Takiwaki Hirotsugu, Adachi Atsuko, Kohno Hiroaki, Ogawa Yutaka
Department of Dermatology, The University of Tokushima School of Medicine, Japan.
J Am Acad Dermatol. 2004 Apr;50(4):585-90. doi: 10.1016/j.jaad.2003.09.025.
Various skin lesions occur in association with rheumatoid arthritis (RA).
We report a distinctive skin lesion observed in 4 patients with RA. All patients had RA for many years and developed asymptomatic, irregularly shaped erythema over the swollen elbow joints and the nearby part of the forearm. Histopathologically, all cases showed massive aggregates mainly composed of histiocytes in markedly dilated vessels in the dermis, accompanied by a dermal infiltrate of lymphocytes, plasma cells, neutrophils, or a combination of these. A total of 9 cases, including ours, showing similar histopathologic findings have been reported in the literature, of which 7 were associated with RA and presented relatively common clinical appearance.
In spite of some disagreement as to whether the dilated vessels are blood vessels or lymphatics, it is most likely that these 7 cases belong to the same clinical entity closely associated with RA.
类风湿关节炎（RA）常伴有各种皮肤病变。
我们报告了4例RA患者中观察到的一种独特皮肤病变。所有患者患RA多年，在肿胀的肘关节及前臂附近出现无症状、形状不规则的红斑。组织病理学上，所有病例均显示真皮内明显扩张的血管中主要由组织细胞构成的大量聚集物，伴有淋巴细胞、浆细胞、中性粒细胞浸润或这些细胞的组合浸润。包括我们的病例在内，文献中总共报道了9例具有相似组织病理学表现的病例，其中7例与RA相关且呈现相对常见的临床表现。
尽管对于扩张的血管是血管还是淋巴管存在一些分歧，但很可能这7例病例属于与RA密切相关的同一临床实体。
