BACKGROUND Malignant atrophic papulosis is a rare and potentially lethal thrombo-occlusive microvasculopathy characterized by cutaneous papules and gastrointestinal perforation.The precise pathogenesis of this disease...BACKGROUND Malignant atrophic papulosis is a rare and potentially lethal thrombo-occlusive microvasculopathy characterized by cutaneous papules and gastrointestinal perforation.The precise pathogenesis of this disease remains obscure.CASE SUMMARY We describe the case of a 67-year-old male patient who initially presented with cutaneous aubergine papules and dull pain in the epigastrium.One week after symptom onset,he was admitted to the hospital for worsening abdominal pain.Exploratory laparotomy showed patchy necrosis and subserosal white plaque lesions on the small intestinal wall,along with multiple perforations.Histological examination of the small intestine showed extensive hyperemia,edema,necrosis with varying degrees of inflammatory reactions in the small bowel wall,small vasculitis with fibrinoid necrosis and intraluminal thrombosis in the mesothelium.Based on the mentioned evidence,a diagnosis of malignant atrophic papulosis was made.We also present the case of a 46-year-old man with known cutaneous manifestations,abdominal pain,nausea and vomiting.His physical examination showed positive rebound tenderness.A computed tomography scan revealed free intraperitoneal air.He required surgical intervention on admission and then developed an esophageal perforation.He ultimately died of a massive hemorrhage.CONCLUSION In previously published cases of this disease,the cutaneous lesions initially appeared as small erythematous papules.Subsequently,the papules became porcelain-white atrophic depression lesions with a pink,telangiectatic peripheral rim.In one of the patients,the cutaneous lesions appeared as aubergine papules.The other patient developed multiple perforations in the gastrointestinal tract.Due to malignant atrophic papulosis affecting multiple organs,many authors speculated that it is not a specific entity.This case series serves as additional evidence for our hypothesis.展开更多
Objective:Traditional Chinese medicine(TCM)and modern medicine have both been used in arresting malignant transformation of chronic atrophic gastritis(CAG)in China with good therapeutic effect.However,no studies have ...Objective:Traditional Chinese medicine(TCM)and modern medicine have both been used in arresting malignant transformation of chronic atrophic gastritis(CAG)in China with good therapeutic effect.However,no studies have been undertaken to assess the risk of malignant transformation in CAG patients using both modern medicine and TCM features.Our study aimed to develop risk assessment models for malignant transformation of CAG combining indicators of both TCM and modern medicine.These models will facilitate early warning and control of malignant transformation of CAG from the perspective of evidence-based integrative medicine.Methods:In the proposed registry study,a total of 1000 eligible CAG patients will be recruited from four hospitals in China.A 10-year follow-up study will be conducted both on-site and off-site to track the events of malignant transformation.Frequency analysis and chi-squared tests will be used to perform the comparative analysis on the prevalence of malignant transformation events and indicators in TCM or modern medicine in different groups.A multivariate Cox proportional hazard model will be used to perform correlation analyses of malignant transformation events and factors of TCM or modern medicine.Conclusion:The proposed study has been designed with a large sample size and long follow-up period,in which wide-ranging modern medicine and TCM indicators can be gathered over the whole process of malignant transformation of CAG.Based on this study,risk assessment models for malignant transformation ofCAGmaybe constructed fromthe perspective of integrative medicine.This may provide clinicians and patients with an optimized early warning system as well as prevention strategies for malignant transformation of CAG.展开更多
目的:评估塞来昔布对胃黏膜肠化生的疗效并分析治疗失败的相关因素。方法:本研究回顾性纳入2019年04月01日至2022年01月01日在我院就诊的223例胃黏膜肠化生患者,均接受塞来昔布胶囊(200 mg/次,1次/天)治疗6个月。通过基于肠化生的胃炎...目的:评估塞来昔布对胃黏膜肠化生的疗效并分析治疗失败的相关因素。方法:本研究回顾性纳入2019年04月01日至2022年01月01日在我院就诊的223例胃黏膜肠化生患者,均接受塞来昔布胶囊(200 mg/次,1次/天)治疗6个月。通过基于肠化生的胃炎评价系统(operative link on the gastric intestinal metaplasia assessment,OLGIM)和基于胃炎的评价系统(operative link on gastritis assessment,OLGA)的变化评估疗效。采用多因素回归法分析治疗失败的危险因素。结果:塞来昔布治疗肠化生和胃黏膜萎缩的逆转率分别为49.8%(111/223)和45.3%(101/223),分别有50.4%(65/129)和61.4%(43/70)的患者从OLGA高分期和OLGIM高分期逆转到低分期。此外,塞来昔布对OLGA、OLGIM高分期患者的有效率高于低分期患者。多因素分析结果显示,胃黏膜重度炎症(3~4分)与塞来昔布治疗失败有关(OR=3.313,95%CI:1.359~8.076,P<0.05)。结论:塞来昔布可有效逆转胃黏膜的萎缩和肠化生,对于降低患者的胃癌风险具有积极意义。展开更多
A 18-year-old male patient’s case was diagnosed as Degos’disease with pathognomonic skin lesions,accompanied by small bowel perforation,and reported here. Skin histopothological test show that the typical wedge-shap...A 18-year-old male patient’s case was diagnosed as Degos’disease with pathognomonic skin lesions,accompanied by small bowel perforation,and reported here. Skin histopothological test show that the typical wedge-shaped necrobiosis and lymphocyte inflammatory infiltration. Vessels showed narrowing and thrombosis,with lymphocyte infiltration. Degos’disease is a systemic necrotizing vasculitis. Skin biopsy can confirm its diagnosis. Severe systemic complication should be prevented. Degos’disease should be considered in the differential diagnosis of skin lesions associated with systemic involvement.展开更多
Degos' disease,otherwise known as "malignant atrophic papulosis" is a rare vasculopathy with an unknown etiology characterized by typical cutaneous lesions.Involvement of the gastrointestinal(GI) tract i...Degos' disease,otherwise known as "malignant atrophic papulosis" is a rare vasculopathy with an unknown etiology characterized by typical cutaneous lesions.Involvement of the gastrointestinal(GI) tract is observed in approximately half of patients and small infarctions in the mucosa can cause perforation and resulting peritonitis,the leading cause of death.We present a fatal case of Degos' disease with skin and GI involvement,manifesting as recurrent intestinal perforations and peritonitis,in a 15-year-old Iranian boy.展开更多
基金Key Project of Science and Technology Department of Sichuan Province,No.2022YFS0337.
文摘BACKGROUND Malignant atrophic papulosis is a rare and potentially lethal thrombo-occlusive microvasculopathy characterized by cutaneous papules and gastrointestinal perforation.The precise pathogenesis of this disease remains obscure.CASE SUMMARY We describe the case of a 67-year-old male patient who initially presented with cutaneous aubergine papules and dull pain in the epigastrium.One week after symptom onset,he was admitted to the hospital for worsening abdominal pain.Exploratory laparotomy showed patchy necrosis and subserosal white plaque lesions on the small intestinal wall,along with multiple perforations.Histological examination of the small intestine showed extensive hyperemia,edema,necrosis with varying degrees of inflammatory reactions in the small bowel wall,small vasculitis with fibrinoid necrosis and intraluminal thrombosis in the mesothelium.Based on the mentioned evidence,a diagnosis of malignant atrophic papulosis was made.We also present the case of a 46-year-old man with known cutaneous manifestations,abdominal pain,nausea and vomiting.His physical examination showed positive rebound tenderness.A computed tomography scan revealed free intraperitoneal air.He required surgical intervention on admission and then developed an esophageal perforation.He ultimately died of a massive hemorrhage.CONCLUSION In previously published cases of this disease,the cutaneous lesions initially appeared as small erythematous papules.Subsequently,the papules became porcelain-white atrophic depression lesions with a pink,telangiectatic peripheral rim.In one of the patients,the cutaneous lesions appeared as aubergine papules.The other patient developed multiple perforations in the gastrointestinal tract.Due to malignant atrophic papulosis affecting multiple organs,many authors speculated that it is not a specific entity.This case series serves as additional evidence for our hypothesis.
基金This study will be supported by grants from the National Natural Science Foundation of China(No.81630080,91129714,81270466,81173424 and 81373796)the Science Research Foundation of BUCM(No.2014-JYBZZ-XS-134)+1 种基金the Research Foundation of the Doctoral Program of Higher Education of China(No.20120013110014)the National Undergraduates Innovating Experimentation Project of the Ministry of Education of China(No.081002609).
文摘Objective:Traditional Chinese medicine(TCM)and modern medicine have both been used in arresting malignant transformation of chronic atrophic gastritis(CAG)in China with good therapeutic effect.However,no studies have been undertaken to assess the risk of malignant transformation in CAG patients using both modern medicine and TCM features.Our study aimed to develop risk assessment models for malignant transformation of CAG combining indicators of both TCM and modern medicine.These models will facilitate early warning and control of malignant transformation of CAG from the perspective of evidence-based integrative medicine.Methods:In the proposed registry study,a total of 1000 eligible CAG patients will be recruited from four hospitals in China.A 10-year follow-up study will be conducted both on-site and off-site to track the events of malignant transformation.Frequency analysis and chi-squared tests will be used to perform the comparative analysis on the prevalence of malignant transformation events and indicators in TCM or modern medicine in different groups.A multivariate Cox proportional hazard model will be used to perform correlation analyses of malignant transformation events and factors of TCM or modern medicine.Conclusion:The proposed study has been designed with a large sample size and long follow-up period,in which wide-ranging modern medicine and TCM indicators can be gathered over the whole process of malignant transformation of CAG.Based on this study,risk assessment models for malignant transformation ofCAGmaybe constructed fromthe perspective of integrative medicine.This may provide clinicians and patients with an optimized early warning system as well as prevention strategies for malignant transformation of CAG.
文摘目的:评估塞来昔布对胃黏膜肠化生的疗效并分析治疗失败的相关因素。方法:本研究回顾性纳入2019年04月01日至2022年01月01日在我院就诊的223例胃黏膜肠化生患者,均接受塞来昔布胶囊(200 mg/次,1次/天)治疗6个月。通过基于肠化生的胃炎评价系统(operative link on the gastric intestinal metaplasia assessment,OLGIM)和基于胃炎的评价系统(operative link on gastritis assessment,OLGA)的变化评估疗效。采用多因素回归法分析治疗失败的危险因素。结果:塞来昔布治疗肠化生和胃黏膜萎缩的逆转率分别为49.8%(111/223)和45.3%(101/223),分别有50.4%(65/129)和61.4%(43/70)的患者从OLGA高分期和OLGIM高分期逆转到低分期。此外,塞来昔布对OLGA、OLGIM高分期患者的有效率高于低分期患者。多因素分析结果显示,胃黏膜重度炎症(3~4分)与塞来昔布治疗失败有关(OR=3.313,95%CI:1.359~8.076,P<0.05)。结论:塞来昔布可有效逆转胃黏膜的萎缩和肠化生,对于降低患者的胃癌风险具有积极意义。
文摘A 18-year-old male patient’s case was diagnosed as Degos’disease with pathognomonic skin lesions,accompanied by small bowel perforation,and reported here. Skin histopothological test show that the typical wedge-shaped necrobiosis and lymphocyte inflammatory infiltration. Vessels showed narrowing and thrombosis,with lymphocyte infiltration. Degos’disease is a systemic necrotizing vasculitis. Skin biopsy can confirm its diagnosis. Severe systemic complication should be prevented. Degos’disease should be considered in the differential diagnosis of skin lesions associated with systemic involvement.
文摘Degos' disease,otherwise known as "malignant atrophic papulosis" is a rare vasculopathy with an unknown etiology characterized by typical cutaneous lesions.Involvement of the gastrointestinal(GI) tract is observed in approximately half of patients and small infarctions in the mucosa can cause perforation and resulting peritonitis,the leading cause of death.We present a fatal case of Degos' disease with skin and GI involvement,manifesting as recurrent intestinal perforations and peritonitis,in a 15-year-old Iranian boy.
