Francès C, Barete S, Soria A
Service de dermatologie-allergologie, hôpital Tenon, université Paris-VI, 4, rue de la Chine, 75020 Paris, France.
Rev Med Interne. 2012 Apr;33(4):200-5. doi: 10.1016/j.revmed.2011.10.003. Epub 2011 Nov 10.
A wide variety of dermatologic manifestations has been described in the antiphospholipid syndrome (APS). The most frequent skin lesion is livedo reticularis, present not only on the limbs but also on the trunk, with a fine irregular pattern. It belongs to the arterial subset of APS. Circumscribed ulcerations, resembling livedoid vasculitis, may be the first manifestation of APS. Ulcerations may also occur as a late complication of recurrent venous thrombosis. Extensive skin necrosis is a classic manifestation of catastrophic APS. Pseudo-vasculitis lesions are misdiagnosed if a skin biopsy is not performed, especially in the context of systemic lupus erythematosus. In systemic lupus erythematosus, primary anetoderma is always associated with antiphospholipid antibodies.
抗磷脂综合征(APS)已被描述有各种各样的皮肤表现。最常见的皮肤损害是网状青斑,不仅出现在四肢,也出现在躯干,呈细小不规则图案。它属于APS的动脉亚型。局限性溃疡,类似青斑样血管炎,可能是APS的首发表现。溃疡也可能作为复发性静脉血栓形成的晚期并发症出现。广泛的皮肤坏死是灾难性APS的典型表现。如果不进行皮肤活检,假血管炎病变会被误诊,尤其是在系统性红斑狼疮的情况下。在系统性红斑狼疮中,原发性皮肤松弛症总是与抗磷脂抗体相关。