什么是 "湿疹"?

Yoshiki Tokura, Marina Yunoki, Shumpei Kondo, Masaki Otsuka
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摘要

湿疹是炎症性皮肤病中最常见的一类,因为皮肤科医生在日常工作中会遇到很多湿疹患者。湿疹有三大形态特征:多针尖状态、多形性和瘙痒。为了描述多形性,德国/日本皮肤病学界使用了 "湿疹三角 "一词。多针点相当于许多微小的病灶,单个丘疹/疱疹就是从这些病灶中产生的。多形性反映了急性湿疹中红斑、丘疹、血清丘疹、水疱、脓疱、鳞屑和结痂的构成。而慢性湿疹则表现为苔藓化和色素沉着,也可能表现为色素减退。在急性湿疹中,海绵状增生与透明质酸过度分泌、自我保护的 galectin-7 分泌和 E-cadherin 表达减少有关。在真皮上层,Th1/Tc1 或 Th2/Tc2 以及额外的 Th17、Th22 和/或 Tc22 细胞浸润,这取决于每种湿疹疾病。先天性淋巴细胞也参与了湿疹的形成。在慢性湿疹中,表皮生长因子(periostin)有助于炎症皮肤的重塑和真皮纤维化,表皮黑色素生成和真皮色素沉积导致色素沉着。最后,湿疹疾病可能会增加合并症的风险,其中不仅包括其他过敏性疾病,还包括冠心病和抑郁症等精神问题。虽然湿疹的原词源自古希腊语 "ekzein",但湿疹仍然是现代科学和新型疗法的主要目标。
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What is "eczema"?

Eczema is the most common category of inflammatory skin disorders as dermatologists see many patients with eczematous diseases in daily practice. It is characterized by the three major morphological features: multiple-pinpoint condition, polymorphism, and itch. To describe polymorphism, "eczema triangle" has been used in German/Japanese dermatology. The multiple pinpoints correspond to numerous tiny foci from which individual papules/vesicles arise. The polymorphism betrays composition of erythema, papule, seropapule, vesicle, pustule, scale, and crust, which are seen in acute eczema. Meanwhile, chronic eczema is represented by lichenification and hyperpigmentation, and possibly by hypopigmentation. In acute eczema, spongiosis is associated with overproduction of hyaluronic acid, secretion of self-protective galectin-7, and decreased expression of E-cadherin. In the upper dermis, Th1/Tc1 or Th2/Tc2, and additional Th17, Th22, and/or Tc22 infiltrate, depending on each eczematous disease. Innate lymphoid cells are also involved in the formation of eczema. In chronic eczema, periostin contributes to remodeling of inflammatory skin with dermal fibrosis, and epidermal melanogenesis and dermal pigment deposition result in hyperpigmentation. Finally, eczematous diseases are potentially associated with increased risk of comorbidities, including not only other allergic diseases but also coronary heart disease and mental problems such as depression. Although the original word for eczema is derived from old Greek "ekzein," eczema remains a major target of modern science and novel therapies.

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