U.O. Dermatology I, P.O. Piero Palagi, USL Toscana Centro.
Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Curr Opin Rheumatol. 2019 Jan;31(1):46-52. doi: 10.1097/BOR.0000000000000563.
Cutaneous vasculitis reflects a spectrum ranging from skin limited to severe systemic forms. To date, there is still no generally acknowledged nomenclature for cutaneous vasculitis. This review aims to summarize the recent advances in the nomenclature of cutaneous vasculitis.
The most widely adopted vasculitis classification system is the one of 2012 Revised Chapel Hill Consensus Conference (CHCC) which represent not such a classification but a nomenclature system that name vasculitis on the basis of the size of the vessel affected. The CHCC 2012 did not deal with the special features of cutaneous vasculitis and did not explicitly discuss the presence of skin-limited or skin-dominant forms of vasculitis. Therefore, a consensus group was formed to propose an Addendum to CHCC 2012, focusing on cutaneous vasculitis. The Addendum better clarify the main aspects of some single-organ vasculitis, including IgM/IgG vasculitis, nodular vasculitis, erythema elevatum et diutinum and recurrent macular vasculitis in hypergammaglobulinemia. Moreover, it differentiated normocomplementemic from hypocomplementemic urticarial vasculitis. Finally, it recognized cutaneous polyarteritis nodosa as a distinct subtype of polyarteritis nodosa.
Classification criteria are useful tools to standardize names and definitions for cutaneous vasculitis; however, they do not represent diagnostic criteria. Collaborative efforts are still needed to get a shared classification and valid diagnostic criteria for cutaneous vasculitis.
皮肤血管炎反映了一个范围,从皮肤局限到严重的系统性形式。迄今为止,皮肤血管炎仍然没有一个普遍认可的命名法。本综述旨在总结皮肤血管炎命名法的最新进展。
最广泛采用的血管炎分类系统是 2012 年修订版 Chapel Hill 共识会议(CHCC)的系统,它不是一种分类,而是一种基于受影响血管大小命名血管炎的命名系统。CHCC 2012 没有涉及皮肤血管炎的特殊特征,也没有明确讨论皮肤局限或皮肤占主导地位的血管炎形式。因此,成立了一个共识小组,提出了 CHCC 2012 的附录,重点讨论皮肤血管炎。附录更好地阐明了一些单一器官血管炎的主要方面,包括 IgM/IgG 血管炎、结节性血管炎、隆起性红斑和高丙种球蛋白血症中的复发性斑状血管炎。此外,它区分了正常补体血症性和低补体血症性荨麻疹性血管炎。最后,它承认皮肤多发性动脉炎是多发性动脉炎的一个独特亚型。
分类标准是标准化皮肤血管炎名称和定义的有用工具;然而,它们不代表诊断标准。仍需要协作努力,以获得皮肤血管炎的共享分类和有效的诊断标准。