Simon R W, Fritz T, Amann-Vesti B R, Romer G Schenk, Fischer B, Kägi M K
Dermatology Center, Schaffhauserstr. 355, Zürich, Switzerland.
Vasa. 2005 May;34(2):128-30. doi: 10.1024/0301-1526.34.2.128.
A 77-year-old-man with giant cell arteritis who developed bitemporal scalp ulcerations is described. Since 1946 when Cooke et al. reported the first case of scalp necrosis there were approximately 55 cases published. Scalp ulceration is a rare complication of giant cell arteritis and occurs mainly in elderly persons, particularly women. About half of all patients were presented to dermatologists. Most of the patients (70%) had other serious complications of giant cell arteritis: blindness, gangrene of the tongue and nasal septum necrosis. Seventy percent of the cases were confirmed by a temporal artery biopsy. The necrosis were of varying extent and uni- or bilateral. Although, in most cases necrosis has been located bilaterally as in the presented case. Scalp healing was complete nearly in all patients by conservative treatment within a year. Scalp ulceration is a potentially reversible complication of giant cell arteritis which indicates extensive vessel involvement and adequate coricosteroid therapy is required and essential.
本文描述了一名77岁患巨细胞动脉炎并出现双侧颞部头皮溃疡的男性患者。自1946年库克等人报告首例头皮坏死病例以来，约有55例相关病例发表。头皮溃疡是巨细胞动脉炎的一种罕见并发症，主要发生在老年人，尤其是女性。约半数患者曾就诊于皮肤科医生。大多数患者（70%）患有巨细胞动脉炎的其他严重并发症：失明、舌坏疽和鼻中隔坏死。70%的病例经颞动脉活检确诊。坏死范围各异，可为单侧或双侧。尽管在大多数病例中，如本病例一样坏死为双侧性。几乎所有患者经保守治疗后在一年内头皮均完全愈合。头皮溃疡是巨细胞动脉炎一种潜在可逆的并发症，提示血管广泛受累，需要且必须进行充分的糖皮质激素治疗。
