Zusammenfassung
Vaskulitiden stellen seltene Ursachen für Hautulzerationen dar. Abhängig vom Kaliber des betroffenen Gefäßes, von Komorbiditäten des Patienten und vorliegender Pathophysiologie zeigen sich unterschiedliche klinische Morphologien, die nicht selten erste Hinweise auf die Art der zugrunde liegenden Vaskulitis geben können. Es können systemische oder rein kutane Manifestationsformen vorliegen, sodass frühzeitig eine gezielte Diagnostik eingeleitet werden sollte. Das Therapiekonzept sollte bei Vorliegen einer Systembeteiligung interdisziplinär abgestimmt werden. Abzugrenzen sind die Vaskulopathien, wie z. B. die Livedovaskulopathie, bei denen pathophysiologisch die Okklusion des Gefäßlumens im Vordergrund steht. Bei Vorliegen von vaskulitischen oder vaskulopathischen Ulzerationen wird ein stadiengerechtes Wundmanagement empfohlen.
Abstract
Vasculitis is a rare cause of skin ulceration. Depending on the size of the affected vessel, the patient’s comorbidities and the pathophysiology present, different clinical morphologies can be seen, which can often give preliminary indications of the type of underlying vasculitis. There may be systemic or cutaneous manifestations; thus, a targeted diagnostic workup should be initiated at an early stage. Treatment should be interdisciplinary if there is systemic participation. Vasculopathies (e.g., livedoid vasculopathy), in which occlusion of the vascular lumen is the main pathophysiological feature, should be delimitated from vasculitis. If vasculitic or vasculopathic ulceration is present, stage-appropriate wound management is recommended.
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T. Görge hat Vortragshonorare der Fa. Bayer Vital GmbH erhalten. C. Mitschang gibt an, dass kein Interessenkonflikt besteht.
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Mitschang, C., Görge, T. Diagnostik und Behandlung vaskulitischer Ulzerationen. Hautarzt 71, 870–879 (2020). https://doi.org/10.1007/s00105-020-04694-0
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DOI: https://doi.org/10.1007/s00105-020-04694-0
Schlüsselwörter
- Vaskulitis
- Vaskulopathische Ulzerationen
- Klinische Manifestationsformen
- Livedovaskulopathie
- Wundmanagement