23例青斑样血管病临床分析

Clinical analysis of 23 cases with livedoid vasculopathy

目的:提高对青斑样血管病的临床认识及诊断能力,探讨有效的治疗方法。方法:回顾性分析2010-2017年诊断的青斑样血管病患者的临床资料,包括临床及组织病理特点、治疗方法及疗效。结果:诊断了23例青斑样血管病患者,其中男6例,女17例,发病年龄(24.86±7.63)岁;皮损主要发生于踝周(21/23),皮损表现为疼痛性紫癜、溃疡及象牙色萎缩;组织病理改变主要表现为真皮浅中层小血管壁纤维素样变性及管腔内透明血栓形成;治疗上以抗凝、抗血小板聚集及促纤溶为主,己酮可可碱、达那唑、阿司匹林治疗效果好。结论:青斑样血管病具有特征性临床及组织病理学改变,但早期容易误诊误治,己酮可可碱有助于本病的治疗及预防复发。

Objective: To raise the clinical recognition and diagnostic ability of livedoid vasculopathy, and to explore effective treatments. Methods: The clinical and pathological data of patients with livedoid vasculopathy from the year 2010 to 2017 were retrospective analyzed. Results: Totally, there were 23 cases of livedoid vasculopathy including. There were 6 male and 17 female.The average age of onset was 24.86±7.63 years old. The lesions were mainly on the ankle(21/23). The lesions presented with painful purpura, ulceration and ivory atrophy. Biopsy manifested as fibrous degeneration of the small vascular wall and transparent thrombosis within the lumen in the superficial and middle dermis. Anticoagulation, anti-platelet aggregation and fibrinolysis were the main treatments.The disease was usually successfully treated with pentoxifylline, danazol combinated with aspirin. Conclusion: Livedoid vasculopathy has characteristic clinical and histopathological features, but it is easy to misdiagnose and mistreatment in the early stage. Pentoxifylline may be contributed to the treatment and prevent recurrence of livedoid vasculopathy.