Stewart W M, Lauret P, Testart J, Thomine E, Boulliê M C, Leroy D
Ann Dermatol Venereol. 1977 Jan;104(1):5-8.
Fifty cases from the literature and one personal case of cutaneous cholesterol embioli are reviewed. These emboli come from abdominal atheromatous aotitis, sometimes complicated by aneurysm. The cholesterol micro-embolism is sometices induced by vascular surgery or arterial opacification. Male prevalence (47 cases) is evident. Alone or with visceral involvement, cutaneous lesions frequently simulate periarteritis nodosa: circumscribed to abdomen, thighs, legs, dorsum of the feet, the livedo reticularis is the most stricking feature associated or not with cutaneous nodes, purple toes, ulcers and gangrene. Histopathologic study is required for diagnosis: showing "negative" pictures of cholesterol cristals in an obliterating arteriolitis. Nevertheless special intetest is focused on a macrophagic granuloma centered in the vessel.
本文回顾了文献报道的50例及1例皮肤胆固醇栓子的个人病例。这些栓子源于腹主动脉粥样硬化,有时并发动脉瘤。胆固醇微栓塞有时由血管手术或动脉造影诱发。男性患病率明显(47例)。皮肤病变单独出现或伴有内脏受累时,常类似结节性多动脉炎:局限于腹部、大腿、小腿、足背,网状青斑是最显著的特征,可伴有或不伴有皮肤结节、紫趾、溃疡和坏疽。诊断需要进行组织病理学研究:在闭塞性小动脉炎中显示胆固醇结晶的“阴性”图像。然而,特别关注的是血管中心的巨噬细胞肉芽肿。