皮肤红细胞外溢在慢性静脉疾病中的表现。

Skin erythrodiapedesis during chronic venous disorders.

机构信息

Department of Anatomy, Sapienza University of Rome, Rome, Italy.

出版信息

J Vasc Surg. 2011 Jun;53(6):1649-53. doi: 10.1016/j.jvs.2011.01.045.

DOI:10.1016/j.jvs.2011.01.045

PMID:21609798

Abstract

BACKGROUND

Extravasation of erythrocytes (erythrodiapedesis [ED]) is currently included among causes of skin damage in legs with chronic venous disorders (CVD) and ascribed to venular hypertension. ED is followed by erythrocyte disruption, degradation of hemoglobin, and storing of ferric iron into hemosiderin. The aim of this study was to evaluate the occurrence of ED in the skin of legs with different clinical stages of CVD.

METHODS

One hundred eighteen skin biopsies from legs with CVD underwent histologic evaluation for ED and hemosiderin deposition (HD).

RESULTS

ED was found in only 21/118 specimens. In particular, it was found in ulcer samples, in tissues surrounding varicophlebitis and, finally, in acute eczematous skin. ED was found in only 15/30 samples showing HD.

CONCLUSION

Our findings confirm the occurrence of ED during CVD. However, it was found only in concomitance of severe dermal inflammation. Hemosiderin deposition in the absence of actual ED could be explained with previous healed episodes of skin inflammation. However, ED is not likely the only cause of skin iron overload, which could also occur by a molecular mechanism. Further studies are needed to define the mechanism of iron deposition in the skin of legs afflicted with CVD.

摘要

背景

红细胞外渗（红细胞溢出[ED]）目前被认为是慢性静脉疾病（CVD）腿部皮肤损伤的原因之一，并归因于静脉高压。ED 后会发生红细胞破裂、血红蛋白降解以及铁离子储存为含铁血黄素。本研究旨在评估不同临床阶段 CVD 腿部皮肤中 ED 的发生情况。

方法

对 118 例 CVD 腿部皮肤活检标本进行 ED 和含铁血黄素沉积（HD）的组织学评估。

结果

仅在 21/118 个标本中发现 ED。特别是在溃疡样本、静脉曲张炎周围组织以及急性湿疹性皮肤中发现了 ED。在显示 HD 的 15/30 个样本中仅发现 ED。

结论

我们的发现证实了 ED 在 CVD 期间的发生。然而，仅在严重的皮肤炎症同时存在时才发现 ED。在没有实际 ED 的情况下发生含铁血黄素沉积，可以用先前已愈合的皮肤炎症发作来解释。然而，ED 不太可能是导致 CVD 腿部皮肤铁过载的唯一原因，也可能通过分子机制发生。需要进一步的研究来确定 CVD 腿部皮肤中铁沉积的机制。