Gottlieb N L, Penneys N S
JAMA. 1980 Mar 28;243(12):1260-1.
A 52-year-old woman with rheumatoid arthritis experienced painless spontaneous hemorrhage, tearing, and necrosis of the skin on the lower laternal aspect of both legs. Thereapy with systemic prednisone had been used to suppress active synovitis for almost four years and was associated with moon facies, hirsutism, truncal obesity, thinning of the skin, extensive purpura on the extremities, and other manifestations of hypercortisolism. There was no evidence of rheumatoid vasculitis, trauma, or blood dyscrasia. The leg lesions may represent an exaggerated type of steroid-induced purpura resulting in localized areas of gangrenous skin.
一名52岁的类风湿关节炎女性患者，双侧小腿下外侧皮肤出现无痛性自发性出血、撕裂及坏死。全身应用泼尼松治疗以抑制活动性滑膜炎已近四年，出现了满月脸、多毛症、躯干肥胖、皮肤变薄、四肢广泛紫癜以及其他皮质醇增多症表现。无类风湿性血管炎、外伤或血液系统疾病的证据。腿部病变可能代表一种严重类型的类固醇诱导性紫癜，导致局部皮肤坏疽。
