中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (8): 575-579.doi: 10.12144/zgmfskin202608575

• 临床研究 • 上一篇    下一篇

青斑样血管病三例并文献复习

柯丽娥1,纪明开2   

  1. 1 厦门市集美区灌口镇中心卫生院皮肤科，福建厦门，361021;2 厦门医学院附属第二医院皮肤科，福建厦门，361021
  • 出版日期:2026-08-15 发布日期:2026-08-03

Three cases of livedoid vasculopathy and literature review

KE Li'e1, JI Mingkai2   

  1. 1 Department of Internal Medicine, Guankou Township Center Hospital, Xiamen 361021, China; 2 Department of Dermatology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361021, China
  • Online:2026-08-15 Published:2026-08-03

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摘要： 本文报道 3 例青斑样血管病患者，均以双下肢反复疼痛性瘀点、瘀斑、溃疡及萎缩性白斑为主要表现，组织病理示真皮浅中层小血管内透明血栓形成，予小剂量己酮可可碱联合利伐沙班治疗，症状快速改善，长期随访未见复发且无明显不良反应。结合文献复习，抗凝为一线方案，临床常用阶梯治疗，抗血小板联合抗凝疗效确切；糖皮质激素、免疫球蛋白、JAK 抑制剂等可用于难治病例，但证据等级有限。

关键词: 青斑样血管病, 血栓形成, 己酮可可碱, 利伐沙班

Abstract: We report three cases of livedoid vasculopathy (LV). All patients presented with recurrent painful petechiae, ecchymoses, ulcers and atrophic plaques on both lower extremities. Histopathology revealed hyaline thrombi in small vessels of the superficial and middle dermis. Treatment with low-dose pentoxifylline combined with rivaroxaban resulted in rapid symptomatic improvement. No recurrence or obvious adverse reactions were observed during long-term follow-up. Literature review indicates that anticoagulation is the first-line therapy and stepwise management is commonly adopted in clinical practice. The combination of antiplatelet and anticoagulant therapy is effective. Corticosteroids, intravenous immunoglobulin and JAK inhibitors can be used for refractory cases, although the level of evidence is limited.

Key words: livedoid vasculopathy, thrombosis, pentoxifylline, rivaroxaban