Antiphospholipid syndrome (APS) is a prothrombotic condition that can affect both the venous circulation and the arterial system. The deep veins of the lower extremities and cerebral blood flow are the most common sit...Antiphospholipid syndrome (APS) is a prothrombotic condition that can affect both the venous circulation and the arterial system. The deep veins of the lower extremities and cerebral blood flow are the most common sites of venous and arterial thrombosis, respectively. Skin ulceration and gangrene may be associated with an active vasculitis in patients with APS. These kinds of ulcers are considered intractable because healing is difficult to achieve. Using steroids as immunesuppressant therapy is still a basic part of managing APS and vasculitis. Nevertheless, in the presence of steroid-induced diabetes mellitus, the priority is to achieve faster wound healing, because of the potential complications that can develop due to metabolic dysfunction and augmented vulnerability to infection. Until recently, there were few reports demonstrating the benefits of the use of adjuvant phosphodiesterase-5 inhibitors like sildenafil citrate in different clinical entities with courses like Raynaud’s phenomenon, scleroderma, and resistance to vasodilator therapy. We present the first report demonstrating the additional benefit of sildenafil citrate for the integration of grafts in a patient with steroid-induced diabetes and APS who had ulcers due to vasculitis resistant to the usual vasodilator therapy.展开更多
A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD), including pyoderma gangrenosum, erythema nodosum, perianal disease, erythematous eruptions, urticaria, and purpura. ...A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD), including pyoderma gangrenosum, erythema nodosum, perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.展开更多
原发性中枢神经系统血管炎(primary angiitis of the central nervous system,PACNS)是一种罕见重度的累及脑实质、脊髓、软脑膜中小血管的免疫炎性疾病。该病由Harbitz在1922年首次报道,随后20世纪50~70年代陆续有数10篇相关病例的报道...原发性中枢神经系统血管炎(primary angiitis of the central nervous system,PACNS)是一种罕见重度的累及脑实质、脊髓、软脑膜中小血管的免疫炎性疾病。该病由Harbitz在1922年首次报道,随后20世纪50~70年代陆续有数10篇相关病例的报道,其中绝大多数都是尸检后诊断[1],在1988年由Calabrese和Mallek正式命名为PACNS。展开更多
累及中枢神经系统的血管炎被称为中枢神经系统血管炎。头痛是中枢神经系统血管炎的非特异表现之一,也是其中最常见的神经系统症状。目前按照2012年Chapel Hill会议(Chapel Hill consensus conference,CHCC)血管炎分类标准将血管炎按照...累及中枢神经系统的血管炎被称为中枢神经系统血管炎。头痛是中枢神经系统血管炎的非特异表现之一,也是其中最常见的神经系统症状。目前按照2012年Chapel Hill会议(Chapel Hill consensus conference,CHCC)血管炎分类标准将血管炎按照受累血管大小不同进行分类。血管炎所致头痛的发病机制不明,血脑屏障及神经血管单元的破坏在血管炎头痛中可能起到重要作用。不同类型血管炎累及中枢神经系统的发生率以及头痛的发生时机和特点有差异。识别血管炎相关的头痛,并快速进行诊断至关重要,以免进行不必要的治疗或导致严重神经系统后遗症。展开更多
文摘Antiphospholipid syndrome (APS) is a prothrombotic condition that can affect both the venous circulation and the arterial system. The deep veins of the lower extremities and cerebral blood flow are the most common sites of venous and arterial thrombosis, respectively. Skin ulceration and gangrene may be associated with an active vasculitis in patients with APS. These kinds of ulcers are considered intractable because healing is difficult to achieve. Using steroids as immunesuppressant therapy is still a basic part of managing APS and vasculitis. Nevertheless, in the presence of steroid-induced diabetes mellitus, the priority is to achieve faster wound healing, because of the potential complications that can develop due to metabolic dysfunction and augmented vulnerability to infection. Until recently, there were few reports demonstrating the benefits of the use of adjuvant phosphodiesterase-5 inhibitors like sildenafil citrate in different clinical entities with courses like Raynaud’s phenomenon, scleroderma, and resistance to vasodilator therapy. We present the first report demonstrating the additional benefit of sildenafil citrate for the integration of grafts in a patient with steroid-induced diabetes and APS who had ulcers due to vasculitis resistant to the usual vasodilator therapy.
文摘A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD), including pyoderma gangrenosum, erythema nodosum, perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.
文摘原发性中枢神经系统血管炎(primary angiitis of the central nervous system,PACNS)是一种罕见重度的累及脑实质、脊髓、软脑膜中小血管的免疫炎性疾病。该病由Harbitz在1922年首次报道,随后20世纪50~70年代陆续有数10篇相关病例的报道,其中绝大多数都是尸检后诊断[1],在1988年由Calabrese和Mallek正式命名为PACNS。
文摘累及中枢神经系统的血管炎被称为中枢神经系统血管炎。头痛是中枢神经系统血管炎的非特异表现之一,也是其中最常见的神经系统症状。目前按照2012年Chapel Hill会议(Chapel Hill consensus conference,CHCC)血管炎分类标准将血管炎按照受累血管大小不同进行分类。血管炎所致头痛的发病机制不明,血脑屏障及神经血管单元的破坏在血管炎头痛中可能起到重要作用。不同类型血管炎累及中枢神经系统的发生率以及头痛的发生时机和特点有差异。识别血管炎相关的头痛,并快速进行诊断至关重要,以免进行不必要的治疗或导致严重神经系统后遗症。
