Delgado-Jiménez Y, Fraga J, Fernández-Herrera J, García-Diez A
Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España.
Actas Dermosifiliogr. 2007 Sep;98 Suppl 1:22-8. doi: 10.1016/s0001-7310(07)70178-3.
Sepsis is one of the commonest causes of death around the world. The real frequency of cutaneous lesions in the setting of sepsis is unknown, but when they appear, they are usually one of the earliest signs of sepsis, thus allowing a rapid diagnosis of this potentially life-threatening condition. Four are the main physiopathologic mechanisms that can induce cutaneous lesions in sepsis: a) disseminated intravascular coagulation; b) direct vessel wall invasion by the microorganism; c) immune-mediated vasculitis, and d) septic embolism. We know that more than one of these mechanisms can appear in one single patient. In this review, we analyse these four mechanisms, their clinical presentation, and the histological findings that can be found in the cutaneous biopsy.
脓毒症是全球最常见的死亡原因之一。脓毒症患者皮肤病变的实际发生率尚不清楚，但一旦出现，通常是脓毒症最早的体征之一，从而有助于对这种潜在的危及生命的疾病进行快速诊断。脓毒症中可诱发皮肤病变的主要病理生理机制有四种：a）弥散性血管内凝血；b）微生物直接侵袭血管壁；c）免疫介导的血管炎；d）脓毒性栓塞。我们知道，这些机制中的一种以上可能在同一患者身上出现。在本综述中，我们分析了这四种机制、它们的临床表现以及皮肤活检中可能发现的组织学结果。
