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Clinics in Dermatology 2020Drug-induced vasculitis and anticoagulant-related skin reactions are commonly encountered in the inpatient and outpatient settings. The spectrum of clinical presentation... (Review)
Review
Drug-induced vasculitis and anticoagulant-related skin reactions are commonly encountered in the inpatient and outpatient settings. The spectrum of clinical presentation is broad and ranges from focal, skin-limited disease, to more extensive cutaneous and soft tissue necrosis, to potentially fatal systemic involvement. The prompt recognition of these adverse events can have a significant impact on patient morbidity and mortality. We highlight the key features of the clinical presentation with an emphasis on primary lesion morphology, distribution, and epidemiology of purpuric drug reactions. The proposed pathophysiology, histologic findings, and therapeutic interventions of these potentially life-threatening diseases are discussed.
Topics: Anti-Infective Agents; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Antidiuretic Agents; Antipsychotic Agents; Biological Factors; Cardiovascular Agents; Factor Xa Inhibitors; Humans; Purpura; Skin Diseases, Vascular; Vasculitis
PubMed: 33341196
DOI: 10.1016/j.clindermatol.2020.06.015 -
British Journal of Haematology May 2023
Topics: Humans; Purpura; Age Factors
PubMed: 36920454
DOI: 10.1111/bjh.18739 -
Indian Journal of Dermatology,... 2023
Topics: Female; Humans; Purpura
PubMed: 37067121
DOI: 10.25259/IJDVL_784_2022 -
Therapie 2022
Topics: Humans; Influenza Vaccines; Pigmentation Disorders; Purpura
PubMed: 34175124
DOI: 10.1016/j.therap.2021.05.012 -
Dermatologic Therapy Nov 2020
Topics: Humans; Mycosis Fungoides; Pigmentation Disorders; Purpura; Skin Neoplasms
PubMed: 32705758
DOI: 10.1111/dth.14062 -
Cutis Jul 2023Purpuric or erythematous eruptions of the lower extremities can be perplexing, especially because this clinical sign has been associated with COVID-19 infection. Since... (Review)
Review
Purpuric or erythematous eruptions of the lower extremities can be perplexing, especially because this clinical sign has been associated with COVID-19 infection. Since the start of the pandemic, COVID-19 often has been the first differential diagnosis for many clinical findings; however, pigmented purpuric dermatoses (PPDs) are distinctive, reassuring, eponymous, and not linked to this virus. In this article, we differentiate the PPDs and delineate them from potentially serious differential diagnoses, including inflammatory retiform purpura, leukocytoclastic vasculitis, stasis dermatitis, and cellulitis.
Topics: Humans; COVID-19; Purpura; Cellulitis; Diagnosis, Differential; Eczema
PubMed: 37611310
DOI: 10.12788/cutis.0815 -
JAMA Dermatology Jun 2020
Topics: Adult; Biopsy; Dermatitis Herpetiformis; Diet, Gluten-Free; Female; Glutens; Humans; Purpura; Skin; Treatment Outcome
PubMed: 32267467
DOI: 10.1001/jamadermatol.2020.0378 -
Dermatologic Surgery : Official... Nov 2019
Topics: Humans; Lasers, Solid-State; Low-Level Light Therapy; Purpura; Severity of Illness Index; Skin Aging; Sunlight; Treatment Outcome
PubMed: 30640778
DOI: 10.1097/DSS.0000000000001784 -
Haematologica Jul 2018Although outstanding progress has been made in understanding the pathophysiology of thrombotic thrombocytopenic purpura (TTP), knowledge of the immunopathogenesis of the... (Review)
Review
Although outstanding progress has been made in understanding the pathophysiology of thrombotic thrombocytopenic purpura (TTP), knowledge of the immunopathogenesis of the disease is only at an early stage. Anti-ADAMTS13 auto-antibodies were shown to block proteolysis of von Willebrand factor and/or induce ADAMTS13 clearance from the circulation. However, it still remains to identify which immune cells are involved in the production of anti-ADAMTS13 autoantibodies, and therefore account for the remarkable efficacy of the B-cell depleting agents in this disease. The mechanisms leading to the loss of tolerance of the immune system towards ADAMTS13 involve the predisposing genetic factors of the human leukocyte antigen class II locus DRB1*11 and DQB1*03 alleles as well as the protective allele DRB1*04, and modifying factors such as ethnicity, sex and obesity. Future studies have to identify why these identified genetic risk factors are also frequently to be found in the healthy population although the incidence of immune-mediated thrombotic thrombocytopenic purpura (iTTP) is extremely low. Moreover, the development of recombinant ADAMTS13 opens a new therapeutic era in the field. Interactions of recombinant ADAMTS13 with the immune system of iTTP patients will require intensive investigation, especially for its potential immunogenicity. Better understanding of iTTP immunopathogenesis should, therefore, provide a basis for the development of novel therapeutic approaches to restore immune tolerance towards ADAMTS13 and thereby better prevent refractoriness and relapses in patients with iTTP. In this review, we address these issues and the related challenges in this field.
Topics: Animals; Autoimmunity; Biomarkers; Disease Susceptibility; Environment; Genetic Predisposition to Disease; Humans; Prognosis; Purpura, Thrombotic Thrombocytopenic
PubMed: 29674502
DOI: 10.3324/haematol.2016.151407 -
Journal of the American Academy of... Jan 2016
Topics: Biopsy, Needle; Cardiomyopathies; Facial Dermatoses; Humans; Immunohistochemistry; Male; Middle Aged; Purpura
PubMed: 26702806
DOI: 10.1016/j.jaad.2015.08.021