眭洪峰 邹俊仙 周梅华

[摘要]目的：探討瘢痕-毛囊炎型反常性痤疮和经典型反常性痤疮的临床和组织病理特征并进行比较，进一步揭示反常性痤疮的临床特点及发病机制。方法：纳入2017年6月-2019年6月就诊于南通大学附属丹阳医院的20例反常性痤疮患者为观察组，6名健康者为对照组。记录患者临床和穿刺病理信息后进行统计学分析。结果：共计纳入了20例16～25岁反常性痤疮患者进行观察，其中瘢痕-毛囊炎型11例（55.0%）、经典型9例（45.0%）。瘢痕-毛囊炎型患者臀部和/或腹股沟受累比例（81.8% vs 22.2%，P=0.002）、化学物品接触史（81.8%vs22.2%，P=0.002）和职业暴露史（45.5%vs0.0%，P=0.038）显著高于经典型患者。瘢痕-毛囊炎型患者病理学可有多种表现，而经典型则仅有表皮色素沉着和囊泡周围炎。瘢痕-毛囊炎型患者皮脂腺面积显著小于对照组。 结论：瘢痕-毛囊炎型反常性痤疮可有多种病变类型、病理学改变，并且皮脂腺显著萎缩，以腹股沟和臀部受累为特征，可有相关化学物质接触史等。

[关键词]反常性痤疮;瘢痕-毛囊炎型;经典型;临床特征;病理学特征

[中图分类号]R758.73+3    [文献标志码]A    [文章编号]1008-6455（2021）01-0066-04

Study on Clinical and Histopathological Characteristics of Scar Folliculitis-type Abnormal Acne

SUI Hong-feng，ZOU Jun-xian，ZHOU Mei-hua

（Department of Dermatology， Danyang People's Hospital， Danyang 212300， Jiangsu， China）

Abstract： Objective To explore the clinical and histopathological characteristics of scar-folliculitis-type abnormal acne and classic abnormal acne， and to reveal the clinical characteristics and pathogenesis of abnormal acne. Methods  Twenty patients with abnormal acne who were treated in our hospital from June 2017 to June 2019 and 6 healthy controls without known skin diseases were prospectively included. Statistical analysis was performed after recording patient clinical information and puncture pathology information. Results  Twenty patients aged 16-25 years were included in the study， including 11 cases of scarring folliculitis type （55.0%） and 9 cases of regular type （45.0%）. The incidence of gluteal and/or groin involvement （81.8% vs 22.2%， P = 0.002）， chemical exposure （81.8% vs 22.2%， P =0.002） and occupational exposure （45.5% vs 0.0%， P =0.038） in patients with scarring folliculitis type were significantly higher than those in patients with regular type. There are multi-types of pathological manifestations in patients with scarring folliculitis type，while in the classic type，only epidermal hyperpigmentation and perifollicular inflammation are found. The area of sebaceous glands in patients with scarring folliculitis type was significantly smaller than that in the control group. Conclusion The scarring folliculitis type in acne inversa in Chinese population could be characterized by depressed scars， double-ended comedones， epidermal cysts and had high proportion of smokers， or occupational exposure as well as diminished sebaceous gland.

Key words： acne inversa; scarring folliculitis;regular type; clinical characteristics; histopathological characteristics

反常性痤疮（Acne inversa，AI）又称化脓性汗腺炎（Hidradenitis suppurativa，HS）、毛囊闭锁三联征（Follicular occlusion triad，FOT）等，以反复皮肤脓肿、窦道和瘢痕形成为特征，目前其发病机制尚不清楚，可能与遗传、激素及吸烟等多种内源性和外源性因素相关[1]，可对患者生理、心理产生影响[2]。最常用于评价痤疮反转严重程度和分类的是Hurley分类法[3]，但该方法很少用于临床上皮肤病变的判断。2015年，van der Zee等进一步提出了6种临床亚型的分类方法，即：经典型、摩擦性疖肿型、瘢痕-毛囊炎型、聚合型、综合型和异位类型[4]。……