Shaposhnikov O K, Khaizov I E
Vestn Dermatol Venerol. 1990(9):4-8.
The notion of a trophic ulcer is nosologically indefinite at present. Basing on current understanding of the pathogenesis of the processes that underlie the development of trophic ulcers on the lower limbs, the authors present a classification of such ulcers. They suggest a working scheme of trophic ulcers pathogenesis; according to this scheme, impaired blood microcirculation [correction of microhemocirculation] in the skin underlies the development of trophic ulcers on the lower limbs. These disorders involve hemocoagulation, angiopathic, and chronic inflammatory processes in the derma, that lead to necrosis and sclerosis of dermal connective tissue. Contribution of the body reactivity characteristics to the formation of trophic ulcers is discussed, as are the role of skin morphofunctional features and of exogenous factors. The authors believe that closely related pathogenetic mechanisms of trophic ulcer development imply treatment with the same complex of therapeutic modalities.
目前，营养性溃疡在疾病分类学上尚无明确定义。基于目前对下肢营养性溃疡发生过程发病机制的理解，作者提出了此类溃疡的分类方法。他们提出了营养性溃疡发病机制的一个实用方案；根据该方案，下肢皮肤血液微循环[微血流循环的纠正]受损是营养性溃疡发生的基础。这些紊乱涉及血液凝固、血管病变以及真皮中的慢性炎症过程，进而导致真皮结缔组织的坏死和硬化。文中讨论了机体反应性特征对营养性溃疡形成的作用，以及皮肤形态功能特征和外源性因素的作用。作者认为，营养性溃疡发展的密切相关发病机制意味着采用相同的综合治疗方式进行治疗。
