Cutaneous manifestations of gastrointestinal disease Part II
Cutaneous manifestations of gastrointestinal disease Part II
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DOI：
10.1016/j.jaad.2012.10.036
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发表时间：
2013-02-01
影响因子：
13.8
通讯作者：
Menter, Alan
中科院分区：
文献类型：
--
作者：
Thrash, Breck;Patel, Mahir;Menter, Alan
胃肠道（GI）和皮肤器官系统紧密相连。在这篇继续医学教育文章的第一部分中，探讨了这种关系的复杂性，因为它们与遗传性息肉病、错构瘤疾病和副肿瘤性疾病有关。第二部分重点介绍皮肤系统与炎症性肠病和血管疾病的联系。对炎症性肠病皮肤检查结果进行深入分析，以帮助皮肤科医生识别和促进胃肠病学家的早期咨询和干预。炎症性肠病的皮肤体征包括裂隙和瘘管、结节性红斑、坏疽性脓皮病、植物性脓口炎、口腔阿弗他溃疡、皮肤结节性多动脉炎、坏死性血管炎和获得性大疱性表皮松解症。还将讨论其他免疫介导的疾病，例如憩室炎、肠道相关皮肤病关节炎综合征、过敏性紫癜、疱疹样皮炎和德戈斯病，其中皮肤和胃肠道系统相互参与。胃肠道和皮肤常见的遗传性皮肤病包括赫曼斯基-普德拉克综合征、弹力假黄瘤、埃勒斯-当洛斯综合征、遗传性出血性毛细血管扩张症和蓝色橡胶泡痣综合征。卡波西肉瘤是一种肿瘤性疾病，病变累及皮肤和胃肠道。肠病性肢端皮炎是一种缺锌性疾病，同样会影响胃肠道和皮肤系统。我们对这些病症进行了回顾，更新了遗传基础、诊断和筛查方式以及治疗方案。最后，还将讨论与血管疾病相关的胃肠道并发症。 (J Am Acad Dermatol 2013；68:211.e1-33。)
The gastrointestinal (GI) and cutaneous organ systems are closely linked. In part I of this continuing medical education article, the intricacies of this relationship were explored as they pertained to hereditary polyposis disorders, hamartomatous disorders, and paraneoplastic disease. Part II focuses on the cutaneous system's links to inflammatory bowel disease and vascular disorders. An in-depth analysis of inflammatory bowel disease skin findings is provided to aid dermatologists in recognizing and facilitating early consultation and intervention by gastroenterologists. Cutaneous signs of inflammatory bowel disease include fissures and fistulae, erythema nodosum, pyoderma gangrenosum, pyostomatitis vegetans, oral aphthous ulcers, cutaneous polyarteritis nodosa, necrotizing vasculitis, and epidermolysis bullosa acquisita. Additional immune-mediated conditions, such as diverticulitis, bowel-associated dermatosis-arthritis syndrome, Henoch-Schonlein purpura, dermatitis herpetiformis, and Degos disease, in which the skin and GI system are mutually involved, will also be discussed. Genodermatoses common to both the GI tract and the skin include Hermansky-Pudlak syndrome, pseudoxanthoma elasticum, Ehlers-Danlos syndrome, hereditary hemorrhagic telangiectasia, and blue rubber bleb nevus syndrome. Kaposi sarcoma is a neoplastic disease with lesions involving both the skin and the gastrointestinal tract. Acrodermatitis enteropathica, a condition of zinc deficiency, likewise affects both the GI and dermatologic systems. These conditions are reviewed with updates on the genetic basis, diagnostic and screening modalities, and therapeutic options. Finally, GI complications associated with vascular disorders will also be discussed. (J Am Acad Dermatol 2013;68:211.e1-33.)