有青斑样血管炎表现的系统性红斑狼疮

Systemic lupus erythematous with livedoid vasculitis:a case report

报告1例有青斑样血管炎表现的系统性红斑狼疮。患者男,31岁。面部出现蝶形红斑,足背和踝关节周围皮肤出现疼痛性溃疡,以及可触性紫癜和萎缩性瓷白色瘢痕2年。足背皮损组织病理检查:真皮浅层血管扩张、弯曲,部分血管腔有大量纤维蛋白样物质和红细胞栓塞,血管周围散在淋巴细胞浸润。结合其他实验室检查,诊断为系统性红斑狼疮。对患者采用糖皮质激素和雷公藤多苷进行治疗,同时给予抗凝和抗血小板活化治疗,皮损得到部分缓解。

A 31-year-old man presented with a 2-year history of butterfly pattern erythema on the face and painful ulcerations, palpable purpura, porcelain-white atrophic scars on the malleolar region. Histopathology of skin lesion of the dorsum of his foot revealed thrombosis of the microvasculatore with a scarce lymphocyte infiltration in the dermis. Combined with other laboratory studies, SLE was diagnosed. The patient was treated with corticosteroid, tripterygium glycosides, anticoagulant therapy, and the inactivation of platelets.