Karimi Karen, Odhav Ashika, Kollipara Ramya, Fike Jesse, Stanford Carol, Hall John C
1 Texas Tech University Health Sciences Center, Department of Dermatology, Lubbock, TX, USA.
2 National Jewish Health, Department of Allergy and Immunology, Denver, CO, USA.
J Cutan Med Surg. 2017 Sep/Oct;21(5):425-437. doi: 10.1177/1203475417708164. Epub 2017 May 4.
Acute cutaneous necrosis is characterised by a wide range of aetiologies and is associated with significant morbidity and mortality, warranting complex considerations in management. Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin. This review discusses major causes of cutaneous necrosis, examines the need for early assessment, and integrates techniques related to diagnosis and management. The literature, available via PubMed, on acute cutaneous necrotic syndromes was reviewed to summarise causes and synthesise appropriate treatment strategies to create a clinician's guide in the early diagnosis and management of acute cutaneous necrosis. Highlighted in this article are key features associated with common causes of acute cutaneous necrosis: warfarin-induced skin necrosis, heparin-induced skin necrosis, calciphylaxis, pyoderma gangrenosum, embolic phenomena, purpura fulminans, brown recluse spider bite, necrotising fasciitis, ecthyma gangrenosum, antiphospholipid syndrome, hypergammaglobulinemia, and cryoglobulinemia. This review serves to increase recognition of these serious pathologies and complications, allowing for prompt diagnosis and swift limb- or life-saving management.
急性皮肤坏死病因多样，与显著的发病率和死亡率相关，在治疗中需要综合多方面因素考量。对于皮肤突然出现的坏疽性变化，早期识别在诊断和治疗中至关重要。本综述讨论了皮肤坏死的主要原因，探讨了早期评估的必要性，并整合了与诊断和治疗相关的技术。通过PubMed检索了有关急性皮肤坏死综合征的文献，以总结病因并综合适当的治疗策略，为临床医生提供急性皮肤坏死早期诊断和治疗的指南。本文重点介绍了与急性皮肤坏死常见病因相关的关键特征：华法林诱导的皮肤坏死、肝素诱导的皮肤坏死、钙过敏、坏疽性脓皮病、栓塞现象、暴发性紫癜、棕色隐士蜘蛛咬伤、坏死性筋膜炎、坏疽性臁疮、抗磷脂综合征、高球蛋白血症和冷球蛋白血症。本综述旨在提高对这些严重病症和并发症的认识，以便及时诊断并迅速采取挽救肢体或生命的治疗措施。
