Alterações dos folículos pilo-sebáceos em um caso de sindromo bolhoso do grupo pênfigo: presença de inclusões intranucleares das doenças por virus filtraveis

Abstract

Tendo a oportunidade de estudar fragmentos de pele retirados de diversas regiões, algumas providas de abundante revestimento capilar, em um caso de autopsia de doente com sindromo bolhoso do grupo pênfigo, chamaram a nossa atenção as alterações histologicas dos folículos pilo-sebaceso, sôbre as quais não encontramos referencia especial na literatura que nos foi dado consultar.<br>Several skin fragments were available for histological study some of them from hairy regions in a case of pemphigus vulgaris observed in Asunción, Paraguay, which came to autopsy. The lesions on the skin are similar to those described in "fogo selvagem", a subtype of pemphigus which is endemic and sometimes epidemic in South America. The hair follicle shows hyperplasia of the outer sheath (acanthosis), acantholysis, dyskeratosis as well as necrosis of epithelial cells, dilatation of its mouth, loosening and loos of the hair. The first changes mentioned are more or less similar to those described in the epidermis. The striking finding, however, is the presence in some of them of intranuclear inclusion bodies in most cells of the outer sheath. The enlarged nuclei show thickening of the nuclear membrane and condensation of most intranuclear structures in acidophilic corpuscles of irregular shape, sometimes single, other times multiple, always separated from the nuclear membrane by a clear space apparently deprived of structure. Remaining portions of the linin reticulum are sometimes recognised besides the inclusion bodies. Minute granules suggestive of elementary corpuscles appear scattered in other nuclei faintly blue stained (advanced stages of the intranuclear inclusion bodies?). Intranuclear inclusion bodies could be demonstrated also in the epithelial cells of sebaceous glands which presented changes similar to those found in the hair follicles, but never in the cells of the epidermis. The histological changes in the epidermis however were quite similar to those just mentioned in the above structures