皮肤变应性结节性血管炎1100例分析

目的 研究复杂的小腿结节损害疾病。方法 应用临床、组织病理、免疫学及免疫组织化学和血液学检查等。结果 女性发病多于男性（６．０９：１）,主要发生在２１￣５０岁（７３．３６％）;临床表现以下肢皮下结节损害为主;疾病发作与缓解似与季节有关。组织病理学改变;病变限于真皮乳突下层和皮下脂肪组织内,血管炎、液化性坏死和肉芽肿与肉芽肿样结构是其基本病变;毛细血管和细血管全部受累,内皮细胞增生为一显著特征;以淋     

变应性皮肤血管炎56例临床分析

目的探讨变应性皮肤血管炎患者的临床表现,实验室检查和治疗的特点,从而提高变应性皮肤血管炎的诊治水平。方法回顾性分析56例变应性皮肤血管炎患者的门诊和住院临床资料。结果56例患者均有不同程度的皮肤损害,18例有肾脏损害,15例出现关节炎症状,8例累及胃肠道,5例有肺部损害。除特发性和合并其他结缔组织病及肿瘤外,感染和药物只是血管炎的诱发因素,不是直接因素。结论变应性皮肤血管炎是累及皮肤和内脏器官的细小血管,特别是毛细血管后静脉的坏死性血管炎,临床上常有多形性皮损。治疗上应常规用糖皮质激素,并进行综合性治疗,控制感染,中药活血化瘀,清热利湿,可有显著疗效。     

变应性皮肤血管炎43例临床分析

2004-2007年对天津长征医院住院的43例变应性皮肤血管炎患者的临床资料进行回顾性分析.结果:43例患者均有不同程度的皮肤损害,15例有肾脏损害,13例出现关节炎症状,6例累及胃肠道,3例有肺部损害.除特发性和合并其他结缔组织病或肿瘤外,发病因素以感染和药物为多见.本组病例采用以糖皮质激素为主联合中药的治疗方法取得较好的疗效.     

皮肤变应性血管炎23例临床及病理分析

目的:分析皮肤变应性血管炎的临床表现及组织病理特点,以进一步提高对该病的认识。方法:回顾性分析23例皮肤变应性血管炎患者的临床表现及组织病理特点。结果:23例患者中男性10例,女性13例,平均发病年龄(43.65±14.28)岁。皮疹表现为多形性损害,其中以溃疡、紫癜为主,分别占65.21%、56.52%,所有患者均有下肢受累,其中发生于小腿者占65.21%,大腿占21.74%,四肢同时受累占4.35%,泛发全身占8.70%。典型组织病理表现为真皮毛细血管内皮细胞肿胀、闭塞,有管壁纤维蛋白渗出,变性坏死,血管壁及血管周围有嗜中性粒细胞浸润和碎裂,有数量不等的红细胞外渗。结论:皮肤变应性血管炎以多形性皮疹为主要表现,典型组织病理表现为白细胞碎裂性血管炎,可根据临床表现及组织病理确诊。     

57例皮肤变应性血管炎的临床特点及诊治

目的探讨皮肤变应性血管炎的临床特点、早期诊断及治疗。方法对2003年12月~2004年12月接诊的57例皮肤变应性血管炎的临床表现及并发症情况进行回顾性分析,制定合理的早期诊治方案。结果归纳出典型临床特点,结合实验室检查结果,予以正确诊断并获满意治疗效果。结论早期诊断,及时对症合理的药物治疗,可以有效改善皮肤变应性血管炎的预后。     

变应性皮肤血管炎中医辨证治疗临床研究

目的研究中医辨证治疗变应性皮肤血管炎的疗效和对复发的影响。方法按多中心随机对照研究方案,分中医辨证治疗组和西医治疗对照组,治疗组给予中医辨证治疗,对照组给予甲泼尼龙片,或加罗红霉素片治疗。评估完成4周治疗后的总体疗效和治疗第1、2、4周的阶段疗效,以及治疗完成后4、8、12周的症状复发情况。结果治疗4周后,两组病例症状评分较基线下降百分值≥50%7、5%、90%的频数比较,差异均无显著性(P>0.05)。治疗第1、24、周时,两组各随访段症状评分较基线下降百分值比较,第1、2周差异有显著性(P<0.05或P<0.01),第4周时无显著差异(P>0.05)。治疗后复发情况随访,第8、12周复发率比较有显著差异(P<0.05)。结论对于所选病例,中医辨证治疗和糖皮质激素治疗疗效接近,然而起效不如糖皮质激素迅速。但在减少本病的复发方面中医辨证治疗有明显优势。     

变应性皮肤血管炎患者皮损内纤维蛋白的光镜与电镜观察

用普通病理、直接免疫荧光技术及电镜观察了７例变应性皮肤血管炎患者皮损内纤维蛋白，发现血管壁纤维蛋白样变性是纤维蛋白沉积的结果，纤维蛋白沉积是继发性的，但它对血管内皮细胞的损伤及血管炎的发展有重要作用。     

复发性皮肤坏死性嗜酸性血管炎一例

患者女,40岁。因左手拇指、食指屈侧皮肤坏死2月伴瘙痒来我所就诊。就诊2个月前左手拇指指面出现小丘疹, 瘙痒,搔抓后出现水疱、渗液,自行外用青霉素溶液、氯霉素溶液、氢化可的松溶液和甲硝唑溶液外敷数日,无明显效果,     

重症变应性血管炎1例

1病历摘要 患者女,56岁，因全身丘疹1个月余，加重1周，于2006年11月9日来我科就诊.患者1个月前服用中草药（具休不详）后下腹部出现红色丘疹，无明显痒痛感，未予重视。半个月前丘疹逐渐扩展至胸部及双下肢，为紫红色微痛皮损，于当地医院诊断为“过敏性紫癜”．     

重症变应性血管炎1例

<正>1临床资料患者女,54岁。四肢出现瘀点、瘀斑、血疱和溃疡,伴瘙痒3个月,加重20h。3个月前,无明显诱因患者四肢皮肤出现瘀点、瘀斑、血疱和溃疡,以"变应性皮肤血管炎"予常规非激素治疗12d,皮疹消退。20h前,无明显诱因皮疹复发,伴气短,静滴"头孢曲松钠、病毒唑、氨茶碱、复方甘草酸单胺"无效,且四肢皮疹呈暴发性增多趋势,伴剧烈疼痛。患慢性支气管炎30年;否认药物和食物过敏史。体检:咽略赤,双肺可闻及喘鸣音及少许湿啰音,余正常。皮肤科情况:四肢可见密集对称分布的针尖至指甲大瘀点、瘀斑、大量血疱、糜烂、浅溃疡及大片坏死,部分     

复发性皮肤坏死性嗜酸性血管炎1例并文献复习

报道1例复发性皮肤坏死性嗜酸性血管炎并对相关文献进行复习。患者,女,64岁,因双下肢痛性皮疹12天就诊。偶有干咳,无哮喘病史。皮肤科查体：双下肢散在紫红色斑片、斑块,胫前数个结节、血疱样损害;右前臂有少量类似损害。外周血嗜酸性粒细胞计数增多。胸部X线提示双肺渗出性改变。皮损组织病理符合皮肤坏死性嗜酸性血管炎。口服强的松45mg/天治疗1周后临床症状明显好转,激素减量过程中曾有复发。     

Propylthio-uracil-induced cutaneous vasculitis

Three cases of cutaneous vasculitis, leukocytopenia and arthralgia, presumably caused by the antithyroid drug Propylthio-uracil, are presented. Acute vasculitis of the superficial and deep dermal blood vessels accompanied by vascular thrombus formation were found in biopsy specimens. Direct immunofluorescence studies demonstrated deposits of C3 or IgM and C3 in the walls of vessels in affected and unaffected skin, suggesting immune complex deposition. The skin lesions and leukocytopenia rapidly disappeared on discontinuation of the drug, while the arthralgia continued for weeks or months.     

Atenolol-induced cutaneous vasculitis

We present a case of cutaneous vasculitis apparently due to an adverse reaction to atenolol. The causal relationship between the drug and the eruption was based mainly on circumstantial evidence. It has been further strengthened by positive results of the indirect rat mast cell degranulation test. The number of published cases of reaction to atenolol is limited. Cutaneous vasculitis has, to the best of our knowledge, never been reported as an adverse reaction to atenolol, although it is not a rare side effect of other beta blocker drugs including propranolol and practolol. Atenolol should be added to the list of beta blocker medications that may produce cutaneous vasculitis.     

皮肤播散型孢子丝菌病引起白细胞碎裂性血管炎1例

患者女,55岁,因右膝部破溃伴疼痛2个月,渐累及双上肢10 d,于2016年6月就诊。患者2个月前右膝部出现红斑、破溃,自行外用依沙吖啶未见明显疗效。10 d前累及右手背及左腕部,四肢皮肤肿胀。起病以来偶有咳嗽,无咳痰,无恶心、呕吐,有腹胀,无明显腹痛,大便正常……     

Gallbladder vasculitis associated with cutaneous leucocytoclastic vasculitis

A 72-year-old woman presented with a 1-week history of a painful, purpuric, pruritic rash on her legs, buttocks and arms. Skin biopsy revealed histological features typical of leucocytoclastic vasculitis. She was admitted, her usual medications were withheld, and she was commenced on ibuprofen and loratadine. The patient had undergone a laparoscopic cholecystectomy 2 months prior to her rash appearing. She had been having upper abdominal pain for 2 years and, following a more severe acute episode, an abdominal ultrasound scan had revealed a solitary cholelithiasis. Histology of the gallbladder revealed acute fibrinoid vasculitis in two small arteries, on a background of chronic cholecystitis. A mild postoperative wound infection was treated with a short course of cephalexin and no other investigations were conducted. As an inpatient, the patient's rash improved, but she progressed to develop systemic vasculitis and acute renal failure. Renal biopsy showed focal necrotizing glomerulonephritis, consistent with vasculitis. She was subsequently commenced on cyclophosphamide 100 mg daily, prednisolone 50 mg daily and one prophylactic trimethoprim/sulphamethoxazole (160 mg/800 mg) tablet 3 days/week. Following discharge, the patient's cutaneous vasculitis eventually resolved and renal function gradually improved. Her prednisolone was gradually reduced to 7 mg daily and cyclophosphamide was weaned, then substituted with azathioprine 100 mg daily.