，从表皮排出真皮内变性物质。电镜观察见大量组织细胞、变性的胶原纤维和弹力纤维，坏死区组织细胞呈现变性，未见吞噬弹力纤维，但在其周围见变性弹力纤维与质膜密切接触     

泛发型环状肉芽肿合并糖尿病1例

患者女,67岁。四肢、颈部丘疹1年,伴血糖升高。皮疹呈环状扩大,中央消退,周边隆起。皮损组织病理示:真皮内可见胶原纤维、弹力纤维变性,黏蛋白沉积,组织细胞及多核巨细胞呈栅栏状排列。诊断:泛发型环状肉芽肿合并糖尿病。     

合并面癣的面部光化性肉芽肿1例报道

报告1例合并面癣的面部光化性肉芽肿。患者男,73岁,面部潮红、丘疹1月余就诊。右面颊皮肤癣菌镜检（＋）。皮肤病理检查示真皮浅层组织细胞、上皮样细胞、淋巴细胞及多核巨细胞浸润,胶原日光弹力变性,抗酸染色组织细胞内有红染颗粒样物质,弹力纤维染色见弹力纤维明显减少。诊断为光化性肉芽肿合并面癣。     

非感染性肉芽肿

971104 穿通性环状肉芽肿2例/吕玲…∥临床皮肤科杂志,-1996,25(3).-171均为丘疹型,1例临床应损类似寻常疣.组织病理示真皮上部栅状肉芽肿和穿通管道,从表皮排出真皮内变性物质.电镜观察见大量组织细胞、变性的胶原纤维和弹力纤维,坏死区组织细胞呈现变性,未见吞噬弹力纤维,但在其周围见变性弹力纤维与质膜密切接触.参5(原文摘要)971105 进行性慢性盘状肉芽肿病一例/陈明华…∥     

环状弹性组织溶解性巨细胞肉芽肿1例

患者男,52岁,双双手背及前胸、颈部多发环形红斑2年余。颈部皮损病理组织显示:真皮中部见肉芽组织改变,其中较多组织细胞、多核巨细胞及淋巴细胞浸润,弹力纤维染色减少。诊断:环状弹性组织溶解性巨细胞肉芽肿。     

弹力纤维假黄瘤1例

患儿男,12岁。颈部及腋下皮肤出现淡黄色小丘疹1年。心电图检查示:频发性室性早搏,短P-R综合症,I导联见异常Q波。组织病理示:真皮中下部弹力纤维肿胀、断裂、卷曲;弹性纤维染色(Weigert染色)显示真皮中下部断裂、卷曲的弹力纤维呈暗红色碎羊毛状。诊断:弹力纤维假黄瘤。     

A Case of Eruptive Collagenoma on the Left Calf

Eruptive collagenoma is an acquired connective tissue nevus without family history. It is typically described as numerous small papules or nodules on the trunk and arms with histopathological features of decreased or degenerated elastic fibers. We report a case of a 16-year-old male who presented with multiple asymptomatic 2 to 5 mm sized yellowish grouped papules on the left calf. Histopathologically, the lesion showed thickened homogenized collagen fibers highlighted by Masson trichrome stain and decreased and fragmented elastic fibers stained by Verhoeff-van Gieson stain. The skin lesion was diagnosed as eruptive collagenoma and no treatment was provided.     

The -SH and SS positive components in dermal connective tissues: a study by N-(7-dimethylamino-4-methyl-3-coumarinyl) maleimide (DACM) stain

Summary Although -SH and SS positive components in dermal connective tissue have been observed by N-(7-dimethylamino-4-methyl-3-coumarinyl) maleimide (DACM) stain, their nature is as yet unknown. In our study, we stained several organs such as human skin, rabbit aorta, auricle, and trachea using DACM stain, and studied the distribution of -SH groups and SS linkages among the elastic fibers in those organs. In the dermis of human skin, a moderately strong fluorescence by both -SH and SS stain was present all over the layer, especially in the lower half among collagen fibers in a fine linear or wavy pattern, and a fluorescence ascending vertically from the lower papillary dermis toward the epidermis was also observed. In rabbit aorta, a strong fluorescence by both -SH and SS stain was observed on well-developed elastic fibers. In the matrix of rabbit elastic cartilage, a strong reticular fluorescence by both -SH and SS stain was present. On the other hand, in rabbit hyaline cartilage, no -SH fluorescence was present on any components of the cartilage. However, though a diffuse moderate fluorescence for SS linkages was observed in the matrix, there was no reticular fluorescence such as that seen in the elastic cartilage. These results suggest that the -SH and SS components observed in the dermis by DACM stain are in fact elastic fibers, more precisely, elastic tissue microfibrils.     

Atrophic dermatofibroma. Elastophagocytosis by the tumor cells

A 55-year-old woman presented with an asymptomatic red plaque on the left upper back for 6 or 7 years. The lesion was depressed in response to finger pressure. The clinical diagnosis was anetoderma. Histopathologically, the characteristic cells of cellular dermatofibroma proliferated within the thinned dermis, which showed atrophy of about 60 or 70%. The proliferated cells were positive for factor XIIIa and negative for CD34. The involved dermis showed the loss of elastic fibers on elastica van Gieson stain. Electron microscopically, the proliferating cells phagocytized the elastic fibers. We report a typical case of atrophic dermatofibroma and show the possibility that the cause of this disease might be elastophagocytosis between the collagen fibers by the dermatofibroma cells.     

Facial linear focal elastosis: a case report

BACKGROUND: Linear focal elastosis is an uncommon disorder that clinically shows band-like stria and a histological focal increase in elastic fibers. The disorder preferentially affects men after the age of 60 years and occurs on the lower back. The pathogenesis of linear focal elastosis is still somewhat of an enigma. METHOD: A 50-year-old farmer presented with an unusual linear lesion on the left side of his chin. The patient was frequently exposed to sun because of fieldwork for a period of more than 40 years. RESULTS: Skin biopsy specimen revealed a massive abnormal collagen deposition extending from the subpapillary dermis to the lower dermis with numerous wavy bundles of fibers. Elastin van Gieson stain for elastic fibers showed that abnormal elastic fibers were increased within a massive abnormal collagen deposition. Diagnosis of facial linear focal elastosis was made after clinicopathological correlation. CONCLUSION: Facial involvement of linear focal elastosis has not been reported previously in the literature. It has been suggested that sunlight has a minor role in the development of elastotic change in linear focal elastosis. However, our patient was a farmer and was exposed to sunlight frequently for a period of more than 40 years, suggesting that ultraviolet radiation may play a role in the pathogenesis of linear focal elastosis.     

Elastic fiber pattern in scleroderma/morphea

Background: Scleroderma/morphea is characterized by expansion of the dermis with thickened collagen bundles and loss of CD34⁺ dermal dendrocytes. Variable elastic fiber changes have been described, but to our knowledge, no systematic study of the elastic fiber pattern correlated with CD34 expression has been reported.
Methods: To better define the typical elastic fiber morphology, we examined seven cases of normal skin and 28 cases of scleroderma/morphea ranging from inflammatory to sclerosing stages. All but four biopsies were submitted with a clinical impression of either scleroderma or morphea. CD34 immunohistochemistry was performed on 26 biopsies with available tissue.
Results: Elastic van Gieson stain showed preservation of elastic fibers in all cases. In addition, straightening with parallel orientation and compression between thickened collagen bundles was frequently present and was graded as limited in 46% and diffuse in 54% of cases. The extent of elastic fiber alteration correlated with the degree of sclerosis. A variable loss of CD34⁺ dermal dendritic cells was seen in all cases.
Conclusion: This study confirms the preservation and frequent presence of parallel, straightened and compressed elastic fibers in scleroderma/morphea and suggests that the elastic fiber pattern, in addition to CD34 immunohistochemistry, may serve as a useful diagnostic adjunct.     

Histological evaluation of dermal tissue remodeling with the 1444‐nm neodymium:yttrium–aluminum–garnet laser in in vivo model

Laser lipolysis has a skin tightening effect by heating the deep dermis, in addition to the removal of fat tissues. The 1444‐nm neodymium:yttrium–aluminum–garnet (Nd:YAG) laser has been expected to be more effective and safe for laser lipolysis, due to higher affinity to fat and water, than 1064‐nm and 1320‐nm wavelengths. The purpose of this study was to evaluate the skin tightening effect of the 1444‐nm Nd:YAG laser through in vivo guinea pig models. The 1444‐nm Nd:YAG laser was used to irradiate shaved dorsal skin of the guinea pigs and compared with controls (no power, only tunneling). Immediately, 1 week, 1 month and 3 months after laser administration, full‐thickness skins were harvested and to evaluate dermal thickness, collagen organization, fibroblast proliferation, and intensity of elastic fibers and mucopolysaccharides, using hematoxylin–eosin, Masson‐trichrome, Verhoeff's stain and Alcian blue stain. Dermal thickness showed an increase with time in all groups. In collagen organization, fibroblast proliferation, and intensity of elastic fibers and mucopolysaccharides, the treatment groups were higher than those of the control group, overall. Our study showed that the 1444‐nm Nd:YAG laser appeared to be effective for the skin tightening effect in in vivo guinea pig models. The 1444‐nm Nd:YAG laser can be used for skin tightening, as well as reduction of fat tissues.     

Was bleibt von der Haut nach 2000 Jahren Moor?

BACKGROUND AND OBJECTIVE: Mummies have an important place in the study of archaeology and paleopathology because they are so well preserved. For the first time skin samples of six 2300-1600 year old bog bodies from North Germany were examined by histology, transmission electron microscopy and immunohistology. METHODS: For histology the samples were stained with H&E and van Gieson elastic stain. Fixation and embedding in epoxy followed for the transmission electron microscopy. Specific antibodies directed to type IV collagen and S-100 were used. RESULTS: Histologically it was possible to observe collagen bundles in the dermis, with a density similar to recently stained samples. Epidermis was not preserved. The electron microscopy showed collagen fibrils with a diameter of 45-110 nm and the characteristic axial periodicity. Throughout the dermis, a number of spores of bacteria with a diameter of 0.83 +/- 0.051 micron and an electron dense core were found. No activity against the used antibodies could be detected. CONCLUSIONS: Histology and electron microscopy demonstrate the excellent conservation of the dermal collagen in the bog. In contrast to ice mummies like "Otzi" and mummies from Egypt, no cellular elements could be found in the skin of bog bodies.     

Characterizing Cutaneous Elastic Fibers by Eosin Fluorescence Detected by Fluorescence Microscopy

Background

Though elastic fibers are as important as collagen fibers in interpretation of the histopathologic findings, it is impossible to observe them on the hematoxylin & eosin (H&E) stained specimen.

Objective

Characterizing eosin fluorescence emitted by elastic fibers in H&E stained specimens.

Methods

Normal skin tissue sections were stained in 4 different ways (unstained, hematoxylin only, eosin only, H&E) and observed under a fluorescence microscope using a FITC filter set. Fluorescent findings of 30 H&E-stained specimens showing abnormal dermal findings were compared with bright field findings of Miller''s elastic stained specimen.

Results

Strong eosin fluorescence was related to the differential binding property of eosin with elastic fibers. Hematoxylin stain quenched excessive eosin fluorescence from other tissue components and contributed to better contrast. Fluorescence microscopy of H&E-stained sections was found to be especially useful in observing mature elastic fibers in the reticular dermis. In 74% of the specimens, eosin fluorescence findings of elastic fibers in reticular dermis matched well with that of specimens with elastic fiber special stain.

Conclusion

Analysis of skin elastic fibers by fluorescence microscopy is a useful and complementary method to reveal hidden elastic fibers in H&E-stained specimens.     

Acquired perforating calcific collagenosis after topical calcium chloride exposure

A 24‐year‐old healthy man presented with a 6‐week history of numerous umbilicated coalescing erythematous papules with some scale and crust on his anterior medial thighs. The eruption began 1 to 2 weeks after he spilled calcium chloride rock salts on his pants while salting the sidewalk during a snow storm. The salts dissolved and remained in contact with his skin for at least 4 hours until he was able to change clothes. A skin biopsy shows thick and thin collagen fibers with partial calcification in the papillary and upper reticular dermis associated with a sparse infiltrate of neutrophils, lymphocytes and mononuclear histiocytes. There are foci of transepidermal elimination of calcified fibers with adjacent epidermal hyperplasia and ortho‐ and parakeratosis. Von Kossa stain highlights calcification of the fibers, and trichrome stain confirms the fibers are collagen. A Verhoeff‐van Gieson stain shows no abnormality of elastic fibers. The patient was treated with topical betametasone diproprionate cream twice daily for 3 weeks, as well as a short course of oral levofloxacin and topical gentamicin cream. The lesions resolved over 3 weeks with residual scarring. We report a unique case of acquired perforating calcific collagenosis secondary to topical calcium chloride exposure. Patel RR, Zirvi M, Walters RF, Kamino H. Acquired perforating calcific collagenosis after topical calcium chloride exposure.     

Abnormalities of connective tissue components in lesional and non-lesional tissue of patients with pseudoxanthoma elasticum

Pseudoxanthoma elasticum (PXE) is a disorder of connective tissue in which abnormalities of elastic tissue and collagen are found. The purpose of this study was to examine the ultrastructure and distribution of connective tissue components in lesional and non-lesional skin of patients by means of indirect immunofluorescence, electron microscopy and indirect immunoelectron microscopy. Prominent abnormalities of elastic tissue were seen on electron microscopy and confirmed by immunoelectron microscopy. Abnormal elastic fibers containing electron-dense bodies and holes were seen even in non-lesional skin. In addition, the normal pattern of collagen bundles was disrupted in lesional skin, but not in non-lesional skin of patients with PXE. The majority of individual collagen fibrils appeared normal by electron microscopy. The distribution of type IV collagen and laminin was normal in small blood vessels. Finally, abnormalities in the distribution of fibronectin were seen. The finding of atypical elastic fibers in non-lesional skin supports an early role for elastic tissue components in the pathogenesis of PXE. Interactions between elastin, collagen and other matrix substances may explain some of the abnormalities seen.