Xu Lisa Y, Esparza Edward M, Anadkat Milan J, Crone Kimberley G, Brasington Richard D
Rheumatology and Dermatology, Department of Internal Medicine and Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University School of Medicine, St. Louis, MO, USA.
Semin Arthritis Rheum. 2009 Apr;38(5):348-60. doi: 10.1016/j.semarthrit.2008.01.007. Epub 2008 Mar 20.
To discuss the clinical features, diagnostic evaluation, and treatment options for cutaneous vasculitis.
The literature in the PubMed database was reviewed regarding the presentation, pathophysiology, clinical workup, and treatment of cutaneous vasculitis.
Available classification criteria of vasculitis are based on histopathologic criteria or clinicohistologic features. These have been designed more for research purposes than for clinical application. Skin findings such as palpable purpura, nodules, urticaria, ulcers, and infarction are clues to the presence of vasculitis. Pathologic findings of fibrinoid necrosis, infiltration by neutrophils or lymphocytes, and deposition of complement and immunoglobulin may be helpful in reaching a specific diagnosis. However, there is considerable overlap across different conditions.
The correct diagnosis of cutaneous manifestations of vasculitis requires an understanding of vasculitis classification, recognition of specific clinical patterns, and the ability to interpret histopathologic data.
探讨皮肤血管炎的临床特征、诊断评估及治疗方案。
回顾了PubMed数据库中有关皮肤血管炎的表现、病理生理学、临床检查及治疗的文献。
现有的血管炎分类标准基于组织病理学标准或临床组织学特征。这些标准更多是为研究目的而设计,而非临床应用。皮肤表现如可触及的紫癜、结节、荨麻疹、溃疡和梗死是血管炎存在的线索。纤维蛋白样坏死、中性粒细胞或淋巴细胞浸润以及补体和免疫球蛋白沉积的病理表现可能有助于做出明确诊断。然而,不同情况之间存在相当大的重叠。
正确诊断血管炎的皮肤表现需要了解血管炎分类、识别特定临床模式以及解读组织病理学数据的能力。