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首页> 外文期刊>Clinics in dermatology >Lymphedema and subclinical lymphostasis (microlymphedema) facilitate cutaneous infection, inflammatory dermatoses, and neoplasia: A locus minoris resistentiae
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Lymphedema and subclinical lymphostasis (microlymphedema) facilitate cutaneous infection, inflammatory dermatoses, and neoplasia: A locus minoris resistentiae

机译：淋巴水肿和亚临床淋巴结肿大（微淋巴水肿）促进皮肤感染，炎症性皮肤病和瘤形成：小位抵抗性

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摘要

Whether primary or secondary, lymphedema is caused by failure to drain protein-rich interstitial fluid. Typically affecting a whole limb, it has become apparent that lymphedema can also affect localized regions of the skin, or it can be clinically silent but histologically evident, denoted by dilated lymphangiectases (latent lymphedema). Chronic lymph stasis has numerous consequences, including lipogenesis, fibrosis, inflammation, lymphangiogenesis, and immunosuppression. For example, lymphedema's disruption of immune cell trafficking leads to localized immune suppression, predisposing the area affected to chronic inflammation, infection (cellulitis and verrucosis), and malignancy (angiosarcoma and nonmelanoma skin cancer). The pathogenesis of lymphedema is reviewed and exemplified by describing how a combination of lymph stasis-promoting factors such as trauma, obesity, infection, and inflammatory disorders produces localized elephantiasis; furthermore, the finding of lymphangiectases is found to be common in numerous dermatologic disorders and argued to play a role in their pathogenesis. Lastly, it is discussed how antigen burden, which is controlled by lymphatic clearance, affects the immune response, resulting in immune tolerance, immunopathology, or normal adaptive immunity.
机译：不论是原发性还是继发性，淋巴水肿都是由于未能排出富含蛋白质的组织液所致。淋巴水肿通常会影响整个肢体，因此很明显，淋巴水肿也可以影响皮肤的局部区域，或者在临床上是沉默的，但在组织学上很明显，表现为淋巴管扩张（潜伏性淋巴水肿）。慢性淋巴淤积有许多后果，包括脂肪生成，纤维化，炎症，淋巴管生成和免疫抑制。例如，淋巴水肿对免疫细胞运输的破坏会导致局部免疫抑制，从而使该区域易患慢性炎症，感染（蜂窝组织炎和疣状皮肤病）和恶性肿瘤（血管肉瘤和非黑素瘤皮肤癌）。通过描述淋巴淤滞促进因子（如创伤，肥胖，感染和炎性疾病）的组合如何产生局部象皮病，来回顾和举例说明淋巴水肿的发病机理。此外，发现淋巴管扩张酶在许多皮肤病中很常见，并被认为在其发病机理中起作用。最后，讨论了由淋巴清除控制的抗原负荷如何影响免疫反应，从而导致免疫耐受，免疫病理或正常的适应性免疫。

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