全身脫皮治不好 免疫出包 2015-12-22 記者劉曉欣／彰化報導 彰濱秀傳醫院副院長鄭賀雄表示，這名男子「這裡癢、那裡癢」，原本以為沒什麼大不了，直到癢到抓不停，全身都脫皮，才連忙去看皮膚科醫師，可是連換兩家，卻依然沒有改善。由於該名男子本身就有氣喘，醫生建議他去過敏免疫風濕科診療，經過胸部Ｘ光、抽血等多項檢查，結果確診為過敏性血管炎。鄭賀雄指出，該名個案不但皮膚癢，還有氣喘病史，在皮膚科無法獲得改善，才到過敏免疫風濕科尋求解答，終於可以對症下藥，不然很可能錯過治療的黃金時間，讓病情更加擴大。 一般來說，血管炎的分類很多，但發生原因不明，主要還是認為與免疫系統不正常活化有關，臨床症狀五花八門，從皮膚起疹子到發燒、頭痛、腹痛都可能出現，只有進一步檢查確診、找出病因，才能對症下藥。 鄭賀雄強調，許多人聽過「過敏免疫風濕科」，卻不知道什麼症狀要掛這一科，往往都是碰到疼痛、腫痛，或是有兩個器官以上的問題，才會選擇來看，不少看診醫師經常碰到「整個醫院科別都看完了」，但始終都找不到病因，最後就到「過敏免疫風濕科」來試試運氣的情況。 鄭賀雄提醒，西醫所稱的「過敏免疫風濕」，主要是科別名稱，西醫的「風濕」名稱起源應該與「風濕熱」有關，只要患者有慢性、反覆性、肌肉骨骼症狀，時間超過6個星期以上還無法痊癒，就可到該科進一步檢查，以免錯失治療時機。
Study links psoriasis with blood vessel inflammation Written by Honor Whiteman Published: Fri 9 October 2015 at 12am PST Researchers have associated greater severity of psoriasis with increased inflammation of the blood vessels. Senior author Dr. Nehal N. Mehta, a Lasker clinical investigator at the National Heart, Lung, and Blood Institute of the National Institutes of Health, and colleagues publish their findings in the journal Arteriosclerosis, Thrombosis and Vascular Biology. Psoriasis is a chronic autoimmune skin disease estimated to affect around 7.5 million people in the US. The condition is characterized by red, flakey patches on the skin, most commonly on the elbows, knees, scalp, face, lower back, palms and soles of feet. Past studies have suggested that people with psoriasis are at greater risk for heart attack and other cardiovascular events, as well as increased risk of cardiovascular-related death. For their study, Dr. Mehta and colleagues set out to investigate whether psoriasis may be associated with vasculitis - a condition in which the immune system mistakingly attacks the blood vessels, causing them to inflame. Inflammation of the blood vessels may lead to complications such as aneurism and blood clots, which can obstruct blood flow to the heart and raise risk for heart attack and stroke. 51% greater blood vessel inflammation with most severe psoriasis To reach their findings, the team enrolled 60 adults with an average age of 47 who had psoriasis, alongside 20 adults with an average age of 41 who did not have the skin condition. All participants were at low risk for cardiovascular disease. A dermatologist assessed the extensiveness of psoriasis among participants, which ranged from mild (less than 3% of the skin surface affected) to severe (at least 10% of the skin surface affected). Blood vessel inflammation was determined through a nuclear scan. Compared with participants who were free of psoriasis, those with the most severe form of the skin condition experienced a 51% rise in blood vessel inflammation, and this association was still relevant even after accounting for other factors related to cardiovascular disease. Overall, the team found that the more severe a participant's psoriasis, the more inflammation there was of their blood vessels. "In other words, what we see on the outside is mirrored on the inside," says Dr. Mehta. The researchers say their findings support the theory that psoriasis and vasculitis share an underlying mechanism related to the immune system.
Dr. Mehta adds: "People who have psoriasis - particularly if it is severe - should be assessed by their doctor for cardiovascular risk factors, including diabetes, high cholesterol and obesity. They should also maintain an active lifestyle, avoid smoking and follow a balanced diet." Earlier this month, Medical News Today reported on a study suggesting people with psoriasis are more likely to develop depression - a finding the researchers say may be related to the social reaction psoriasis patients receive in response to their appearance. Written by Honor Whiteman
What is the aetiology (cause)? No cause for HV is found in between one third and one half of patients. HV can be caused by a specific drug or by infection. The most common drugs include: antibiotics(particularly penicillins), non-steroidal anti-inflammatory drugs (NSAIDS) and diuretics. Infections which may be associated with HV include: hepatitis B or C virus, chronic infection with bacteria or HIV. HV type rashes and symptoms may also be seen as part of other inflammatory disease including other types of vasculitis, Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis, Sjögren's Syndrome, inflammatory bowel disease and very rarely some types of cancer. Vasculitis can sometimes develop after an infection has come and gone. Usually in these cases, the infection triggers an abnormal response in the person's immune system, damaging the blood vessels. Vasculitis also may be related to other diseases of the immune system that the person has had for months or years. For example, it could be a complication of rheumatoid arthritis, lupus, or Sjögren's syndrome.
Vasculitis Symptoms An enormous number of vasculitis symptoms are possible because any organ system may be involved. If the skin is involved, there may be a rash. If nerves suffer loss of blood supply, there may initially be an abnormal sensation followed by a loss of sensation. Vasculitis in the brain may cause a stroke, or in the heart, may result in a heart attack. Inflammation in the kidney could result in abnormalities noted on urine tests and can lead to progressive kidney failure. Sometimes the symptoms may be as general as fever, loss of appetite, weight loss, and loss of energy. If you suffer any unusual symptoms, see your doctor.
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