RESUMO
INTRODUCTION: Cutaneous and vascular manifestations of cancer are numerous. Among paraneoplastic acral vascular syndrome, we report a case of blue toe syndrome as the first manifestation of a prostate cancer following with analysis of this syndrome according literature. OBSERVATION: A 56-year-old man, with Raynaud's phenomenon of the upper limbs for 2 to 3 years, had 4 blue toes of the left foot evolving for 18 months, without ulceration, the pulses being present. Vascular and cardiac explorations (ultrasound, angio-MRI) were normal. There was no biological or immunological abnormality except an elevated PSA level. Prostate biopsies confirmed diagnosis and abdomino-pelvic CT scan proved the bone and lymph node metastasis. CONCLUSION: The revelation of a prostate cancer with bone metastases by a blue toe syndrome is a rare situation. In a patient with a blue toe syndrome with no obvious clinical or biological abnormality, especially atheromatous, investigations should include a search for cancer, which can be revealed by blue toes.
Assuntos
Síndrome do Artelho Azul , Neoplasias Ósseas , Neoplasias da Próstata , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/etiologia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/complicações , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Tomografia Computadorizada por Raios X/efeitos adversosAssuntos
Síndrome do Artelho Azul/etiologia , Eritema/etiologia , Dor/etiologia , Pele/irrigação sanguínea , Idoso , Aspirina/uso terapêutico , Síndrome do Artelho Azul/diagnóstico , Eritema/diagnóstico , Feminino , Humanos , Dor/diagnóstico , Inibidores da Agregação Plaquetária/uso terapêutico , Trombocitemia Essencial/complicações , Trombocitemia Essencial/diagnóstico , Trombocitemia Essencial/tratamento farmacológico , Dedos do Pé , Resultado do TratamentoRESUMO
INTRODUCTION: Arterial and venous thromboses occur in almost one in five patients with POEMS syndrome and usually in macrocirculation. CASE REPORT: We report a 67-year-old male with a POEMS syndrome who presented initially with a blue toe syndrome. He complained of Raynaud's syndrome and left foot paresthesia. Physical examination showed gynecomastia, lymphadenopathies and skin lesions. Cardiovascular investigations excluded atrial fibrillation, unstable atherosclerotic lesions and vascular calcifications. Imaging studies showed diffuse osteosclerotic lesions. Monoclonal protein with lambda light chain was discovered and serum level of VEGF was increased at 2900pg/ml. CONCLUSION: This is to our knowledge the first case of thrombotic microangiopathy in POEMS syndrome without embolic cause or calciphylaxis.
Assuntos
Síndrome do Artelho Azul/etiologia , Síndrome POEMS/complicações , Idoso , Antineoplásicos Alquilantes/uso terapêutico , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/tratamento farmacológico , Dexametasona/uso terapêutico , Glucocorticoides/uso terapêutico , Humanos , Masculino , Melfalan/uso terapêutico , Síndrome POEMS/diagnóstico , Síndrome POEMS/tratamento farmacológico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Fator A de Crescimento do Endotélio Vascular/sangueAssuntos
Síndrome do Artelho Azul , Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos , Colesterol/sangue , Complicações Pós-Operatórias , Prednisolona/administração & dosagem , Idoso , Anti-Inflamatórios/administração & dosagem , Biópsia , Síndrome do Artelho Azul/sangue , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/etiologia , Síndrome do Artelho Azul/terapia , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Dedos do Pé/diagnóstico por imagem , Dedos do Pé/patologia , Resultado do TratamentoAssuntos
Aterosclerose/complicações , Síndrome do Artelho Azul , Succinatos/administração & dosagem , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/tratamento farmacológico , Síndrome do Artelho Azul/etiologia , Síndrome do Artelho Azul/fisiopatologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/prevenção & controle , Inibidores da Agregação Plaquetária/administração & dosagem , Resultado do TratamentoRESUMO
Cholesterol crystal embolism (CCE) is an arterio-arterial embolism originating from the breakdown of atherosclerotic plaques in the aortic wall. The embolism affects the skin and kidney particularly, as well as frequently affects the gastrointestinal tract and other organs. Although there are no clearly effective direct therapies for CCE, corticosteroid therapy and combination therapy with low-density lipoprotein apheresis (LDL-A) followed by corticosteroids were recently reported to be effective for renal manifestations in some cases. However, few cases offer suggestions for the treatment of skin lesions caused by CCE. We report here a case of a 58-year-old man diagnosed with CCE with skin manifestations and kidney dysfunction who achieved complete remission after LDL-A. LDL-A may be a useful treatment for CCE, particularly in cases with skin manifestations.
Assuntos
Remoção de Componentes Sanguíneos , Síndrome do Artelho Azul/terapia , Lipoproteínas LDL , Corticosteroides/uso terapêutico , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Venomous animals are those that, by means of a hunting and defense mechanism, are able to inject their prey with a toxic substance produced in their bodies, directly from specialized glands (e.g., tooth, sting, spur) through which the poison passes. Millipedes are poisonous animals; they can be harmful to humans, and their effects usually manifest as erythematous, purpuric, and cyanotic lesions; local pain; and paresthesia. Here, we report a case of skin contact with a millipede for 6h resulting in skin lesions similar to blue toe syndrome.
Assuntos
Artrópodes , Síndrome do Artelho Azul/diagnóstico , Dermatite de Contato/diagnóstico , Animais , Artrópodes/química , Dermatite de Contato/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Fatores de Tempo , Adulto JovemRESUMO
Venomous animals are those that, by means of a hunting and defense mechanism, are able to inject their prey with a toxic substance produced in their bodies, directly from specialized glands (e.g., tooth, sting, spur) through which the poison passes. Millipedes are poisonous animals; they can be harmful to humans, and their effects usually manifest as erythematous, purpuric, and cyanotic lesions; local pain; and paresthesia. Here, we report a case of skin contact with a millipede for 6h resulting in skin lesions similar to blue toe syndrome.
Assuntos
Animais , Feminino , Humanos , Adulto Jovem , Artrópodes , Síndrome do Artelho Azul/diagnóstico , Dermatite de Contato/diagnóstico , Artrópodes/química , Diagnóstico Diferencial , Dermatite de Contato/etiologia , Fatores de TempoRESUMO
El síndrome o signo del dedo azul (SDA) es una entidad poco frecuente causada por la oclusión de vasos periféricos distales. Se manifiesta como una coloración inicialmente azulada de uno o más dedos, referidos primero en las extremidades inferiores, en ausencia de traumatismo previo, y de etiología múltiple. La importancia de establecer un diagnóstico temprano y tratamiento oportuno es evitar la evolución extrema de necrosis o la pérdida de la vida del paciente.
The blue finger syndrome (or sign) is a rare entity caused by distal occlusion of peripheral vessels, which initially manifested as bluish discoloration of one or more fingers, first descriptions described in lower extremities in the absence of previous trauma of multiple etiologies; the importance of early diagnosis and treatment to prevent extreme changes in necrosis or loss of patient life.
Assuntos
Síndrome do Artelho Azul , Síndrome do Artelho Azul/complicações , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/etiologia , Síndrome do Artelho Azul/terapiaAssuntos
Antineoplásicos Alquilantes/administração & dosagem , Síndrome do Artelho Azul/etiologia , Cateterismo Periférico/efeitos adversos , Melfalan/administração & dosagem , Neoplasias da Retina/tratamento farmacológico , Retinoblastoma/tratamento farmacológico , Anticoagulantes/uso terapêutico , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/tratamento farmacológico , Humanos , Lactente , Infusões Intra-Arteriais , Masculino , Resultado do TratamentoRESUMO
Blue toe syndrome (BTS) is an important vascular condition characterized by painful blue discoloration of one or more digits. It is frequently due to emboli and is important because of the risk of progressive ischemia and tissue loss. A 53-year-old male presented with recurrent episodes of painful blue discoloration and blistering of the skin of the right hallux. On examination, the patient was found to have a cool, blue-purple great toe; all peripheral pulses were present. The patient was investigated for coagulopathy and potential sources of emboli, but the only abnormality was significant stenosis of the dorsalis pedis artery due to extrinsic compression by the extensor hallucis brevis tendon. In the absence of any other embolic source or abnormality, we believe that this case presents a novel and potentially remediable cause of BTS and indicates the need for a careful search for an underlying lesion when common causes of BTS have been excluded.
Assuntos
Arteriopatias Oclusivas/etiologia , Síndrome do Artelho Azul/etiologia , Embolia/etiologia , Pé/irrigação sanguínea , Tendões/anormalidades , Angiografia Digital , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/terapia , Síndrome do Artelho Azul/diagnóstico , Síndrome do Artelho Azul/terapia , Constrição Patológica , Embolia/diagnóstico , Embolia/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/uso terapêutico , Recidiva , Tendões/cirurgia , Tenotomia , Resultado do Tratamento , Ultrassonografia Doppler DuplaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Artelho Azul/diagnóstico , Aneurisma/diagnóstico , Artéria Poplítea/fisiopatologia , BiópsiaRESUMO
Cholesterol microembolization syndrome (CMS) is a multiorgan ischemic disorder resulting from occlusion of small vessels by cholesterol crystals that are derived from atherosclerotic plaques of major arteries. Flow distribution of cholesterol crystals determines the clinical picture of CMS. Cholesterol crystals distributed to the lower extremities cause a typical "blue toe" appearance. The predisposing factors of CMS include various vascular procedures that scratch the luminal surface of the vascular wall and make the release of cholesterol crystals from the atherosclerotic plaques possible. However, CMS can also occur as a consequence of continuous anticoagulant use. Therefore, patients on anticoagulant therapy complaining even minor toe symptoms should be examined for possible CMS.
Assuntos
Anticoagulantes/efeitos adversos , Síndrome do Artelho Azul/induzido quimicamente , Síndrome do Artelho Azul/diagnóstico , Idoso , Diagnóstico Diferencial , Humanos , Fatores de RiscoRESUMO
Blue toe syndrome (BTS), is a well-known entity of toe gangrene and rest pain secondary to micro emboli lodged within the digital arteries. BTS among young patients should alert physicians to look for causes such as trauma, connective tissue disease, hypercoagulability state, and others. We hereby describe a 32-year-old female with right BTS. A mass obstructing 80% of the right popliteal artery lumen was the source of emboli. The histologic results of the replaced arterial segment revealed a thrombus on top of epithelioid hemangioendothelioma. This is the first description of the association between primary vascular tumor and BTS.