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成人血管炎性皮肤病变的评估

Author
Nicole Fett, MD
Section Editor
Jeffrey Callen, MD, FACP, FAAD
Deputy Editor
Abena O Ofori, MD
Translators
孙仁山, 主任医师，教授

引言

皮肤血管炎可以由多种疾病引起，可具有多种临床表现。因为其他疾病也可能表现出相似的临床特征，所以组织病理学检查是确诊必不可少的。

血管炎患者存在血管炎累及其他器官的风险。此外，皮肤血管炎的病因并非总是能立即明了。进行全面的病史询问和体格检查可指导选择用于患者评估的合适的实验室检查和放射影像学检查。

有关疑似血管炎皮肤病变的成人的临床、组织病理学及实验室评估将总结在此。对儿童期血管炎的评估、网状紫癜患者的评估，以及关于皮肤血管炎具体类型的详细信息将在别处讨论。 (参见“儿童血管炎的评估”和“网状(成角的)紫癜患者的病因和评估”和“成人血管炎的分类及诊断方法”和“成人特发性皮肤小血管炎的处理”)

病因

皮肤血管炎由皮肤内的小血管或中等大小血管的炎症所致。小血管(<50μm)是指真皮浅层、中层中的毛细血管、毛细血管后微静脉及非肌型小动脉。中等大小血管由真皮深部和皮下组织中具有肌型管壁的管径为50-150μm的血管组成[1-5]。

皮肤血管炎可发生于多种临床情况下(表 1)。可表现为皮肤病变的血管炎性疾病的实例包括[6]：

                    

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Literature review current through: 2017-06 . | This topic last updated: 2016-04-12.
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