背景:冻疮/羊水病是一种非冻结性的冷损伤,可引起疼痛的炎性皮肤损伤。它的发病机理仍然知之甚少,因为它经常被研究为继发于其他潜在疾病。
方法:我们系统地调查了人口特征,症状,以及暴露于凉爽/寒冷环境的健康成年人冻疮的诱发因素。我们筛选了PubMed,Embase,和Cochrane图书馆,我们采用了PRISMA报告指南(PROSPERO:CRD42021245307)。偏倚风险由两名独立审阅者(RTI项目银行)评估。进行随机效应模型荟萃分析以计算组织病理学特征的合并患病率。混合效应荟萃回归用于评估研究间异质性的其他来源。
结果:共纳入13项研究(477例患者)。冻疮对女性的影响大于男性,高达12%的身体皮肤表面,最常见的是,手和手指。对9项研究(303例患者)的荟萃分析显示,经常存在血管周围淋巴细胞浸润(81%),基底表皮细胞层空泡化(67%),乳头状真皮水肿(66%),和周围淋巴细胞浸润(57%)。meta-regressions(p≤0.05)显示吸烟和频繁的职业接触水增加了组织病理学特征的可能性。
结论:人口特征,症状,在此分析中揭示的冻疮的诱发因素应纳入医疗护理中,以改善病情的诊断和管理。
BACKGROUND: Chilblains/
perniosis is a non-freezing cold injury causing painful inflammatory skin lesions. Its pathogenesis remains poorly understood because it is often studied as secondary to other underlying conditions.
METHODS: We systematically investigated the population characteristics, symptoms, and predisposing factors of chilblains in healthy adults exposed to cool/cold environments. We screened PubMed, Embase, and Cochrane Library, and we adopted PRISMA reporting guidelines (PROSPERO: CRD42021245307). The risk of bias was assessed by two independent reviewers (RTI item bank). Random-effects model meta-analyses were performed to calculate the pooled prevalence of histopathological features. Mixed-effects meta-regressions were used to assess other sources of between-study heterogeneity.
RESULTS: Thirteen studies (477 patients) were included. Chilblains affect more women than men, up to 12% of the body skin surface, and most frequently, the hands and fingers. Meta-analyses of nine studies (303 patients) showed a frequent presence of perivascular lymphocytic infiltrate (81%), basal epidermal-cell layer vacuolation (67%), papillary dermal edema (66%), and perieccrine lymphocytic infiltrate (57%). Meta-regressions (p ≤ 0.05) showed that smoking and frequent occupational exposure to water increase the likelihood of histopathological features.
CONCLUSIONS: The population characteristics, symptoms, and predisposing factors of chilblains revealed in this analysis should be incorporated in medical care to improve the condition\'s diagnosis and management.