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红斑狼疮的皮肤表现谱。

The Cutaneous Spectrum of Lupus Erythematosus.

机构信息

Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.

Center of Research of Immunopathology and Rare Diseases- Department of Clinical and Biological Sciences, University of Turin, San Giovanni Hospital, Turin, Italy.

出版信息

Clin Rev Allergy Immunol. 2017 Dec;53(3):291-305. doi: 10.1007/s12016-017-8627-2.

Abstract

Systemic lupus erythematosus is a complex autoimmune disease with a wide spectrum of clinical and immunopathological features. Cutaneous and articular manifestations are the most common signs in patients with systemic lupus erythematosus. We here review the pathogenesis and the new classification of cutaneous lupus erythemathosus with a discussion of the significance of the various cutaneous signs. The lesions are classified according to the level of the cellular infiltrate and tissue damage in the epidermis, dermis, and/or subcutis. Furthermore, cutaneous lesions pointing to the presence of a thrombotic vasculopathy and those due to a distinct inflammatory, neutrophilic-mediated reaction pattern are highlighted. Particular attention will be given in describing the histology of skin manifestation. Treatment options for cutaneous lupus erythemathosus have increased with the introduction of new biological therapies. However, the majority of the patients still benefit from antimalarials, which remain the cornerstone of treatment. The evaluation and management of cutaneous lupus erythemathosus patients depend on the clinical findings and associated symptoms.

摘要

系统性红斑狼疮是一种复杂的自身免疫性疾病,具有广泛的临床和免疫病理学特征。皮肤和关节表现是系统性红斑狼疮患者最常见的体征。我们在此回顾了皮肤红斑狼疮的发病机制和新分类,并讨论了各种皮肤表现的意义。病变根据表皮、真皮和/或皮下细胞浸润和组织损伤的程度进行分类。此外,突出了提示血栓性血管病变和由于独特的炎症、中性粒细胞介导的反应模式导致的皮肤病变。特别注意描述皮肤表现的组织学。随着新型生物疗法的引入,治疗皮肤红斑狼疮的选择有所增加。然而,大多数患者仍受益于抗疟药,这些药物仍然是治疗的基石。皮肤红斑狼疮患者的评估和管理取决于临床发现和相关症状。

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