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[皮肤型结节性多动脉炎]

[Cutaneous polyarteritis nodosa].

作者信息

Turska Monika, Parada-Turska Jolanta

机构信息

Zakład Farmakologii, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Lublin, Polska.

Katedra i Klinika Reumatologii i Układowych Chorób Tkanki Łącznej, Uniwersytet Medyczny, Lublin, Polska.

出版信息

Wiad Lek. 2018;71(1 pt 1):73-77.

Abstract

Cutaneous polyarteritis nodosa is a rare disease that affects vessels of the deep skin and the subcutaneous tissue. Its etiopathology remains unknown. It predominantly affects skin, and the main cutaneous symptoms are subcutaneous nodules, livedo reticularis, and ulcerations that are mainly located on legs. Cutaneous polyarteritis nodosa can also cause extracutaneous symptoms (fever, malaise, myalgias, arthralgias, neuropathy). It is a chronic benign disease with a relapsing course. Diagnostic criteria for this disease were recently proposed and both clinical and typical histological features must be present to confirm the diagnosis. Treatment of cutaneous polyarteritis nodosa depends on the severity of the disease and the frequency of relapses. Mild forms limited to skin lesions should be treated with nonsteroidal anti-inflammatory drugs, colchicine and locally applied glucocorticosteroids. Cases that are refractory to the treatment, that recur with extracutaneous symptoms may require applying more aggressive approach (glucocorticosteroids orally, hydroxychloroquine, azathioprine, methotrexate, mycophenolate mofetil or intravenous immunoglobulins). The prognosis in cutaneous polyarteritis nodosa is favorable and the disease rarely turns into a systemic form.

摘要

皮肤型结节性多动脉炎是一种罕见疾病,累及深部皮肤和皮下组织的血管。其病因病理尚不清楚。它主要影响皮肤,主要的皮肤症状是皮下结节、网状青斑和溃疡,主要位于腿部。皮肤型结节性多动脉炎也可引起皮肤外症状(发热、不适、肌痛、关节痛、神经病变)。它是一种具有复发病程的慢性良性疾病。最近提出了该病的诊断标准,必须同时具备临床和典型的组织学特征才能确诊。皮肤型结节性多动脉炎的治疗取决于疾病的严重程度和复发频率。局限于皮肤病变的轻度病例应使用非甾体抗炎药、秋水仙碱和局部应用糖皮质激素治疗。对治疗难治、伴有皮肤外症状复发的病例可能需要采用更积极的方法(口服糖皮质激素、羟氯喹、硫唑嘌呤、甲氨蝶呤、霉酚酸酯或静脉注射免疫球蛋白)。皮肤型结节性多动脉炎的预后良好,该病很少转变为系统性形式。

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