Webster G F, Iozzo R V, Schwartzman R J, Tahmoush A J, Knobler R L, Jacoby R A
Department of Dermatology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107-5102.
J Am Acad Dermatol. 1993 Jan;28(1):29-32. doi: 10.1016/0190-9622(93)70004-d.
Reflex sympathetic dystrophy (RSD) is a poorly understood syndrome of post-traumatic pain, autonomic dysfunction, and progressive tissue atrophy. Classical descriptions of the cutaneous manifestations of RSD are usually limited to skin atrophy, vascular instability, and hyperhidrosis.
Our objective was to further delineate the cutaneous changes in RSD.
We have observed RSD-related inflammatory and bullous lesions in nine patients with active RSD.
Eight patients had significant edema of involved skin, two patients had evidence of a pigmented purpura-like inflammatory dermatitis, and two other patients had bullae on involved skin. Ultrastructural studies on a biopsy specimen from one patient with recurrent bullae revealed a disrupted basement membrane and abnormal anchoring fibrils.
Skin disease in RSD is more diverse than commonly appreciated and includes severe edema, inflammatory lesions, and a nonimmune bullous eruption.
反射性交感神经营养不良（RSD）是一种创伤后疼痛、自主神经功能障碍和进行性组织萎缩的综合征，目前对其了解甚少。RSD皮肤表现的经典描述通常仅限于皮肤萎缩、血管不稳定和多汗症。
我们的目的是进一步描述RSD的皮肤变化。
我们观察了9例活动期RSD患者的RSD相关炎症和大疱性病变。
8例患者受累皮肤有明显水肿，2例有色素性紫癜样炎症性皮炎表现，另外2例受累皮肤有大疱。对1例反复出现大疱的患者活检标本进行超微结构研究，发现基底膜破坏和锚定原纤维异常。
RSD的皮肤疾病比通常认为的更为多样，包括严重水肿、炎症性病变和非免疫性大疱性皮疹。
