臨床特徵 (Clinical Features)
- 過去數年間，出現一種與非法使用古柯鹼 (cocaine) 相關的流行性血管炎／血管病變 (vasculitis/vasculopathy) 型態。
- 病人典型表現為四肢與軀幹的網狀紫斑 (retiform purpura)，其發生在時間上與 cocaine 使用相關 (Fig. 16.134)。
- 耳部受侵犯很常見，且為診斷的線索之一。
組織病理特徵 (Histopathology)
- 病理特徵為伴隨程度不等發炎反應的機化性血栓 (organizing thrombus with variable inflammation)。
- 一篇病例報告強調受侵犯血管中 podoplanin 呈陰性免疫反應，提示 Mondor disease 與血管血栓 (vascular thrombosis) 相關，而非代表淋巴管炎 (lymphangitis)。
圖 16-134：古柯鹼相關網狀紫斑 (cocaine-related retiform purpura)：(A) 網狀紫斑伴隨表皮壞死 (retiform purpura with associated epidermal necrosis)；(B) 此病人有耳部的紫斑性病灶 (purpuric lesions of the ears)。By courtesy of Anthony P. Fernandez, MD, PhD, Cleveland Clinic, Cleveland, USA.
Fig. 16.134 Cocaine-related retiform purpura: (A) retiform purpura with associated epidermal necrosis; (B) this patient had purpuric lesions of the ears. By courtesy of Anthony P. Fernandez, MD, PhD, Cleveland Clinic, Cleveland, USA.