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皮膚型結節(jié)性多動脈炎并發(fā)周圍神經(jīng)炎

發(fā)布時間:2018-03-03 20:13

  本文選題:皮膚型結節(jié)性多動脈炎 切入點:白色萎縮 出處:《臨床皮膚科雜志》2017年06期  論文類型:期刊論文


【摘要】:報告1例皮膚型結節(jié)性多動脈炎并發(fā)周圍神經(jīng)炎;颊吲,40歲。雙下肢斑疹、紫癜、結痂伴麻木疼痛5年,加重5個月。皮膚科檢查:雙小腿、足背散在褐黃色胡椒粉樣色素沉著,部分呈環(huán)狀分布。雙踝內(nèi)、外側(cè)有可觸及的紫癜、點狀壞死、結痂、象牙白色萎縮性瘢痕。皮損組織病理:真皮淺層小血管栓塞,真皮深層中等大小動脈周圍淋巴細胞和組織細胞浸潤,伴管腔纖維蛋白樣壞死。左側(cè)腓腸神經(jīng)組織病理:重度軸索性周圍神經(jīng)改變。該患者診斷為皮膚型結節(jié)性多動脈炎并發(fā)周圍神經(jīng)炎。給予潑尼松和羥氯喹抗炎,西洛他唑和胰激肽原酶腸溶片等抗血小板聚集、擴血管,甲鈷胺和呋喃硫胺營養(yǎng)神經(jīng)治療后,皮損基本痊愈,神經(jīng)癥狀部分緩解。隨訪1年無復發(fā)。
[Abstract]:A case of cutaneous nodular polyarteritis complicated with peripheral neuritis was reported. The patient was 40 years old. The dorsal foot is scattered in brown-yellow pepper-like pigmentation, some of which are circularly distributed. There are palpable purpura, punctate necrosis, scab, ivory white atrophic scar in the inside and outside of the ankle. Histopathology: small vascular embolism in the superficial dermis. The infiltration of lymphocytes and histocytes around the middle and large arteries in the deep dermis. Left sural nerve histopathology: severe axonal peripheral nerve changes. This patient was diagnosed as cutaneous nodular polyarteritis complicated with peripheral neuritis. Prednisone and hydroxychloroquine were given to prevent inflammation. Cilostazol and pancreatic kallikrein enteric-coated tablets inhibited platelet aggregation, vasodilation, methylcobalamin and furanthiamine nutritional neurotherapy, the lesions were basically cured, and the neurological symptoms were partly relieved. No recurrence was observed for one year.
【作者單位】: 上海交通大學醫(yī)學院附屬瑞金醫(yī)院皮膚科;上海交通大學醫(yī)學院附屬瑞金醫(yī)院神經(jīng)內(nèi)科;
【分類號】:R593.27;R745

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