Pacientka po 4 týždňoch liečebného pobytu s dg. F10.2 (syndróm závislosti od alkoholu) pozorovala náhly výskyt kožných erupcií vo forme papúl takmer na celom tele. Po 9 týždňoch trvania choroby navštívila dermatológa, ktorý stav diagnostikoval ako pityriasis lichenoides. Histologicky boli zistené cysticky dilatované folikuly s náplňou keratínu aj parakeratotických hmôt a s časťami fragmentovaného kolagénu, so zápalovou celulizáciou. Ložiskovo sa nachádzali perforácie infundibulárneho epitelu s tkanivovou debris. V okolí atakovaných folikulov bola obrovskobunková zápalová reakcia s fragmentovanými kolagénovými aj elastickými zvyškami vláken. Histologický aj klinický obraz bol uzavretý ako folliculitis perforans-entita zo skupiny perforujúcich kožných chorôb.

A 26-year-old woman suddenly noticed an onset of disseminated papular exanthema during her institutional treatment for alcohol abuse. After 9 weeks of slowly progressive course a dermatologist was consulted, who suggested a diagnosis of pityriasis lichenoides. Skin biopsy revealed cystical enlargement of hair follicles that were filled up with keratinous and parakeratotic masses interspersed with particles of fragmented collagen. Numerous inflammatory cells were present within the lesion. Many focal perforations of infundibular epithelium draining a cellular debris were prominent. Severely disturbed follicles were engulfed by giant cell inflammatory infitrate containing remnants of collagen and elastic fibers. Considering all the histopathologic findings and clinical course, the case was finally diagnosed as perforating folliculitis, a distinct type from the family of perforating dermatoses.

Ústav patologickej anatómie JLF Martin Univ Kom Bratislava

Perforating folliculitis. Case report and differential diagnosis

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