Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Department of Dermatology, University of California, San Francisco, California.
J Am Acad Dermatol. 2020 Apr;82(4):783-796. doi: 10.1016/j.jaad.2019.07.112. Epub 2019 Aug 31.
Retiform purpura is a specific morphology within the spectrum of reticulate eruptions of vascular origin. It develops when blood vessels serving the skin are compromised resulting in downstream cutaneous ischemia, purpura, and necrosis. Identifying retiform purpura is important particularly in the acutely ill patient. It may elucidate the underlying diagnosis, provide prognostic information, and suggest a treatment approach. The differential diagnosis of retiform purpura is vast, reflecting the myriad conditions that can lead to cutaneous vessel wall damage or lumen occlusion. In this article, we give an overview of the differential diagnosis of this cutaneous morphology, provide an approach to workup, and highlight updates in treatment of some of the more common conditions that manifest as retiform purpura.
网状青斑是血管源性网状皮损的一种特殊形态。当皮肤供血血管受损导致下游皮肤缺血、出现瘀斑和坏死时,就会出现网状青斑。特别在急性病患者中,识别网状青斑很重要。它可以明确潜在的诊断,提供预后信息,并提示治疗方法。网状青斑的鉴别诊断范围广泛,反映了许多可能导致皮肤血管壁损伤或管腔阻塞的疾病。本文概述了这种皮肤形态的鉴别诊断,提供了一种检查方法,并重点介绍了一些常见表现为网状青斑的疾病的治疗更新。