CAJ | 학술논문

目的探讨多形性日光疹(PLE)表皮中板层小体的分布、神经酰胺酶的表达与皮肤屏障受损的相关性.方法选取PLE患者47例及正常人对照40例,通过电镜观察两组皮损处颗粒层、棘层板层小体的数量及分布情况,运用免疫组化测定皮损处神经酰胺酶的表达,采用无创性皮肤测试仪测量皮损处经皮水分丢失(TEWL)、角质层含水量及皮脂含量.结果透射电镜结果显示:与对照组相比,PLE患者颗粒层、棘层板层小体数量明显少于正常人对照组,分布较正常人对照组紊乱.免疫组化结果显示:PLE患者皮损处神经酰胺酶表达20例阳性、21例弱阳性、6例阴性；正常人对照组中36例阳性、4例弱阳性,差异有统计学意义(P＜0.01)；皮损处TEWL(34.2191±12.70)较正常人对照组(16.8350±6.50)高,角质层含水量(22.7319±8.71)较正常人对照组(29.4250±5.08)低,差异有统计学意义(P＜0.01)；皮脂含量两者之间差异无统计学意义.结论 PLE患者存在神经酰胺合成障碍,可能是皮肤屏障受损的原因之一.
목적 탐토다형성일광진(PLE)표피중판층소체적분포、신경선알매적표체여피부병장수손적상관성.방법 선취PLE환자47례급정상인대조40례,통과전경관찰량조피손처과립층、극층판층소체적수량급분포정황,운용면역조화측정피손처신경선알매적표체,채용무창성피부측시의측량피손처경피수분주실(TEWL)、각질층함수량급피지함량.결과 투사전경결과현시:여대조조상비,PLE환자과립층、극층판층소체수량명현소우정상인대조조,분포교정상인대조조문란.면역조화결과현시:PLE환자피손처신경선알매표체20례양성、21례약양성、6례음성；정상인대조조중36례양성、4례약양성,차이유통계학의의(P＜0.01)；피손처TEWL(34.2191±12.70)교정상인대조조(16.8350±6.50)고,각질층함수량(22.7319±8.71)교정상인대조조(29.4250±5.08)저,차이유통계학의의(P＜0.01)；피지함량량자지간차이무통계학의의.결론 PLE환자존재신경선알합성장애,가능시피부병장수손적원인지일.
Objective To investigate the correlation of epidermal distribution of lamellar bodies and expression of ceramidase with skin barrier dysfunction in polymorphous light eruption.Methods Forty-seven patients with polymorphous light eruption and 40 healthy volunteers were recruited into this study.Noninvasive instruments were used to measure skin sebum content,transepidermal water loss(TEWL)and water content in stratum corneum in all of the subjects.Then,tissue specimens were obtained from the lesions at sunexposed sites in the patients and normal skin of the healthy volunteers.The ultrastructure and distribution of lamellar bodies were observed with transmission electron microscopy in five lesion and control specimens.Immunohistochemistry was performed to detect the expression of ceramidase in the tissue specimens.Results Compared with the normal skin from healthy volunteers,the lesions from patients showed decreased number of lamellar bodies in the granular layer and prick cell layer with a disorganized arrangement.Ceramidase was positively expressed in 20 lesion specimens and 36 normal control specimens,weakly expressed in 21 lesion specimens and 4 normal control specimens,and negative in 6 lesion specimens; there was a significant difference in the expression of ceramidase between the lesion specimens and normal control specimens(P ＜ 0.01).The lesions also showed high TEWL(34.2191 ± 12.70 vs.16.8350 ± 6.50,P ＜ 0.01),lower water content in stratum corneum(22.7319 ± 8.71 vs.29.4250 ± 5.08,P ＜ 0.01)and similar skin sebum content compared with the normal skin.Conclusions There is a disturbance in the synthesis of ceramide in patients with polymorphous light eruption,which may contribute to the impairment of skin barrier.