Correlation of Livedo Racemosa, Cutaneous Inflammatory Plaques, and Antiphospholipid Antibodies in Patients With Cutaneous Polyarteritis Nodosa
Correlation of Livedo Racemosa, Cutaneous Inflammatory Plaques, and Antiphospholipid Antibodies in Patients With Cutaneous Polyarteritis Nodosa
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DOI：
10.1097/md.0b013e3182115508
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发表时间：
2011-03-01
期刊：
影响因子：
1.6
通讯作者：
Soma, Yoshinao
中科院分区：
文献类型：
--
作者：
Kawakami, Tamihiro;Soma, Yoshinao
我们检查了皮肤结节性多动脉炎（PAN）患者各种皮肤症状的患病率，包括总状青斑和炎性斑块、狼疮抗凝剂（LA）、抗心磷脂（aCL）抗体（Abs）和抗磷脂酰丝氨酸-凝血酶原复合物（抗PS/PT）Abs，以确定其中任何一种是否与临床和/或血清学特征相关。如果存在这种相关性，皮肤表现的临床和血清学特征可能有助于皮肤PAN的早期诊断和/或治疗。我们回顾性研究了2003年至2009年在我们皮肤科就诊的50例皮肤PAN患者的临床和血清学特征、直接免疫荧光结果和治疗方法。所有50例患者均观察到皮下结节，44例（88.0%）有总状青斑，30例（60.0%）有皮肤溃疡，14例（28.0%）有炎性斑块。总状青斑病组血清IgM抗PS/PT抗体水平明显高于非总状青斑病组。血清IgG抗PS/PT Ab水平在有炎性斑块的患者（12.86 +/- 13.16 U/mL）和无炎性斑块的患者（6.53 +/- 5.92 U/mL）之间存在显著差异。在IgG aCL Ab水平方面观察到类似趋势。与此相反，IgM抗PS/PT抗体水平显着低于炎症斑块的患者相比，没有他们。炎症斑块在皮肤溃疡患者中明显更普遍。在有炎性斑块和皮肤溃疡的患者中，华法林和泼尼松龙被选为主要治疗药物的比例显著高于无炎性斑块和皮肤溃疡的患者。我们认为，各种抗磷脂抗体可能会影响皮肤PAN的皮肤模式。特别是，IgG抗PS/PT Ab和/或IgG aCL Ab可以指示炎性斑块的存在，作为皮肤PAN的特异性皮肤表现。
We examined the prevalence of various cutaneous symptoms including livedo racemosa and inflammatory plaques, lupus anticoagulant (LA), anticardiolipin (aCL) antibodies (Abs), and anti-phosphatidylserine-prothrombin complex (anti-PS/PT) Abs in patients with cutaneous polyarteritis nodosa (PAN) to determine if any of them correlate with the clinical and/or serologic features. If such correlations exist, the clinical and serologic features of the cutaneous manifestations could aid in the early diagnosis and/or treatment of cutaneous PAN. We retrospectively investigated the clinical and serologic features, direct immunofluorescence findings, and treatment methods used in 50 patients with cutaneous PAN seen at our Department of Dermatology between 2003 and 2009. Subcutaneous nodules were observed in all 50 patients, 44 (88.0%) had livedo racemosa, 30 (60.0%) had skin ulcers, and 14 (28.0%) had inflammatory plaques. Levels of serum IgM anti-PS/PT Abs were significantly higher in patients with livedo racemosa than in patients without livedo racemosa. Serum IgG anti-PS/PT Ab levels differed significantly between patients with inflammatory plaques (12.86 +/- 13.16 U/mL) and those without inflammatory plaques (6.53 +/- 5.92 U/mL). Similar trends were seen with respect to IgG aCL Ab levels. In contrast, levels of IgM anti-PS/PT Abs were significantly lower in patients with inflammatory plaques compared to patients without them. Inflammatory plaques were significantly more prevalent in patients with skin ulcers. Warfarin and prednisolone were selected as the primary therapy at a significantly higher rate in patients with inflammatory plaques and skin ulcers than in patients without them.We suggest that a variety of antiphospholipid Abs could influence the cutaneous patterns of cutaneous PAN. In particular, IgG anti-PS/PT Abs and/or IgG aCL Abs could indicate the presence of inflammatory plaques as a specific cutaneous manifestation of cutaneous PAN.