Intravascular histiocytosis presenting with extensive vulvar necrosis
Intravascular histiocytosis presenting with extensive vulvar necrosis
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血管内组织细胞增多症表现为广泛的外阴坏死
DOI：
10.1111/j.1600-0560.2008.01185.x
复制
发表时间：
2009
影响因子：
1.7
通讯作者：
D. Fullen
中科院分区：
文献类型：
--
作者：
P. Pouryazdanparast;Limin Yu;V. Dalton;H. Haefner;C. Brincat;S. Mandell;Kathleen R. Cho;D. Fullen
血管内组织细胞增生症是一种罕见的反应性皮肤病变的发病机制不明。大多数病例与类风湿性关节炎有关，皮疹通常发生在肿胀的关节附近。皮肤变化包括红斑和紫色斑疹、丘疹、斑块和硬化斑块伴青斑样红斑。我们报告了第一例IVH患者，该患者87岁，无类风湿性关节炎病史，表现为鲜艳的外阴坏死。体格检查显示外阴水肿、渗出和弥漫性坏死，坏死区域周围有红斑，并延伸至大腿。清创后的皮肤显示表皮广泛坏死，真皮内有多簇明显扩张的血管。这些血管含有纤维蛋白血栓，并混合有大量CD 68+和CD 163+组织细胞。她的皮肤变化后，手术清创和抗生素治疗显着改善。有趣的是，我们的病人也被发现有狼疮抗凝剂与抗心磷脂抗体升高。这是第一次报告的IVH可能与血栓形成素质与高凝状态。IVH的诊断很重要，可能需要进一步的临床评价，以排除共存的全身性疾病的可能性。
Intravascular histiocytosis (IVH) is a rare reactive cutaneous lesion of unknown pathogenesis. Most cases are reported in association with rheumatoid arthritis, and cutaneous eruptions typically occur near swollen joints. The skin changes have included erythematous and violaceous macules, papules, plaques and indurated patches with a livedo‐like pattern of erythema. We report the first case of IVH presenting with florid vulvar necrosis in an 87‐year‐old patient without a history of rheumatoid arthritis. Physical examination revealed an edematous, exudative and diffusely necrotic vulva with erythema surrounding the areas of necrosis, extending out to the thighs. The debrided skin revealed an extensively necrotic epidermis and multiple clusters of markedly dilated blood vessels within the dermis. These vessels contained fibrin thrombi admixed with numerous CD68+ and CD163+ histiocytes. Her skin changes improved significantly after surgical debridement and treatment with antibiotics. Interestingly, our patient was also found to have a lupus anticoagulant with elevated anticardiolipin antibodies. This is the first report of IVH possibly related to a thrombogenic diathesis associated with a hypercoagulable state. A diagnosis of IVH is important and may necessitate further clinical evaluation to exclude the possibility of co‐existent systemic disease.
Clark 等人：“埃塞俄比亚中阿瓦什更新世智人的地层、年代和行为背景。”《自然》。
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与类风湿性关节炎相关的血管内组织细胞增多症：伴有淋巴管内皮增殖的报告
DOI：
--
发表时间：
2005
期刊：
Br J Dermatol 152(6)
影响因子：
--
作者：
Okazaki A;Asada H;Niizeki H;Nonomura A;Mjyagawa S
通讯作者：
Mjyagawa S