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摘要: 坏疽性脓皮病(PG)是一种罕见的嗜中性皮肤病,与免疫系统密切相关,其发病机制目前并不明确。PG的临床表现及组织病理学变化缺乏特异性,导致其临床诊断周期较长甚至可能被误诊,容易因此延误治疗或促使溃疡创面恶化。目前该病的诊断仍十分困难,给创面修复医师带来了极大的挑战。该文综述了近年来有关PG的病理生理、临床特征、诊断等方面的研究进展,以期为相关临床工作者提供参考。Abstract: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis, closely associated with the immune system. Its pathogenesis is currently not clear. The lack of specificity in the clinical manifestations and histopathological changes of PG leads to a long clinical diagnosis cycle and even misdiagnosis, which is easy to delay treatment or promote the deterioration of ulcer wound. The diagnosis of this disease is still very difficult, which poses a great challenge to wound repair practitioners. This article reviews the research advances on the pathophysiology, clinical features, and diagnosis of PG in recent years, with the aim of providing reference for relevant clinical practitioners.
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Key words:
- Pyoderma gangrenosum /
- Diagnosis /
- Pathology, clinical /
- Clinical typing
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表1 诊断坏疽性脓皮病的PARACELSUS评分量表
诊断标准内容 标准等级 标准评分(分) 病程进展迅速 主要标准 3 相关鉴别诊断的评估 主要标准 3 紫红色溃疡边缘 主要标准 3 对免疫抑制剂反应良好 次要标准 2 典型的不规则形状溃疡 次要标准 2 极度疼痛,VAS评分>4分 次要标准 2 病灶位于创伤部位 次要标准 2 组织病理学证实化脓性炎症 附加标准 1 边缘潜行的溃疡 附加标准 1 与系统性疾病相关 附加标准 1 注:该表引自文献[43];PARACELSUS中各字母为各诊断标准(从上到下依次排列)英文首字母,VAS为视觉模拟评分法 -
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