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[血管性溃疡的诊断与治疗]

[Diagnosis and treatment of vasculitic ulcerations].

作者信息

Mitschang C, Görge T

机构信息

Klinik fürHautkrankheiten, Universitätsklinikum Münster, Von-Esmarch-Str. 58, 48149, Münster, Deutschland.

出版信息

Hautarzt. 2020 Nov;71(11):870-879. doi: 10.1007/s00105-020-04694-0.

Abstract

Vasculitis is a rare cause of skin ulceration. Depending on the size of the affected vessel, the patient's comorbidities and the pathophysiology present, different clinical morphologies can be seen, which can often give preliminary indications of the type of underlying vasculitis. There may be systemic or cutaneous manifestations; thus, a targeted diagnostic workup should be initiated at an early stage. Treatment should be interdisciplinary if there is systemic participation. Vasculopathies (e.g., livedoid vasculopathy), in which occlusion of the vascular lumen is the main pathophysiological feature, should be delimitated from vasculitis. If vasculitic or vasculopathic ulceration is present, stage-appropriate wound management is recommended.

摘要

血管炎是皮肤溃疡的罕见病因。根据受累血管的大小、患者的合并症以及当前的病理生理学情况,可出现不同的临床形态,这往往能为潜在血管炎的类型提供初步线索。可能存在全身或皮肤表现;因此,应在早期开展有针对性的诊断检查。如果有全身受累情况,治疗应采取多学科方法。血管病(如青斑样血管病)应以血管腔闭塞为主要病理生理特征,应与血管炎相鉴别。如果存在血管炎性或血管病性溃疡,建议进行符合分期的伤口处理。

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