Reyes E, Alarcon-Segovia D
Department of Pathology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
Clin Exp Rheumatol. 1991 Jan-Feb;9(1):63-6.
Leg ulcers are associated with antiphospholipid antibodies in patients with systemic lupus erythematosus. They may also occur in patients with primary antiphospholipid syndrome(PAPS). Histopathologic findings at the edges of the ulcers may give insight into their pathogenesis. In a patient with PAPS and a leg ulcer, a biopsy of the ulcer's edge revealed a peculiar small vessel nodular proliferation in the upper and lower dermis. There was mild mixed inflammatory infiltrate in the surrounding connective tissue, a few vessels with fibrin thrombi, and some with fibrin deposition within their walls. A review of the literature revealed similar findings in other skin ulcers associated with lupus anticoagulants. This suggests peculiar pathogenetic mechanisms that may be akin to those responsible for antiphospholipid arterial vasculopathy.
腿部溃疡与系统性红斑狼疮患者的抗磷脂抗体有关。它们也可能发生在原发性抗磷脂综合征（PAPS）患者中。溃疡边缘的组织病理学发现可能有助于深入了解其发病机制。在一名患有PAPS和腿部溃疡的患者中，对溃疡边缘进行活检发现，真皮上层和下层有特殊的小血管结节状增生。周围结缔组织有轻度混合性炎性浸润，一些血管有纤维蛋白血栓，还有一些血管壁内有纤维蛋白沉积。文献回顾显示，在与狼疮抗凝物相关的其他皮肤溃疡中也有类似发现。这表明存在特殊的发病机制，可能与抗磷脂动脉血管病变的发病机制相似。
