Cutaneous lesions of the digits in systemic lupus erythematosus:: 50 cases
Cutaneous lesions of the digits in systemic lupus erythematosus:: 50 cases
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DOI：
10.1177/0961203306075792
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发表时间：
2007-01-01
期刊：
影响因子：
2.6
通讯作者：
Frances, C.
中科院分区：
文献类型：
--
作者：
Bouaziz, J. D.;Barete, S.;Frances, C.
本研究的目的是观察50例系统性红斑狼疮（SLE）患者数字病变的临床和病理特征。我们连续对50例SLE伴指征病变患者进行了活检和指征病变图片检查。36%的病例曾被诊断为血管炎。图片由三位皮肤科医生检查，所有组织切片由同一位病理学家分析。回顾性分析患者档案。根据狼疮活动指数（lupus Activity index， LAI）确定SLE活动度。SLE患者的指端病变常伴有疼痛（60%）和指髓炎症（70%）。根据临床与病理对比，急性皮肤狼疮5例，亚急性皮肤狼疮5例，盘状狼疮21例，冻疮狼疮15例。2例患者出现血管炎：1例伴有红斑狼疮发作的荨麻疹血管炎，另1例有小疱性增高，与SLE的发展无关。两例sle相关抗磷脂综合征患者和两例冻疮狼疮患者存在皮肤血管血栓形成。仅7例患者LAI为bb1.5。这些结果强调了临床倾向于高估无活动性SLE患者手指皮肤血管炎的患病率。指皮肤狼疮的临床特征是多形态的。因此，病变的病理检查往往是必要的诊断和适当的处理。
The objective of this study was to observe the clinical and pathologic features of digital lesions in a cohort of 50 patients with systemic lupus erythernatosus (SLE). Biopsy and pictures of digital lesions were performed in 50 consecutive patients with SLE and digital lesions. A clinical diagnosis of vasculitis was previously suggested in 36% of cases. Pictures were reviewed by three dermatologists and all the tissue sections were analysed by the same pathologist. Files of patients were reviewed retrospectively. Activity of SLE was established according to the lupus activity index (LAI). Digital lesions in SLE were frequently painful (60%) with a finger-pulp inflammation (70%). According to clinical and pathological correlation, five patients had acute cutaneous lupus, five subacute cutaneous lupus, 21 discoid lupus and 15 chilblain lupus. Two patients presented vasculitis: one had an urticarial vasculitis concomitantly to a lupus flare, the other had an crythema elevatum diminum, independent of SLE evolution. Thrombosis of dermal vessels was present in two patients with SLE-associated antiphospholipid syndrome and in two patients with chilblain lupus. LAI was > 1.5 in only seven patients. These results highlight the tendency to clinically overestimate the prevalence of cutaneous vasculitis of the fingers in patients without active SLE. Clinical features of cutaneous lupus of the digits are polymorphous. So, a pathological examination of the lesions is often necessary for diagnosis and proper management.