The Clinical And Pathological Analysis Of Pityriasis Lichenoides Et Varioliformis Acuta

Objective:Pityriasis lichenoides et varioliformis acuta(PLEVA)is a rare inflammatory skin disease,whose exact incidence and etiology are not yet clear.This study analyzed and summarized the epidemic characteristic,clinical manifestations and pathological features of 60 PLEVA patients.To further explore the etiology of PLEVA by detecting the expresssion of Myxovirus resistance protein A(MxA)in PLEVA with SP,provide help for clinical treatment and prognosis.Methods:The clinical data of 60 PLEVA patients diagnosed in outpatient and inpatient departments of our hospital from January 2008 to January 2018 were retrospectively analyzed.The general data,clinical manifestations,laboratory examinations,histopathological features and other clinical data of the PLEVA patients which including central type,diffuse type and peripheral type were statistically analyzed.Skin lesion tissue samples of PLEVA patients and 10 normal skin tissue samples were collected,5 of which were male and 5 of which were female as the control group.Tissue sections that had been confirmed as MxA positive were used as the positive control group and the expression of MxA was detected by SP method.Result:Among the 60 PLEVA patients in our hospital,38 patients(63.3%)were male and 22 patients(36.7%)were female,with a male to female ratio of 1.73:1.The age of onset ranged from 4 to 75 years,and The mean age of onset was 27.52±1.99 years.The most common clinical type is diffuse type,which accounting for 53.33%.There were more males in diffuse type(81.25%)and more females in peripheral type(61.90%).The clinical features of 60 PLEVA patients were erythema(100%),papules(100%),scales(100%),pigmentation(96.67%),atrophic scars(85.00%),papulovesicles(53.33%),necrotic scabs(13.33%),blisters(5.00%)and pustules(3.33%).The course of disease ranged from 1 week to 1 month were common,accounting for 61.67%,and most of the concomitant symptoms were pruritus,accounting for 55%;with leukocyte or neutrophil elevation,accounting for 45%.A total of 29 hospitalized patients were tested for etiology,and the majority(17.25%)of them were positive for herpes simplex virus Ig-M.The pathological changes of 60 PLEVA patients were all accompanied by basal layer liquefactive degeneration,erythrocyte migration into the epidermis and perivascular inflammation in the superficial dermis.There were 32 cases of lymphocyte zonal infiltration,accounting for 53.33%.Vasculitis was found in only 2 cases(3.33%).No eosinophilic infiltration was observed.60 cases of PLEVA patients in histopathology have basal liquefaction degeneration,transepidermal elimination of erythrocytes and perivascular inflammation of the dermis,accounting for 100%;there were 32 cases of lymphocyte infiltration,accounting for 53.33%;vasculitis showed only 2 cases,accounting for 3.33%;The presence of eosinophils were observed in all of the patients.The expression of MxA in PLEVA group was significantly higher than that in normal control group(P<0.05).Conclusions: 1.Most of the patients with PLEVA are male,and the age of onset is mainly from 21 to 40 years old.The diffuse type was mainly observed in males,while the peripheral type was mostly in females;Clinical manifestations of PLEVA were erythema,papules and scales,and the systemic damage was less involved;Mononuclear cell elevation and viral IgM positive were more common in laboratory tests.2.Liquefacient degeneration of basal layer,erythrocyte migration into the epidermis and lymphocyte infiltration around blood vessels are Important conditions for pathological diagnosis of PLEVA.3.Viral infection may be related with the pathogenesis of PLEVA.