ABSTRACT
A vasculopatia livedoide é uma doença rara caracterizada pela oclusão da microvasculatura da derme, originando lesões maculosas que, posteriormente, podem evoluir para úlceras e cicatrizes atróficas. Como um fenômeno vaso-oclusivo, o tratamento geralmente é realizado com antiplaquetários e fibrinolíticos. O presente relato descreve o caso de uma paciente refratária à terapia convencional, que obteve regressão da doença utilizando a rivaroxabana, um fármaco inibidor seletivo do fator Xa. (AU)
Livedoid vasculopathy is a rare disease characterized by occlusion of the dermis microvasculature, leading to spotted lesions that can later develop into ulcers and atrophic scars. As a vaso- occlusive phenomenon, treatment is usually performed with antiplatelet and fibrinolytic agents. The present report describes the case of a female patient refractory to conventional therapy who presented disease remission using rivaroxaban, a selective factor Xa inhibitor drug. (AU)
Subject(s)
Humans , Female , Middle Aged , Thrombosis/drug therapy , Skin Diseases, Vascular/drug therapy , Thrombotic Microangiopathies/drug therapy , Rivaroxaban/therapeutic use , Livedoid Vasculopathy , Paresthesia , Pentoxifylline/therapeutic use , Polyneuropathies/diagnosis , Thrombosis/complications , Vasodilator Agents/therapeutic use , Biopsy , Platelet Aggregation Inhibitors/therapeutic use , Nifedipine/therapeutic use , Fibromyalgia , Skin Diseases, Vascular/complications , Skin Diseases, Vascular/diagnosis , Connective Tissue Diseases/complications , Lower Extremity/injuries , Electromyography , Thrombotic Microangiopathies/complications , Factor Xa Inhibitors/therapeutic use , Foot/pathology , Diverticular Diseases , Smokers , Gabapentin/therapeutic use , Analgesics/therapeutic useABSTRACT
La panarteritis nudosa cutánea es una forma poco frecuente de vasculitis necrosante de arterias de pequeño y mediano calibre, de curso crónico y recurrente, que puede acompañarse defiebre, artralgias, mialgias y neuropatía, pero sin compromiso sistémico. Se presenta un caso de panarteritis nudosa cutánea.
Subject(s)
Humans , Male , Child , Diagnosis, Differential , Skin Diseases, Vascular/complications , Skin Diseases, Vascular/diagnosis , Skin Diseases, Vascular/therapy , Polyarteritis Nodosa , Vasculitis/diagnosisABSTRACT
Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.
Subject(s)
Humans , Female , Adult , Vasodilator Agents/therapeutic use , Skin Diseases, Vascular/complications , Polyarteritis Nodosa/complications , Gangrene/etiology , Fingers , Amputation, Surgical , Alprostadil/therapeutic use , Adrenal Cortex Hormones/therapeutic useABSTRACT
In this case report we describe the first case of hemophagocytic lymphohistiocytosis with concurrent cutis marmorata telangiectatica congenita. She had pancytopenia and hepatosplenomegaly, hemophagocytic cells in spleen necropsy, and she died with respiratory failure and pseudomonas induced septicemia
Subject(s)
Humans , Female , Telangiectasis/congenital , Skin Diseases, Vascular/complications , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/pathology , Telangiectasis/pathology , Bone Marrow/pathology , Skin/pathologyABSTRACT
Objetivo: Se intenta proponer un modelo de razonamiento diagnóstico que pueda orientar al dermatólogo ante un paciente con livedo reticularis durante su primera consulta. Material y método: se presentan 10 pacientes con livedo reticularis y distintas patologías asociadas. Resultados y conclusión: la livedo reticularis puede ser la única manifestación de un proceso patológico que diagnosticado a tiempo permita un tratamiento oportuno para el paciente y una mejor calidad de vida. El estudio racional de estos pacientes evitará incurrir en errores o excesos a la hora de solicitar estudios complementarios y facilitará, de esta manera, el diagnóstico de las distintas entidades clínicas asociadas
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Algorithms , Skin Diseases, Vascular/diagnosis , Diagnosis, Differential , Skin Diseases, Vascular/classification , Skin Diseases, Vascular/complicationsABSTRACT
Os autores apresentam caso de cutis marmorata telangiectásica congênita, de diagnóstico pós-natal imediato. Säo discutidos e comentados os aspectos clínicos, evolutivos e de manuseio dessa patologia, destacando-se suas associaçöes e complicaçöes potenciais.