【中文摘要】 目的根据T淋巴细胞表面抗原CD4、CD8和受体γ的表达分析色素性紫癜性皮肤病(PPD)和蕈样肉芽肿(MF)的关系,探讨前者能否被视为一种皮肤淋巴瘤样疾病(CLD)。方法运用免疫组化技术检测23例已确诊PPD患者皮损表皮和真皮中CD4+T、CD8+T的表达情况;PCR技术测定T细胞受体γ(TCRγ)单克隆基因重排。设立20例MF皮损、20例正常人皮肤组织分别为阳性和阴性对照。结果23例PPD真皮上部均以小淋巴细胞浸润为主,15例观察到淋巴细胞向表皮有明显迁移倾向,其中的5例和20例MF皮损可见淋巴细胞亲表皮现象,正常组未见此现象;18例PPD、20例MF和6例正常皮肤免疫染色以CD4+T为主;PPD和MF两组在真皮中的CD4+T数分别为38.2±30.6和68.8±47.6(P<0.017),CD4+/CD8+值分别为1.7±1.1和2.6±0.8(P<0.05),PPD组数值小于MF组,有显著性差异;余表皮和真皮中两组间的CD4+T、CD8+T计数和CD4+/CD8+值均较接近。TCRγ的PCR扩增结果显示23例PPD中10例阳性,20例MF中16例阳性,正常组无1例阳性。...更多其中7例阳性PPD见淋巴细胞向表皮的明显迁移(包括3例有亲表皮现象的PPD),8例以CD4+T细胞为主,9例表现为除双小腿以外的其它部位也存在皮疹。结论PPD在T细胞表面抗原和受体的表达上有部分类似蕈样肉芽肿的特征,可能系一种皮肤淋巴瘤样疾病。对于皮损分布广泛,治疗效果欠佳,免疫表型和分子学特征类似蕈样肉芽肿的病例在诊疗上应尤为重视,加强随访。 

【英文摘要】 Objective To analyze the relationship between PPD and MF on the basis of the surface antigen CD4 , CD8 and receptorγof T cell ,so as to provide if PPD can represent a cutaneous lymphoid dyscrasia.Methods The expression of CD4+ T cell and CD8+ T cell was measured by immunohistochemical technique in specimens obrained from lesional skin of 23 cases of PPD, 20 cases of MF and skin of 20 cases of normal persons. The TCR gamma gene rearrangement was detected by PCR.Results 23 cases of PPD show small lymphocytes infiltration mainly. 15 cases of PPD have obvious migrations of lymphocytes to the epidermis. Their 5 cases and 20 cases of MF show T cell epidermotopism; 18 cases of PPD, 20 cases of MF and 6 cases of normal persons show a dominance of CD4+ T cell.In the dermis, the numbers of CD4+ T cell between PPD and MF are 38.2±30.6 and 68.8±47.6 ( P<0.017),and the ratios of CD4+/CD8+ are 1.7±1.1 and 2.6±0.8(P<0.05).Both have significant differences.The remains are no obvious differences....TCR gamma gene rearrangement was found in 10 cases of PPD and 16 cases of MF.7 cases of PPD can be seen obvious migrations of lymphocytes to the epidermis(including 3 cases characterized by epidermotopism), 8 cases show a dominance of CD4+ T cell and 9 cases have atypicalerythfra.Conclusions PPD have some similar feature like mycosis fungoides,so it may be one kind of cutaneous lymphoid dyscrasia. We should pay attention to follow the patients with widespread erythra,bad curative effect and similar immunophenotyping and molecular features of mycosis fungoides. 

【中文关键词】 色素性紫癜性皮肤病; 蕈样肉芽肿; CD4; CD8; TCRγ
【英文关键词】 Pigmented purpuric dermatoses; Mycosis fungoides ; C D4 ; C D8 ; T CRγ