静脉瓣功能障碍致假性Kaposi肉瘤1例报告并文献回顾
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1.中南大学湘雅医院 皮肤科,湖南 长沙 410008;2.中南大学湘雅医院 全科医学科,湖南 长沙 410008;3.中南大学湘雅医学院, 湖南 长沙 410013

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范智华,中南大学湘雅医院博士研究生,主要从事免疫相关皮肤病、炎症性皮肤病及毛发等方面的研究。

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湖南省长沙市自然科学基金资助项目(kq2014279)。


Pseudo-Kaposi sarcoma caused by venous valve dysfunction: a case report and literature review
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1.Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008,China;2.Department of General Practice, Xiangya Hospital, Central South University, Changsha 410008,China;3.Xiangya School of Medicine, Central South University, Changsha 410013, China

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    摘要:

    背景与目的 假性Kaposi肉瘤,又称肢端血管性皮炎,是一种罕见的血管外科疾病。本文通过报告1例静脉瓣功能障碍致假性Kaposi肉瘤病例,结合文献回顾探讨其临床病理特征及诊治。方法 回顾性分析1例假性Kaposi肉瘤患者的临床病例资料,结合国内外文献总结假性Kaposi肉瘤的病因、分型、临床表现、病理、诊断及治疗。结果 患者男性,37岁。长期从事站立性体力劳动,两踝关节内侧下方数个暗紫红色瘀斑,近1个月久站后皮损处疼痛。结合病史、病理切片及辅助检查,诊断为“假性Kaposi肉瘤”。经穿弹力袜、促进静脉回流、抗凝、改善循环后,双下肢皮损处无明显疼痛,皮损较前无明显扩大或增多。结论 静脉瓣功能障碍与假性Kaposi肉瘤发生发展相关,较为罕见且鉴别诊断存在一定困难,需结合皮损特点、病理及血管影像特点综合考虑,目前无特异性治疗。

    Abstract:

    Background and Aims Pseudo-Kaposi sarcoma, also known as acroangiodermatitis, is a rare disease in the field of vascular surgery. Hence, this article was conducted to investigate the clinicopathologic characteristics as well as the diagnosis and treatment of this disease through reporting a case of pseudo-Kaposi sarcoma caused by venous valve dysfunction, combined with literature review.Methods The clinical data of one patient with pseudo-Kaposi sarcoma were retrospectively analyzed, and the etiology, typology, clinical manifestations, pathological features, diagnosis, and treatment of pseudo-Kaposi sarcoma were summarized with domestic and foreign literature review.Results The patient was a 37-year-old man who had been engaged in physical work in a standing position for a long time. He had several dark purplish-red ecchymoses on the interior sides of the lower portions of both ankles and had pain after prolonged standing during the past month. He was diagnosed with "pseudo-Kaposi sarcoma" by combining clinical and pathological examinations and adjuvant examinations. After wearing elastic stockings, promoting venous reflux, anticoagulation, and improving circulation, there was no obvious pain in the skin lesion on both lower limbs, and no development or growth of the skin lesions were noted.Conclusion Venous valve dysfunction is associated with the occurrence and development of pseudo-Kaposi sarcoma, which is rare and difficult to make a differential diagnosis, and needs to be considered comprehensively according to the lesion characteristics, pathology, and angiographic features. There is currently no specific and effective treatment.

    表 2 Table 2
    表 1 假性Kaposi肉瘤常见病因的文献总结Table 1 The common causes and literature extraction of pseudo-Kaposi sarcoma
    图1 相关图片资料 A:皮损形态;B:下肢血管彩超示股静脉少量反流Fig.1 The relevant image data A: Appearance of skin lesions; B: Color Doppler ultrasound of the lower limb showing small amount of reflux in the femoral vein
    图2 皮损组织病理学(HE×200) A:毛细血管增生,稀疏淋巴细胞浸润,无明显红细胞外溢(2017年);B:较多红细胞外溢及含铁血黄素沉积(2021年)Fig.2 Histopathological observation of the skin lesions (HE×200) A: Capillary hyperplasia, sparse lymphocyte infiltration, and no obvious extravasation of the red blood cells (2017); B: Increased erythrocyte extravasation and hemosiderin deposition (2021)
    图1 相关图片资料 A:皮损形态;B:下肢血管彩超示股静脉少量反流Fig.1 The relevant image data A: Appearance of skin lesions; B: Color Doppler ultrasound of the lower limb showing small amount of reflux in the femoral vein
    图2 皮损组织病理学(HE×200) A:毛细血管增生,稀疏淋巴细胞浸润,无明显红细胞外溢(2017年);B:较多红细胞外溢及含铁血黄素沉积(2021年)Fig.2 Histopathological observation of the skin lesions (HE×200) A: Capillary hyperplasia, sparse lymphocyte infiltration, and no obvious extravasation of the red blood cells (2017); B: Increased erythrocyte extravasation and hemosiderin deposition (2021)
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范智华,张卫茹,陈静娴,杨光.静脉瓣功能障碍致假性Kaposi肉瘤1例报告并文献回顾[J].中国普通外科杂志,2022,31(6):822-828.
DOI:10.7659/j. issn.1005-6947.2022.06.016

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  • 收稿日期:2021-12-21
  • 最后修改日期:2022-05-31
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  • 在线发布日期: 2022-07-11