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静止性皮炎:临床特征、发病机制和治疗概述。

Stasis Dermatitis: An Overview of Its Clinical Presentation, Pathogenesis, and Management.

机构信息

Miami Itch Center, Miller School of Medicine, University of Miami, Miami, FL, USA.

University Hospitals of Cleveland, Cleveland, OH, USA.

出版信息

Am J Clin Dermatol. 2023 Mar;24(2):275-286. doi: 10.1007/s40257-022-00753-5. Epub 2023 Feb 17.

Abstract

Stasis dermatitis is a chronic inflammatory skin disease of the lower extremities. It typically occurs in older individuals and is the cutaneous manifestation of venous hypertension caused by venous reflux. Such retrograde venous blood flow is the result of incompetent venous valves, valve destruction, or venous obstruction. Stasis dermatitis is eczematous. The associated impairment of venous valves may cause swelling of the legs, leading to serious conditions including venous ulcerations. Diagnosis can be challenging because of its clinical resemblance to other skin conditions and poor clinical recognition by physicians. The cornerstones of stasis dermatitis treatment are compression therapy to ameliorate pain and swelling, topical treatments to alleviate secondary skin changes, and interventional treatment options to correct the underlying causes of venous reflux. Given the central role of inflammation of the lower extremities in driving the cutaneous changes characteristic of stasis dermatitis, new therapeutic approaches that target the inflammation are under clinical evaluation in patients with stasis dermatitis.

摘要

淤滞性皮炎是一种下肢慢性炎症性皮肤病。它通常发生在老年人身上,是由静脉反流引起的静脉高压的皮肤表现。这种逆行静脉血流是静脉瓣膜功能不全、瓣膜破坏或静脉阻塞的结果。淤滞性皮炎是湿疹样的。相关的静脉瓣膜功能障碍可能导致腿部肿胀,导致严重的情况,包括静脉溃疡。由于其临床表现类似于其他皮肤疾病,且医生对其临床认识较差,因此诊断具有挑战性。淤滞性皮炎治疗的基石是加压治疗以缓解疼痛和肿胀、局部治疗以缓解继发性皮肤改变,以及介入治疗以纠正静脉反流的根本原因。鉴于下肢炎症在驱动淤滞性皮炎特征性皮肤改变中的核心作用,针对炎症的新治疗方法正在接受淤滞性皮炎患者的临床评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8c1/9968263/8c1721c4ce25/40257_2022_753_Fig1_HTML.jpg

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