Horev Amir, Etzion Ohad, Halevy Sima
Department of Dermatology and Venereology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, srael
Harefuah. 2010 Mar;149(3):157-60, 195, 194.
Cutaneous necrotizing vasculitis is usually induced by an acute infection or exposure to a drug. Cutaneous vasculitis may precede severe systemic involvement, and may end in death. Accordingly, diagnosis of cutaneous vasculitis, identification of etiological factors, follow-up for systemic involvement and treatment are important. The authors present a case study of a 58-year-old male with fever and extensive eruption involving the trunk and extremities which appeared two days after initiation of treatment with oral naproxen. The clinical and histological findings were consistent with cutaneous necrotizing leukocytoclastic vasculitis. Two events of massive upper gastrointestinal bleeding occurred during treatment with systemic corticosteroids. The possible etiological factors and the mechanisms involved in the induction of the vasculitis and the gastrointestinal bleeding are discussed.
皮肤坏死性血管炎通常由急性感染或接触某种药物引起。皮肤血管炎可能先于严重的全身受累出现,甚至可能导致死亡。因此,皮肤血管炎的诊断、病因识别、全身受累情况的随访及治疗都很重要。作者报告了一例58岁男性患者的病例研究,该患者在开始口服萘普生治疗两天后出现发热,躯干和四肢出现广泛皮疹。临床和组织学检查结果符合皮肤坏死性白细胞破碎性血管炎。在全身使用糖皮质激素治疗期间发生了两次严重的上消化道出血。文中讨论了可能的病因以及血管炎和胃肠道出血发生的相关机制。