A Histological Study on Pustulosis Palmaris et Plantaris

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  • 掌蹠膿疱症の組織学的検討
  • ショウセキノウホウショウ ノ ソシキガクテキ ケントウ

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Abstract

The histological study was carried out on the series sections of 86 specimens obtained from 48 cases of pustulosis palmaris et plantaris, 1 case of trichophytia pompholytiformis, 3 cases of dyshidrosiform eruption, and 1 case of nummular eczema in a hand. The results obtained are as follows. Little or no spongiosis could be seen at the surrounding of its characteristic intraepidermal unilocular pustule. It seemed, therefore, that the histogenesis of pustulosis palmaris et plantaris was not eczematic reaction, but psoriasiform tissue reaction. The histological examination of epidermis showed such various findings as slight spongiosis and altération cavitaire in the suprapapillary regions, intraepidermal bulla and pustule. These changes in epidermis reflected the intensity of the inflammation in dermis. Severe inflammatory changes in dermis were observed in patients with pustule in epidermis. Inflammation in dermis was slight in patients with spongiosis and bullae in epidermis. The histological features of psoriasis, such as parakeratosis, elongation of rete ridges, thinning of suprapapillary portions of the stratum Malpighii, dilatation of the papillary capillaries also existed on the pustulosis, but these were not so distinct. It was assumed that the process of pustule formation might be as follows. The initial change of pustule formation was the degeneration and necrosis of the individual cells in stratum Malpighii. It might be caused by the invasion of the exsudate into the suprapapillary epidermis from the severe underlying inflammatory papilla. Leucotaxis occurred consequently, and then the spongiform pustule was formed. This change gave rise to characteristic unilocular pustule by continuous and strong exosersis. No relations between pustule or bulla and sweat duct was visible. The pustle of the 1 case trichophytia pompholytiformis could not be distiguished from the pustule of the pustulosis without detecting trichophyton in the horny layer by PAS stain. Dyshidrosiform eruption showed eczematic reaction. It was not the same as the tissue reaction of the pustulosis.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 32 (1), 30-53, 1970

    Western Division of Japanese Dermatological Association

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