Kelly Robert I, Wee Edmund, Tancharoen Chasari, Tam Mei M, Balta Showan, Williams Richard A
Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Department of Anatomical Pathology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Australas J Dermatol. 2018 May;59(2):e127-e132. doi: 10.1111/ajd.12679. Epub 2017 Jul 28.
We describe three patients who presented with a striking erythematous non-blanching annular eruption and features of lymphocytic thrombophilic arteritis (LTA), with a prominent lymphocytic vasculitis involving deep dermal vessels. Lymphocytic inflammation was also evident in the superficial vessels and one patient had small superficial ulcers over the ankle area resembling livedoid vasculopathy (LV). Multiple biopsies demonstrated a persistent absence of neutrophils in the infiltrate consistent with a lymphocytic process. In addition to highlighting the annular morphology as a novel presentation of LTA, these cases suggest a possible relationship between LV and LTA and support the notion that they are distinct from neutrophilic vasculitides such as cutaneous polyarteritis nodosa.
我们描述了三名患者,他们表现出显著的红斑性非压褪色环状皮疹以及淋巴细胞性血栓形成性动脉炎(LTA)的特征,伴有累及真皮深层血管的显著淋巴细胞性血管炎。浅表血管中也可见淋巴细胞炎症,一名患者在脚踝区域有类似萎缩性肢端皮炎(LV)的小浅表溃疡。多次活检显示浸润中持续缺乏中性粒细胞,符合淋巴细胞性病变。除了强调环状形态是LTA的一种新表现外,这些病例提示LV与LTA之间可能存在关联,并支持它们与诸如皮肤结节性多动脉炎等中性粒细胞性血管炎不同的观点。