Cutaneous reactive angiomatoses: Patterns and classification of reactive vascular proliferation
Cutaneous reactive angiomatoses: Patterns and classification of reactive vascular proliferation
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DOI：
10.1016/s0190-9622(03)02100-5
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发表时间：
2003-11-01
影响因子：
13.8
通讯作者：
Rebora, A
中科院分区：
文献类型：
--
作者：
Rongioletti, F;Rebora, A
在过去的几年里，皮肤中新的和相对较旧的血管(毛细血管)增殖类型已经被描述或更好地分类。它们包括反应性血管内皮瘤病、肢端血管皮炎(假性卡波西肉瘤)、弥漫性真皮血管瘤病、血管内组织细胞增生症、肾小球样血管内皮细胞瘤病和血管外皮细胞瘤病(伴有低温蛋白的血管瘤病)。临床上均表现为多发性、红斑-紫罗兰色和紫红色斑块和斑块，有时进展为坏死和溃疡，分布广泛，但有累及四肢的倾向。在组织学上，它们的特点是血管内或血管外小叶或血管内皮细胞、周细胞或有时组织细胞的弥漫性增生。虽然这些血管增殖可以在组织学上模拟血管肿瘤，但它们是反应性的，因为它们似乎起源于不同局部或全身性疾病对血管管腔的闭塞，并且血管增殖在诱导缺氧的刺激被取消后停止。在这篇文章中，作者综述了皮肤中所有这些形式的反应性血管增殖，提出了一个新的标题，皮肤反应性血管瘤，并提出了一个统一的发病机制。
New and relatively old types of vascular (capillary) proliferations in the skin have been described or better categorized in the last few years. They include reactive angioendotheliomatosis, acroangiodermatitis (pseudo-Kaposi sarcoma), diffuse dermal angiomatosis, intravascular histocytosis, glomeruloid angioendotheliomatosis, and angiopericytomatosis (angiomatosis with cryoproteins). Clinically, all of them present with multiple, erythematous-violaceous and purpuric patches and plaques, sometimes evolving toward necrosis and ulceration with a wide distribution but a propensity to involve limbs. Histologically, they are characterized by different patterns of intravascular or extravascular lobular or diffuse hyperplasia of endothelial cells, pericytes, and sometimes histiocytes. Although these angioproliferations can histologically mimic vascular tumors, they are reactive in that they seem to originate from the occlusion of vascular lumina by different localized or systemic disorders and the vascular proliferation stops after the inducing hypoxic stimulus has been withdrawn. In this article, the authors review all these forms of reactive angioproliferations in the skin, suggest a novel title, cutaneous reactive angiomatoses, and propose a unifying pathogenetic mechanism.