中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (7): 524-526.doi: 10.12144/zgmfskin202507524

• 病例报告 • 上一篇    下一篇

以皮肤血管炎为首发表现的系统性红斑狼疮一例

宋居艳,王海洪,王妍清,林超群,张绍琴   

  1. 贵阳市第一人民医院皮肤科,贵州贵阳,550000
  • 出版日期:2025-07-15 发布日期:2025-07-07

Systemic lupus erythematosus with cutaneous vasculitis as the first manifestation: a case report

SONG Juyan, WANG Haihong, WANG Yanqing, LIN Chaoqun, ZHANG Shaoqin   

  1. Department of Dermatology, Guiyang First People's Hospital, Guiyang 550000, China
  • Online:2025-07-15 Published:2025-07-07

摘要: 本文报道1例以皮肤血管炎皮损为首发表现的系统性红斑狼疮。患者,女,51岁,双下肢、臀部瘀斑伴痒痛1周。皮损组织病理检查示真皮胶原变性、纤维素样坏死及血管炎改变。抗dsDNA抗体阳性、抗SSA抗体阳性、抗核抗体阳性性等多项抗体阳性,诊断为系统性红斑狼疮,SLEDAI评分12分。患者经过2周糖皮质激素治疗,皮损明显好转。出院后患者自行停药病情加重,出现心、肺、肝、肾、血液系统多系统损害,最终因病情危重死亡。

关键词: 红斑狼疮, 系统性, 血管炎

Abstract: We report a case of systemic lupus erythematosus with cutaneous vasculitis as the initial manifestation. A 51-year-old female presented with ecchymosis on both lower limbs and buttocks with itching and pain for 1 week. The histopathological examination of the skin lesions revealed dermal collagen degeneration, fibrinoid necrosis, and vasculitis changes. Multiple antibodies, such as the anti-dsDNA antibody, anti-SSA antibody, and antinuclear antibody, were positive. The patient was diagnosed with systemic lupus erythematosus, with a SLEDAI score of 12. After two weeks of glucocorticoid treatment, the skin lesions improved significantly. After being discharged from the hospital, the patient stopped taking the medication by herself, and the condition deteriorated, leading to multi-system damage involving the heart, lungs, liver, kidneys, and blood system. Eventually, the patient died due to critical illness.

Key words: lupus erythematosus, systematic, vasculitis