Dermatologic manifestations of the antiphospholipid syndrome -: Two hundred consecutive cases
Dermatologic manifestations of the antiphospholipid syndrome -: Two hundred consecutive cases
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DOI：
10.1002/art.21041
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发表时间：
2005-06-01
影响因子：
--
通讯作者：
Piette, JC
中科院分区：
文献类型：
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作者：
Francès, C;Niang, S;Piette, JC
Objective.描述抗磷脂综合征（APS）的皮肤病学表现，并研究网状青斑与其他APS表现之间可能的相关性。我们对200例原发性或系统性狼疮相关APS的连续患者进行了单中心研究。为了符合这项研究的资格，患者必须符合最新国际共识声明中关于明确ATS分类的临床和实验室标准。由皮肤科医生系统评价皮肤病学表现。仅将可能与APS相关的皮肤病损纳入分析。采用Fisher双尾检验、卡方检验和非参数Mann-Whitney检验确定网状青斑和其他APS表现之间的相关性。49%的患者有皮肤科表现，30.5%的患者有皮肤科表现。网状青斑是最常见的表现，观察到25.5%的患者。网状青斑与脑或眼动脉缺血事件显著相关（比值比[OR] 10.8，95%置信区间[95% CI] 5.2-22.5），癫痫发作（OR 6.5，95% CI 2.6-16），所有动脉事件（OR 6，95% CI 2.9-12.6），超声心动图检测到心脏瓣膜异常（OR 7.3，95% CI 3.6-14.7）和动脉系统性高血压（>= 160/90 mm Hg）（OR 2.9，95% CI 1.5-5.7）。相反，仅静脉血栓形成的患者其发生率降低（OR 0.2，95%CI 0.1-0.5）。APS的皮肤病学表现往往是综合征的表现特征，网状青斑与APS的动脉亚型显著相关。
Objective. To describe dermatologic manifestations of the anti phospholipid syndrome (APS) and to investigate possible correlations between livedo reticularis and other APS manifestations.Methods. We conducted a single-center study of 200 consecutive patients with primary or systemic lupus erythematosus-related APS. To qualify for the study, patients had to fulfill clinical and laboratory criteria from the most recent international consensus statement on classification of definite ATS. Dermatologic manifestations were systematically evaluated by a dermatologist. Only dermatologic lesions that may be related to APS were included in the analyses. Correlations between livedo reticularis and other APS manifestations were determined using Fisher's 2-tailed, chi-square, and nonparametric Mann-Whitney tests.Results. Dermatologic manifestations were noted in 49% of the patients and were the presenting manifestations in 30.5%. Livedo reticularis was the most frequent manifestation, observed in 25.5% of the patients. Livedo reticularis was shown to be significantly associated with cerebral or ocular ischemic arterial events (odds ratio [OR] 10.8, 95% confidence interval [95% CI] 5.2-22.5), seizures (OR 6.5, 95% CI 2.6-16), all arterial events (OR 6, 95% CI 2.9-12.6), heart valve abnormalities detected on echocardiography (OR 7.3, 95% CI 3.6-14.7), and arterial systemic hypertension (>= 160/90 mm Hg) (OR 2.9, 95% CI 1.5-5.7). Conversely, it was observed with decreased frequency in patients with only venous thrombosis (OR 0.2, 95% CI 0.1-0.5).Conclusion. The dermatologic manifestations of APS are frequently the presenting feature of the syndrome, and livedo reticularis is significantly associated with the arterial subset of APS.