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皮肤血管炎;一种诊断的算法方法。

Cutaneous vasculitis; An algorithmic approach to diagnosis.

作者信息

Alpsoy Erkan

机构信息

Department of Dermatology and Venereology, School of Medicine, Akdeniz University, Antalya, Turkey.

出版信息

Front Med (Lausanne). 2022 Sep 21;9:1012554. doi: 10.3389/fmed.2022.1012554. eCollection 2022.

Abstract

Vasculitides, characterized by inflammation and damage of blood vessels, encompass a broad spectrum of diseases. They can occur with different pathophysiological mechanisms and have a rich clinical heterogeneity depending on the vessel diameters they affect. Vasculitides may also present with a broad spectrum of severity, ranging from a mild self-limiting to a potentially life-threatening disease. The high prevalence of skin involvement in vasculitis, visible character and, finally, the easy accessibility of the skin for both physical examination and biopsy offers important advantages for prompt disease recognition and diagnosis. Thus, dermatologists are privileged to diagnose the disease earlier and more effectively than any other discipline. As a consequence, a detailed clinical and histopathological evaluation of the skin is one of the most critical steps in diagnosing vasculitis. Besides obtaining a good medical history, laboratory and radiological evaluation methods are used in the diagnosis. In this review, a practical and algorithmic approach is aimed to assist in the diagnosis of vasculitis. However, this approach should not be seen as strict rules. This stepwise algorithmic diagnostic approach for vasculitis was developed by combining the current literature knowledge and the author's experience in this field to provide a rational framework for selecting the most appropriate among various diagnostic approaches.

摘要

血管炎是以血管炎症和损伤为特征的一系列疾病。它们可通过不同的病理生理机制发生,并且根据所累及血管的直径不同而具有丰富的临床异质性。血管炎的严重程度也有很大差异,从轻度自限性疾病到可能危及生命的疾病不等。血管炎累及皮肤的发生率高、具有可见特征,并且最后,皮肤便于进行体格检查和活检,这为疾病的早期识别和诊断提供了重要优势。因此,皮肤科医生比其他任何学科都更有优势更早、更有效地诊断该疾病。因此,对皮肤进行详细的临床和组织病理学评估是诊断血管炎最关键的步骤之一。除了获取详细的病史外,诊断中还会使用实验室和放射学评估方法。在本综述中,旨在采用一种实用的、按算法进行的方法来辅助血管炎的诊断。然而,这种方法不应被视为严格的规则。这种针对血管炎的逐步算法诊断方法是通过结合当前的文献知识和作者在该领域的经验而开发的,以便为在各种诊断方法中选择最合适的方法提供一个合理的框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/008f/9532537/cf5a288377c3/fmed-09-1012554-g0001.jpg

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