Livedoid vasculitis - التهاب الاوعية الشبيه بالترخم
التهاب الأوعية الشبيه بالترخم (Livedoid vasculitis) هو مرض جلدي مزمن يظهر غالبًا لدى النساء الشابات حتى منتصف العمر. أحد الأوصاف المستخدمة لخصائصه هو "قرحة برفرية مؤلمة ذات نمط شبكي في الأطراف السفلية" (أرجواني). يرتبط المرض بعدة أمراض، بما في ذلك ارتفاع ضغط الدم الوريدي المزمن والدوالي.
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ReferencesLivedoid vasculopathy هي حالة جلدية نادرة تتميز بقرح مؤلمة تتكرر باستمرار في أسفل الساقين.
Livedoid vasculopathy (LV) is a rare thrombotic vasculopathy of the dermis characterized by painful, relapsing ulcers over the lower extremities. Diagnosis is challenging due to the overlap in clinical appearance and nomenclature with other skin disorders. Treatment selection is complicated by poor understanding of the pathogenesis of LV and lack of robust clinical trials evaluating therapy efficacy. The terminology and pathophysiology of LV are reviewed here, along with its epidemiology, clinical and histologic features, and treatment options. A diagnostic pathway is suggested to guide providers in evaluating for comorbidities, referring to appropriate specialists, and choosing from the available classes of therapy.
Livedoid vasculopathy (LV) is a rare thrombotic vasculopathy of the dermis characterized by painful, relapsing ulcers over the lower extremities. Diagnosis is challenging due to the overlap in clinical appearance and nomenclature with other skin disorders. Treatment selection is complicated by poor understanding of the pathogenesis of LV and lack of robust clinical trials evaluating therapy efficacy. The terminology and pathophysiology of LV are reviewed here, along with its epidemiology, clinical and histologic features, and treatment options. A diagnostic pathway is suggested to guide providers in evaluating for comorbidities, referring to appropriate specialists, and choosing from the available classes of therapy.
Livedoid vasculopathy هي حالة جلدية نادرة تسبب تقرحات متكررة في أسفل الساقين، وتترك وراءها ندبات شاحبة تُعرف باسم ضمور بلانش. بينما لا يزال السبب الدقيق غير واضح، يُعتقد أن زيادة تخثر الدم (hypercoagulability) هو العامل الرئيسي، ويلعب الالتهاب دورًا ثانويًا. تشمل العوامل المساهمة في التجلط ما يلي: نقص البروتينات C و S، طفرات جينية مثل العامل V Leiden، نقص الأنثيثرومين III، طفرات جين البروثرومبين، وارتفاع مستويات الهوموسيستين. في الخزعات، تُظهر الحالة جلطات دموية داخل الأوعية، سماكة جدران الأوعية الدموية، وتندبها. يتضمن العلاج نهجًا متعدد الجوانب يركز على منع تجلط الدم باستخدام أدوية مثل مضادات الصفيحات، مخفضات الدم، والعلاج الفوري للفيبرين. يمكن أيضًا استخدام أدوية مختلفة لهذه الحالة الجلدية مثل الكولشيسين (colchicine) والهيدروكسيكلوروكين (hydroxychloroquine)، موسعات الأوعية، ومثبطات المناعة.
Livedoid vasculopathy is a rare skin condition that causes recurring ulcers on the lower legs, leaving behind pale scars known as atrophie blanche. While the exact cause is still unclear, it's believed that increased blood clotting (hypercoagulability) is the main factor, with inflammation playing a secondary role. Factors contributing to clotting include as follows - deficiencies in proteins C and S, genetic mutations like factor V Leiden, antithrombin III deficiency, prothrombin gene mutations, high levels of homocysteine. In biopsies, the condition shows blood clots inside vessels, thickening of vessel walls, and scarring. Treatment involves a multi-pronged approach focusing on preventing blood clots with medications like anti-platelet drugs, blood thinners, and fibrinolytic therapy. Various drugs can be used for this skin condition - colchicine and hydroxychloroquine, vasodilators, immunosuppressants.
Livedoid vasculopathy is a rare skin condition that causes recurring ulcers on the lower legs, leaving behind pale scars known as atrophie blanche. While the exact cause is still unclear, it's believed that increased blood clotting (hypercoagulability) is the main factor, with inflammation playing a secondary role. Factors contributing to clotting include as follows - deficiencies in proteins C and S, genetic mutations like factor V Leiden, antithrombin III deficiency, prothrombin gene mutations, high levels of homocysteine. In biopsies, the condition shows blood clots inside vessels, thickening of vessel walls, and scarring. Treatment involves a multi-pronged approach focusing on preventing blood clots with medications like anti-platelet drugs, blood thinners, and fibrinolytic therapy. Various drugs can be used for this skin condition - colchicine and hydroxychloroquine, vasodilators, immunosuppressants.
Livedoid vasculopathy هي حالة نادرة تُظهر فيها آفات في كلا الساقين. يُعتقد أن تكون جلطات الدم في الأوعية الدموية الصغيرة نتيجةً لزيادة التخثر وانخفاض تحلل الجلطات، إلى جانب تلف بطانة الأوعية الدموية. وتكون أكثر شيوعًا عند الإناث، خاصة بين سن 15 و50 عامًا. وكان الإقلاع عن التدخين والعناية بالجروح واستخدام الأدوية مثل مميعات الدم والأدوية المضادة للصفيحات فعالًا.
Livedoid vasculopathy is a rare vasculopathy that is typically characterized by bilateral lower limb lesions. Increased thrombotic activity and decreased fibrinolytic activity along with endothelial damage are believed to be the cause of thrombus formation in the capillary vasculature. It is 3 times more common in females than in males, especially in patients between the ages of 15 to 50 years. There is no definite first-line treatment, but general measures like smoking cessation, wound care, and pharmacological measures like anticoagulants and antiplatelets have shown good results.
Livedoid vasculopathy is a rare vasculopathy that is typically characterized by bilateral lower limb lesions. Increased thrombotic activity and decreased fibrinolytic activity along with endothelial damage are believed to be the cause of thrombus formation in the capillary vasculature. It is 3 times more common in females than in males, especially in patients between the ages of 15 to 50 years. There is no definite first-line treatment, but general measures like smoking cessation, wound care, and pharmacological measures like anticoagulants and antiplatelets have shown good results.
