荨麻疹性血管炎23例临床表现和组织病理分析  

Clinical and Histopathological Analysis based on 23 Cases of Urticarial Vasculitis

作　　者：赵伟峰[1] 陈连军[2] 马英[2] 黄琼[2] 罗燕[2] 陈明华[2] 

机构地区：[1]广东省佛山市顺德区慢性病防治中心,广东顺德528300 [2]复旦大学附属华山医院皮肤科,上海200040

出　　处：《中国皮肤性病学杂志》2015年第7期694-696,698,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的进一步了解荨麻疹性血管炎的临床表现和组织病理学特征,提高临床医生对本病的认识。方法回顾性分析23例荨麻疹性血管炎患者的临床表现、实验室检查结果和组织病理学资料。结果该病患者以中年女性居多,临床表现为荨麻疹样皮损,均伴有瘙痒,部分患者伴有疼痛、触痛或烧灼感,部分患者皮疹消退后遗留色素沉着,持续时间均超过24h。皮损组织病理学检查可见真皮浅层血管周围炎症细胞浸润,中性粒细胞为主型8例(34.78%);淋巴细胞为主型15例(65.22%),其中4例(17.39%)合并有中性粒细胞、嗜酸性粒细胞浸润,3例(13.04%)有中性粒细胞浸润,5例(21.74%)有嗜酸性粒细胞浸润,3例(13.04%)仅为淋巴细胞浸润。结论荨麻疹性血管炎的临床表现主要为风团和水肿性红斑,组织病理学特征呈谱系性改变,可以从轻微的血管周围淋巴细胞浸润到典型的白细胞碎裂性血管炎改变。Objective To learn more about the clinical and histopathologic features of urticarial vasculitis （UV）,and to im- prove clinicians＇ awareness of this disease. Methods Twenty three patients with urticarial vasculitis were retro- spectively analyzed for clinical manifestations,laboratory test results and histopathological data. Results Urticari- al vasculitis mainly attacked the middle-aged women, manifesting as urticarial lesions and all accompanied by prutitus. Some patients had pain, tenderness or burning sensation, some patients have pigmentation after the rash subsided, and all of the average duration was more than 24 hours. Histopathology showed dermal perivas- cular inflammatory cells infiltration. Eight cases （ 34. 78% ） mainly had neutrophil infiltration. The other 15 cases （65.22%） mainly had lymphocyte ,of which 4 cases （17.39%） were combined with neutrophils and eosinophils infiltration,3 cases （13.04%） neutrophil infiltration ,5 cases （21.74%） eosinophil infiltration, and 3 cases （ 13.04% ） only lymphocytes. Conclusion Clinical manifestations of urticarial vasculitis main- ly were wheal and edematous erythema. Histopathology features of urticarial vasculitis assume the spectrum change,which can range from mild perivascular lymphocytic infiltration to typical white leucocytoclastic vas- culitis.

关 键 词：血管炎 荨麻疹 临床表现 组织病理 

分 类 号：R758.24[医药卫生—皮肤病学与性病学]