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Dermatologische Krankheitsbilder in der Rheumatologie

Dermatological symptoms in rheumatology

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Zusammenfassung

Das Gefäßbindegewebe der Haut, des Bewegungs- und Stützapparates ist bei rheumatischen Erkrankungen oft gemeinsam betroffen. Neben den klassischen Kollagenosen mit den typischen Hauteffloreszenzen treten an der Haut auch unspezifische Reaktionsmuster auf (z. B. Purpura, neutrophile Dermatose, Ulzera), die auch bei anderen Erkrankungen vorkommen. Neuere Erkenntnisse über Chemokin- und Zytokin-gesteuerte Vorgänge lassen dabei zunehmend bestimmte (histo-)pathologische Reaktionsmuster erkennen. Als Beispiele seien das große Spektrum neutrophiler Dermatosen genannt, die bei rheumatischen, hämatologischen und Darmerkrankungen und ohne ersichtliche Grundkrankheit vorkommen, oder Erkrankungen mit „Interphase-Dermatitis“ wie dem Lupus erythematodes, der Dermatomyositis, Lichen ruber planus oder Lichen sclerosus, bei denen die auslösenden Mediatoren bereits bekannt sind. In Zukunft werden sich aus den neuen Erkenntnissen auch neue Wege für gezielte Therapieformen erschließen.

Abstract

The connective tissue of the skin, joints and musculoskeletal system is often involved concomittantly in rheumatic diseases. Specific skin lesions can be the hallmark of certain collagen vascular diseases, but unspecific dermatoses like purpura, neutrophilic dermatoses or ulcers are also common. Recent investigations suggest that the different histopathologic reaction patterns are derived from cytokine- and chemokine-mediated processes. Thus neutrophilic dermatoses are observed in rheumatic, hematologic and gastric diseases, or in patients without apparent disease. The mediators causing interphase dermatitis seen in LE, dermatomyositis, lichen planus or lichen sclerosus have recently be described. The knowledge gained from these findings opens an avenue for the development of new therapeutic agents.

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Abbreviations

ACLE:

Akuter kutaner Lupus erythematodes

CLE:

Kutaner Lupus erythematodes

CCLE:

Chronisch kutaner Lupus erythematodes

CDLE:

Chronisch diskoider Lupus erythematodes

CHLE:

Chilblain-Lupus

DM:

Dermatomyositis

DRESS:

„Drug reaction with eosinophilia and systemic symptoms“

ICLE:

Intermittierender kutaner Lupus erythematodes

LEP:

Lupus erythematodes profundus

SCLE:

Subakuter kutaner Lupus erythematodes

SLE:

Systemischer Lupus erythematodes

DM:

Dermatomyositis

LE:

Lupus erythematodes

PAPA:

„Pyogenic arthritis, pyoderma gangrenosum and acne“

SAPHO:

Synovitis, Akne, Pustulosis, Hyperostosis

RA:

Rheumatoide Arthritis

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  1. Univ.-Klinik für Dermatologie, Medizinische Universität Graz, Auenbrugger Platz 8, 8036, Graz, Österreich

    E. Aberer

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Aberer, E. Dermatologische Krankheitsbilder in der Rheumatologie. Z. Rheumatol. 67, 372–385 (2008). https://doi.org/10.1007/s00393-008-0341-2

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