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[皮肤血管炎]

[Cutaneous vasculitis].

作者信息

Pulido-Pérez A, Avilés-Izquierdo J A, Suárez-Fernández R

机构信息

Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.

出版信息

Actas Dermosifiliogr. 2012 Apr;103(3):179-91. doi: 10.1016/j.ad.2011.06.001. Epub 2011 Aug 12.

Abstract

Vasculitis is a term that refers to damage and inflammation of the walls of blood vessels of any size. The classification of types of cutaneous vasculitis continues to be a challenge, probably because of our lack of understanding of the etiology and pathogenesis of this condition. Changes in the vessel wall will be visible on microscopy and will enable the different clinical forms to be distinguished according to the caliber of affected vessels, the type of cell that predominates in the inflammatory infiltrate, or the presence of such key findings as extravascular granulomas. Skin manifestations (macules, papules, nodules, livedo reticularis, etc) correlate with the size of the vessel affected. The prognosis in cases of vasculitis with skin involvement will be determined by the presence or absence of extracutaneous disease. Systemic vasculitis shows a predilection for certain organs, such as the kidney or lung. The introduction of immunosuppressant drug treatments has led to evident improvement in survival rates for patients with vasculitis. This review covers practical aspects of the pathophysiology, histopathology, treatment, and differential diagnosis of the main clinical presentations of vasculitis with cutaneous involvement.

摘要

血管炎是一个术语,指任何大小血管壁的损伤和炎症。皮肤血管炎类型的分类仍然是一项挑战,这可能是因为我们对这种疾病的病因和发病机制缺乏了解。血管壁的变化在显微镜下可见,并且能够根据受影响血管的管径、炎症浸润中占主导地位的细胞类型或血管外肉芽肿等关键发现来区分不同的临床形式。皮肤表现(斑疹、丘疹、结节、网状青斑等)与受影响血管的大小相关。伴有皮肤受累的血管炎病例的预后将取决于是否存在皮肤外疾病。系统性血管炎对某些器官(如肾脏或肺)有偏好。免疫抑制药物治疗的引入已使血管炎患者的生存率有了明显提高。本综述涵盖了伴有皮肤受累的血管炎主要临床表现的病理生理学、组织病理学、治疗及鉴别诊断的实际方面。

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