Seishima Mariko, Oyama Zuiei, Oda Makiko
Department of Dermatology, Ogaki Municipal Hospital, Minaminokawa-cho 4-86, Ogaki City, 503-8502, Japan.
Eur J Dermatol. 2004 Jul-Aug;14(4):255-8.
Microscopic polyangiitis (MPA) is a systemic vasculitis histologically characterized by small-vessel involvement. Antineutrophil cytoplasmic antibodies (especially anti-myeloperoxidase antibodies) (MPO-ANCA) are often positive in serum. Although the skin is affected in 20-70% of patients, the precise description has been limited. This retrospective study analyzed clinical manifestations in patients of MPA with skin eruptions. Ten patients with skin eruptions diagnosed as MPA according to Chapel Hill consensus criteria consisted of 6 men and 4 women aged from 38 to 80 years (62.1 +/- 13.3). Clinical manifestations, laboratory data, and histological findings were examined. Purpura and petechiae in 6 patients, livedo in 2 patients, and erythema in 7 patients, especially erythema on the hands and\or fingers in 4 patients, were observed. Histological findings from the eruptions in 7 patients showed perivascular lymphocyte infiltration in the upper dermis in 4 patients, and infiltration of lymphocytes and a few neutrophils around small arteries in the middle to deep dermis in 2 patients and diffuse infiltration of histiocytes and lymphocytes in the middle dermis in 1 patient. Cutaneous involvements in MPA showed a wide spectrum of clinical and histological findings.
显微镜下多血管炎(MPA)是一种系统性血管炎,组织学特征为小血管受累。抗中性粒细胞胞浆抗体(尤其是抗髓过氧化物酶抗体)(MPO-ANCA)在血清中常呈阳性。虽然20%-70%的患者皮肤会受累,但确切描述有限。这项回顾性研究分析了有皮肤疹的MPA患者的临床表现。根据查珀尔希尔共识标准诊断为MPA的10例有皮肤疹的患者,包括6名男性和4名女性,年龄38至80岁(平均62.1±13.3岁)。检查了临床表现、实验室数据和组织学发现。观察到6例患者有紫癜和瘀点,2例患者有网状青斑,7例患者有红斑,尤其是4例患者手部和/或手指有红斑。7例患者皮疹的组织学发现显示,4例患者真皮浅层血管周围有淋巴细胞浸润,2例患者真皮中深层小动脉周围有淋巴细胞和少量中性粒细胞浸润,1例患者真皮中层有组织细胞和淋巴细胞弥漫性浸润。MPA患者的皮肤受累表现出广泛的临床和组织学特征。