早期带状疱疹的征象:疱疹仅累及毛囊皮脂腺单位  

Exclusive involvement of folliculosebaceous units by herpes: A reflection of early herpes zoster

作　　者：Walsh N. Boutilier R. Glasgow D. Shaffelburg M. 罗素菊 

机构地区：[1]Dr.Division of Anatomical Pathology, D.J. Mackenzie Bldg., QEII Health Sciences Centre (VG Site), 5788 University Avenue, Halifax, NS B3H 1V8, Canada

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2005年第8期43-44,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：The histopathological changes of herpes simplex,herpes zoster, and varicella are considered to beindistinguishable from one another. Evaluation of the clinical setting, with adjunctive studies if necessary, generally clarifies the specific diagnosis. Vesicular lesions in all three conditions can involve epidermal and adnexal epithelium with characteristic cytopathic features. We describe three patients with non- vesicular eruptions on the head and neck whose biopsies revealed exclusive folliculosebaceous involvement by herpes. All three patients developed typical herpes zoster within days of the biopsy. There is compelling scientific evidence in the literature indicating that, in herpes zoster, the virus is transported from dorsal root or trigeminal ganglia via myelinated nerves to the skin. These terminate at the isthmus of hair follicles and primary infection of follicular and sebaceous epithelium occurs. Spread of infection to the epidermis follows. In contrast, data pertaining to recurrent herpes simplexindicates that axonaltran sport of the virus from sensory ganglia to the skin is directed primarily to the epidermis, via terminal non- myel- inated nerve twigs. The clinical evolution of our three cases and scientific data in the literature indicate that exclusive folliculosebaceous involvement by herpes, in the setting of a non- vesicular eruption, represents early herpes zoster.The histopathological changes of herpes simplex,herpes zoster, and varicella are considered to beindistinguishable from one another. Evaluation of the clinical setting, with adjunctive studies if necessary, generally clarifies the specific diagnosis. Vesicular lesions in all three conditions can involve epidermal and adnexal epithelium with characteristic cytopathic features. We describe three patients with non- vesicular eruptions on the head and neck whose biopsies revealed exclusive folliculosebaceous involvement by herpes. All three patients developed typical herpes zoster within days of the biopsy. There is compelling scientific evidence in the literature indicating that, in herpes zoster, the virus is transported from dorsal root or trigeminal ganglia via myelinated nerves to the skin. These terminate at the isthmus of hair follicles and primary infection of follicular and sebaceous epithelium occurs. Spread of infection to the epidermis follows. In contrast, data pertaining to recurrent herpes simplexindicates that axonaltran sport of the virus from sensory ganglia to the skin is directed primarily to the epidermis, via terminal non- myel- inated nerve twigs. The clinical evolution of our three cases and scientific data in the literature indicate that exclusive folliculosebaceous involvement by herpes, in the setting of a non- vesicular eruption, represents early herpes zoster.

关 键 词：毛囊皮脂腺单位 带状疱疹 复发性单纯疱疹 三叉神经节 附属器 腺上皮 组织病理学改变 感觉神经节 细胞病理 有髓神经 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]