中华皮肤科杂志 ›› 2021, Vol. 54 ›› Issue (10): 856-860.doi: 10.35541/cjd.20201222

• 论著 • 上一篇    下一篇

青斑样血管病64例皮损特点分析

冯素英    荆可    赵晨静   

  1. 中国医学科学院、北京协和医学院皮肤病医院皮肤科，南京  210042
  • 收稿日期:2020-12-24 修回日期:2021-07-30 发布日期:2021-09-28
  • 通讯作者: 冯素英 E-mail:fengsy@pumcderm.cams.cn
  • 基金资助:
    中国医学科学院医学与健康科技创新工程项目（CIFMS-2017-I2M-1-017）；南京市国家级临床医学中心培育计划项目（2019060001）

Analysis of clinical characteristics of 64 cases of livedoid vasculopathy

Feng Suying, Jing Ke, Zhao Chenjing   

  1. Department of Dermatology, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
  • Received:2020-12-24 Revised:2021-07-30 Published:2021-09-28
  • Contact: Feng Suying E-mail:fengsy@pumcderm.cams.cn
  • Supported by:
    CAMS Innovation Fund for Medical Sciences （CIFMS-2017-I2M-1-017）; Nanjing Incubation Program for National Clinical Research Center （2019060001）

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摘要： 【摘要】 目的 分析青斑样血管病网状青斑和紫癜性皮损的特点、分布规律。方法 回顾中国医学科学院皮肤病医院2017年7月至2020年10月诊治的64例青斑样血管病患者的临床资料。结果 64例中男23例，女41例；年龄13 ~ 54岁，发病年龄7 ~ 51岁，48例25岁前发病；病程6个月至10年。49例夏季发病或病情加重，皮损基本表现为坏死性不规则紫癜、紫癜性皮病样红斑、不规则溃疡、网状青斑、毛细血管扩张、不规则的白色萎缩性瘢痕和色素沉着。64例溃疡和坏死性紫癜多为不规则形，发生于足背和踝关节周围。40例有紫癜性皮病样的皮损表现，其中32例表现为色素性紫癜，8例表现为毛细血管扩张性紫癜。4例出现麻木刺痛等神经末梢受损的症状。结论 青斑样血管病的皮损表现多样，对于出现广泛网状青斑、紫癜样皮病样皮损、麻木等症状的患者，需做好鉴别诊断。

关键词: 网状青斑, 紫癜, 皮肤溃疡, 青斑样血管病

Abstract: 【Abstract】 Objective To analyze clinical features and distribution patterns of livedoid vasculopathy lesions, especially obvious livedo reticularis and purpuric lesions. Methods Clinical data were collected from 64 patients with confirmed livedoid vasculopathy in Hospital of Dermatology, Chinese Academy of Medical Sciences from July 2017 to October 2020, and analyzed retrospectively. Results Among the 64 patients, 23 were males and 41 were females, aged 13 - 54 years; their age at onset ranged from 7 to 51 years, and 48 developed livedoid vasculopathy before the age of 25 years; the course of disease ranged from 6 months to 10 years. Livedoid vasculopathy occurred or worsened in summer in 49 patients, and skin lesions mainly manifested as necrotic irregular purpura, purpuric dermatosis-like erythema, irregular ulcers, livedo reticularis, telangiectasia, irregular white atrophic scars and pigmentation. Among the 64 patients, ulcers and necrotic purpura were mostly irregular, and occurred on the dorsum of the foot and around the ankle. A total of 40 patients presented with purpuric dermatosis-like lesions, including 32 with pigmented purpura and 4 with telangiectatic purpura. Besides, numbness, tingling and other symptoms of nerve terminal damage occurred in 4 patients. Conclusion Clinical manifestations of livedoid vasculopathy are diverse, and differential diagnosis is important for patients with generalized livedo reticularis, purpuric dermatosis-like lesions and symptoms such as numbness.

Key words: Livedo reticularis, Purpura, Skin ulcer, Livedoid vasculopathy