青斑样血管炎18例临床分析

Clinical Analysis of 18 Cases of Livedo Vasculitis

目的了解青斑样血管炎的临床特点及治疗等。方法回顾性分析本科收治的18例青斑样血管炎患者的临床资料。结果 18例患者均经过皮损病检而确诊,其中皮损局限在内外踝6例,蔓延至足背及足趾部4例,双小腿及足背泛发8例。10例炎症明显,坏死、瘀点及瘀斑新鲜,疼痛剧烈。予激素+抗凝治疗后,8例皮损局限,且炎症不明显,非急性期仅予抗凝治疗。结论本组病例均无渐进病史、静脉曲张或脂肪皮肤硬化症,且无伴随疾病,是特发性青斑样血管炎。予小剂量激素+抗凝治疗或单纯抗凝治疗有效,但需要监测远期疗效。

Objective To assess the clinical feature and therapy of patients with Livedo vasculitis. Methods Eighteen cases of Livedo vasculitis were retrospectively studied by reviewing the clinical data. Results Eighteen cases of Livedo vasculitis were diagnosed in our hospital by histopathology. Lesions of 6 cases were localized on the lateral ankle, 4 cases localized on the lateral ankle and the dorsum of the feet, Eight cases generalized on the lower leg and the dorsum of feet. Ten cases in acute stage which have necrosis, petechia , ecchymosis and severly pain were treated by anticoagulation in combination with corticosteroids therapy. Eight cases in a non acute stage which are localized type were treated by anticoagulation therapy alone. Conclusion These cases had not a gradual history, varicose veins, Lipodermatosclerosis and secondary disease. These cases were considered Idiopathic Livedo vasculitis. Anticoagulation in combination with low dose corticosteroids therapy or anticoagulation therapy alone has an effective treatment,but long-term monitoring is needed.