结节性红斑与结节性血管炎
Erythema nodosum versus nodular vasculitis.
作者信息
Sanz Vico M D, De Diego V, Sánchez Yus E
机构信息
Department of Dermatology, Hospital Universitario San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
出版信息
Int J Dermatol. 1993 Feb;32(2):108-12. doi: 10.1111/j.1365-4362.1993.tb01447.x.
BACKGROUND
Erythema nodosum (EN) is usually considered to be a septal panniculitis, and nodular vasculitis (NV) a lobular panniculitis. We tested the usefulness of this histologic classification in clarifying a frequent clinical dilemma: EN versus NV.
METHODS
Over 3 years 109 patients with panniculitis were included in this study. After a history and a physical examination, a clinical diagnosis was made according to well-established criteria.
RESULTS
From the study of 88 patients, we concluded that in the clinically typical cases, the clinico-pathologic agreement was 93% and 94% for EN and NV respectively, whereas it diminished to 79%, 72%, and 67% in the cases clinically diagnosed as EN migrans, atypical EN, and atypical NV, respectively. Moreover, septal and lobular panniculitis were always two clear-cut, different, opposite patterns of hypodermal inflammation to these conditions.
CONCLUSIONS
In the absence of a known pathogenetic mechanism, the histopathology remains the most objective discriminating marker between EN and NV, mainly in the clinically atypical and doubtful cases.
背景
结节性红斑（EN）通常被认为是间隔性脂膜炎，而结节性血管炎（NV）是小叶性脂膜炎。我们测试了这种组织学分类在解决常见临床难题（即区分EN和NV）中的实用性。
方法
在3年时间里，本研究纳入了109例脂膜炎患者。经过病史询问和体格检查后，根据既定标准做出临床诊断。
结果
通过对88例患者的研究，我们得出结论，在临床典型病例中，EN和NV的临床病理一致性分别为93%和94%，而在临床诊断为游走性结节性红斑、非典型EN和非典型NV的病例中，一致性分别降至79%、72%和67%。此外，间隔性和小叶性脂膜炎始终是这些病症皮下炎症的两种明确、不同且相反的模式。
结论
在缺乏已知发病机制的情况下，组织病理学仍然是区分EN和NV的最客观的鉴别标志物，主要用于临床非典型和疑难病例。
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