Division of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Department of Nephrology and Rheumatology, Kyorin University School of Medicine/Internal Medicine, Kichijoji Asahi Hospital, Tokyo, Japan.
J Dermatol. 2020 May;47(5):534-537. doi: 10.1111/1346-8138.15273. Epub 2020 Feb 24.
We developed a questionnaire to examine the findings of cutaneous arteritis among dermatological specialists experienced in vasculitis as certified by the Committee for guidelines for the management of vasculitis and vascular disorders of the Japanese Dermatological Association. We sent a questionnaire to 12 dermatological facilities identified through the revised Committee for guidelines for the management of vasculitis and vascular disorders of the Japanese Dermatological Association. Retrospective data obtained from 84 patients at the 12 dermatological facilities between 2012 January 2016 December were evaluated. The 84 patients were categorized into two groups, a systemic steroid treatment group (group 1, n = 52) and a no systemic steroid treatment group (group 2, n = 32). C-reactive protein in group 1 patients was significantly higher than that in group 2 patients. Frequency of fever, arthritis, myalgia- and peripheral neuropathy in group 1 was significantly higher than that in group 2. We propose that these symptoms could serve as early markers for the transfer from cutaneous arteritis to systemic polyarteritis nodosa. We further suggest that patients who are subsequently associated with cerebral hemorrhage and infarction, who are originally diagnosed as having cutaneous arteritis, could progress to systemic polyarteritis nodosa. The study demonstrated that it is important for dermatologists to detect these findings early in order to establish an accurate diagnosis and a timely treatment.
我们开发了一份问卷,以调查日本皮肤科协会血管炎与血管疾病委员会认证的血管炎专家对皮肤动脉炎的发现。我们向通过修订后的日本皮肤科协会血管炎与血管疾病委员会管理指南的 12 个皮肤科机构发送了一份问卷。对这 12 个皮肤科机构在 2012 年 1 月至 2016 年 12 月期间的 84 例患者的回顾性数据进行了评估。将这 84 例患者分为两组,即全身性皮质类固醇治疗组(第 1 组,n=52)和非全身性皮质类固醇治疗组(第 2 组,n=32)。第 1 组患者的 C 反应蛋白显著高于第 2 组患者。第 1 组患者发热、关节炎、肌痛和周围神经病的频率明显高于第 2 组患者。我们提出,这些症状可能作为从皮肤动脉炎向系统性结节性多动脉炎转变的早期标志物。我们进一步建议,最初被诊断为皮肤动脉炎但随后与脑出血和脑梗死相关的患者可能会进展为系统性结节性多动脉炎。该研究表明,皮肤科医生及早发现这些发现对于建立准确的诊断和及时的治疗非常重要。