中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (6): 413-415.

• 论著 • 上一篇    下一篇

肢端血管皮炎12例临床病理分析

徐秀莲,曾学思,孙建方   

  1. 南京 中国医学科学院北京协和医学院皮肤病研究所
  • 收稿日期:2014-09-05 修回日期:2015-03-10 出版日期:2015-06-15 发布日期:2015-06-03
  • 通讯作者: 孙建方 E-mail:fangmin5758@aliyun.com

Clinicopathologic analysis of acroangiodermatitis: 12 case reports

Xiu-Lian Xu 2,   

  • Received:2014-09-05 Revised:2015-03-10 Online:2015-06-15 Published:2015-06-03

摘要:

目的 探讨肢端血管皮炎的临床病理特征及鉴别诊断。 方法 回顾性分析12例肢端血管皮炎患者的临床和病理资料。 结果 肢端血管皮炎临床表现为局限性的棕色至紫红色的斑片、斑块、结节及溃疡形成。皮损均位于下肢,双侧及单侧受累者各6例。组织病理检查:真皮上中部小叶状或团块状毛细血管和小静脉增生,管腔圆形,规则,血管内皮细胞肿胀,可见程度不等的红细胞外溢、含铁血黄素沉积、真皮纤维化及稀疏炎细胞浸润。病变累及真皮浅层者3例,真皮中上部者8例,真皮全层者1例。免疫组化检查:血管内皮细胞CD34和CD31阳性,血管周细胞CD34阴性。 结论 肢端血管皮炎具有特殊的临床及病理特征,病理学检查是诊断肢端血管皮炎的重要依据。

Abstract:

Xu Xiulian, Zeng Xuesi, Sun Jianfang. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China Corresponding author: Sun Jianfang, Email: fangmin5758@aliyun.com 【Abstract】 Objective To investigate the clinicopathologic features and differential diagnosis of acroangiodermatitis (AM). Methods Clinical and pathological data on 12 patients with AM were retrospectively reviewed. Results Clinical manifestations of AM consisted of circumscribed brown to violaceous macules, plaques, nodules and ulceration. Lesions were located in bilateral legs in 6 patients, and in unilateral legs in the other 6 patients. Histopathological examination revealed an increased number of lobular or clump-shaped capillaries and small veins whose lumens were round and regular, swelling of vascular endothelial cells, and different degrees of erythrocyte extravasation, hemosiderin deposition, dermal fibrosis and sparse infiltrates of inflammatory cells. The lesions were histologically located in the superficial dermis in 3 cases, in the upper and middle dermis in 8 cases, and in the entire dermis in 1 case. Immunohistochemical studies showed that vascular endothelial cells stained positive for CD31 and CD34, while perivascular cells stained negative for CD34. Conclusions AM has specific clinical and pathological manifestations, and pathological examination is essential for the diagnosis of AM.