Crowson A Neil, Mihm Martin C, Magro Cynthia M
Dermatology and Pathology, University of Oklahoma, Tulsa, OK, USA.
J Cutan Pathol. 2003 Mar;30(3):161-73. doi: 10.1034/j.1600-0560.2003.00033.x.
As the skin is commonly involved in systemic vasculitic disorders as well as those hypersensitivity states whose expression is largely skin-confined, cutaneous vasculitic lesions offer a window to diagnosis and a ready source of accessible tissue for biopsy. In this review, we discuss the pathologic manifestations of chronic vasculitic syndromes such as granuloma faciale and erythema elevatum diutinum; IgA-associated vasculitis including Henoch-Schonlein purpura; vasculitis seen in the setting of cryoglobulinemia and hypergammaglobulinemia of Waldenstrom, hereditary deficiencies of complement, and IgA deficiency; those leukocytoclastic vasculitides resulting from hypersensitivity reactions to drug, chemical and foodstuff ingestion; and those vasculitides seen in patients with systemic diseases such as polyarteritis nodosa, rheumatoid arthritis, mixed connective tissue disease, systemic lupus erythematosus, Sjogren's syndrome, relapsing polychondritis, Behcet's disease, Wegener's granulomatosis, and allergic granulomatosis of Churg and Strauss.
由于皮肤通常会累及系统性血管炎疾病以及那些主要局限于皮肤表现的超敏反应状态,皮肤血管炎性病变为诊断提供了一个窗口,也是用于活检的现成且易获取的组织来源。在本综述中,我们讨论慢性血管炎综合征的病理表现,如面部肉芽肿和持久性隆起性红斑;与IgA相关的血管炎,包括过敏性紫癜;在冷球蛋白血症、瓦尔登斯特伦高球蛋白血症、补体遗传性缺陷和IgA缺乏情况下出现的血管炎;由对药物、化学物质和食物摄入的超敏反应引起的白细胞破碎性血管炎;以及在系统性疾病患者中出现的血管炎,如结节性多动脉炎、类风湿性关节炎、混合性结缔组织病、系统性红斑狼疮、干燥综合征、复发性多软骨炎、白塞病、韦格纳肉芽肿以及丘格和施特劳斯过敏性肉芽肿。