-
Actas Dermo-sifiliograficas Dec 2017
Topics: Anti-Inflammatory Agents; Cafe-au-Lait Spots; Child; Dermoscopy; Diagnosis, Differential; Diagnostic Errors; Disease Progression; Humans; Lichenoid Eruptions; Male; Methylprednisolone; Mycosis Fungoides; Pigmentation Disorders; Port-Wine Stain; Prednisolone; Purpura; Skin Pigmentation; Treatment Failure
PubMed: 28705517
DOI: 10.1016/j.ad.2017.04.023 -
Medicina (Kaunas, Lithuania) Jan 2023: There is a broad spectrum of vulvar pigmented lesions that differ based on their histopathological and clinical features. Chronic vulvar purpura is a rare entity,...
: There is a broad spectrum of vulvar pigmented lesions that differ based on their histopathological and clinical features. Chronic vulvar purpura is a rare entity, associated with a broad morphological spectrum, from lichen aureus, Zoon's vulvitis, pigmented purpuric dermatosis and with lichen planus as in our case. In this article we discuss a case of an 86-year-old white woman with hyperpigmentation on her upper vulva, next to the introitus, with complaints of urine incontinence. Biopsy revealed subepithelial stromal lichenoid inflammatory infiltrate containing plasma cells, lymphocytes and some neutrophilic granulocytes as well as dilated and congested vessels. Hemosiderin deposits and erythrocyte extravasation were found. There was evidence of hyperkeratosis with hyper granulosis and erosions. Spongiosis was also noted. Few melanocytes were identified with no sign of malignancy. These findings correlate with the diagnosis of vulvar lichen planus. Chronic vulvar purpura is a clinical term used for different chronic inflammatory dermatoses presenting as red bluish or violaceous discolorations on the vulva, often associated with cayenne-pepper-like speckling. Considering a great overlap of possible diseases, the final diagnosis could be challenging. It is important to exclude a melanocytic tumour in these cases.
Topics: Humans; Female; Aged, 80 and over; Lichen Planus; Vulva; Purpura; Biopsy; Hyperpigmentation; Chronic Disease
PubMed: 36837408
DOI: 10.3390/medicina59020206 -
The Journal of Emergency Medicine Aug 2022Although vaccination against coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been proven generally safe, rare but potentially serious...
BACKGROUND
Although vaccination against coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been proven generally safe, rare but potentially serious adverse reactions do occur. Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis that has been associated with other immunizations, but, to our knowledge, has not been previously reported in association with vaccines directed against SARS-CoV-2.
CASE REPORT
We report the case of a 22-year-old man with no known past medical history who presented to the Emergency Department with 2 days of migratory arthritis in his ankles and palpable purpura on his bilateral lower extremities, occurring 10 days after receiving the Johnson & Johnson SARS-CoV-2 vaccine. The patient's clinical presentation was suggestive of leukocytoclastic vasculitis, and this diagnosis was confirmed on skin biopsy. Why Should an Emergency Physician Be Aware of This? Recognition of vasculitides is important for timely treatment and prevention of complications. In a patient presenting with palpable purpura after immunization against SARS-CoV-2, LCV should be promptly considered and worked up by the Emergency Physician, though management is most often entirely outpatient and the clinical course is typically mild and self-resolving.
Topics: Adult; COVID-19; COVID-19 Vaccines; Humans; IgA Vasculitis; Male; Purpura; SARS-CoV-2; Vaccination; Vasculitis, Leukocytoclastic, Cutaneous; Young Adult
PubMed: 35690533
DOI: 10.1016/j.jemermed.2021.10.005 -
Actas Dermo-sifiliograficas Dec 2015
Topics: Adult; Anemia; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Arthralgia; Biopsy; Cocaine; Cocaine-Related Disorders; Drug Contamination; Female; Humans; Levamisole; Purpura
PubMed: 26387453
DOI: 10.1016/j.ad.2015.03.013 -
The Korean Journal of Internal Medicine Jul 2021
Topics: Angioedema; Edema; Eyelids; Humans; Infectious Mononucleosis; Purpura
PubMed: 32872732
DOI: 10.3904/kjim.2020.350 -
Journal of Gastrointestinal and Liver... Mar 2018Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive... (Review)
Review
BACKGROUND AND AIMS
Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients.
METHODS
Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms "celiac disease" AND "blood coagulation disorders", "hemorrhage", "hematoma", "hematuria", "hemoptysis", "epistaxis", "hemosiderosis". Only case reports were identified on the search theme. Information on patients' characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized.
RESULTS
We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review of the literature and summarized the published case reports of 46 CD patients, aged between 19 and 74 years, 64% of male gender. In 25% of cases, the symptomatology was present for more than 5 years prior to CD diagnosis. The clinical hemorrhagic events were as follows: 15 patients had gastrointestinal bleeding, 9 hemoptysis, 4 epistaxis, 6 hematuria, 8 cutaneous hematoma, petechia or ecchymoses, and only in 1 case hemarthrosis, hemorrhagic vesicular dermatitis, subcortical hemorrhage, or adrenal hemorrhage. Sixty percent of the patients had digestive symptoms, while the rest had only extra-digestive CD involvement. The Lane Hamilton syndrome was defined in 15 patients. The evolution under a gluten-free diet was favorable in most cases.
CONCLUSION
This review of case reports aims to increase awareness to hemorrhagic events, rare but possible life-threatening conditions, as part of the CD clinical spectrum. To the best of our knowledge, this is the first review of all types of hemorrhagic events in adult CD patients.
Topics: Adult; Celiac Disease; Ecchymosis; Epistaxis; Gastrointestinal Hemorrhage; Hematoma; Hematuria; Humans; Male; Muscular Diseases; Purpura
PubMed: 29557421
DOI: 10.15403/jgld.2014.1121.271.cld -
Archives of Disease in Childhood Dec 1947
Topics: Humans; IgA Vasculitis; Intussusception; Purpura
PubMed: 18919467
DOI: 10.1136/adc.22.112.242 -
Clinical and Experimental Immunology Jan 1972Serum cryoglobulin levels were estimated in thirty-one patients with cutaneous vasculitis, twenty-nine patients with other skin disorders and forty-seven normal...
Serum cryoglobulin levels were estimated in thirty-one patients with cutaneous vasculitis, twenty-nine patients with other skin disorders and forty-seven normal subjects. Eighteen of the normal sera contained mixed cryoglobulins—the upper limit of the normal range being 80 μg/ml. Twelve of the vasculitis patients had serum cryoglobulin levels above the normal range. All but one of these cryoglobulins were mixed cryoglobulins. A low serum C3 level was found in only one patient. The possible role of mixed cryoglobulins in the pathogenesis of vasculitis is discussed.
Topics: Bence Jones Protein; Cryoglobulins; Erythema; Humans; Hypersensitivity; Immunoglobulins; Proteinuria; Purpura; Rheumatic Diseases
PubMed: 4536972
DOI: No ID Found -
Blood Advances Nov 2020Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a potentially fatal blood disorder resulting from acquired deficiency of plasma ADAMTS13 activity. Despite...
Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a potentially fatal blood disorder resulting from acquired deficiency of plasma ADAMTS13 activity. Despite recent advances in early diagnosis and novel therapeutics, the mortality rate of acute iTTP remains as high as 10% to 20%. Moreover, a reliable clinical and laboratory parameter that predicts disease severity and outcomes is lacking. We show in the present study that plasma levels of syndecan-1 (Sdc-1) and soluble thrombomodulin (sTM) on admission were dramatically increased in patients with acute iTTP and remained substantially elevated in a subset of patients compared with healthy controls. The elevated admission plasma levels of Sdc-1 and sTM were associated with abnormal Glasgow coma scale scores, low estimated glomerular filtration rates, the need for intensive care, and in-hospital mortality rates. Moreover, a further simultaneous increase in plasma Sdc-1 and sTM levels at the time of clinical response/remission (eg, when normalization of platelet counts and substantial reduction of serum lactate dehydrogenase activity were achieved) was highly predictive of iTTP recurrence. These results demonstrate that endothelial injury, resulting from disseminated microvascular thromboses, is severe and persistent in patients with acute iTTP. Plasma levels of Sdc-1 and sTM on admission and in remission are predictive of in-hospital mortality and recurrence of acute iTTP, respectively. Thus, an incorporation of such novel plasma biomarkers into the risk assessment in acute iTTP may help implement a more vigorous and intensive therapeutic strategy for these patients.
Topics: Humans; Plasma; Purpura, Thrombocytopenic, Idiopathic; Purpura, Thrombotic Thrombocytopenic; Syndecan-1; Thrombomodulin
PubMed: 33141886
DOI: 10.1182/bloodadvances.2020003065 -
Indian Journal of Dermatology,... 2020
Topics: Ear; Female; Humans; Middle Aged; Purpura
PubMed: 30319137
DOI: 10.4103/ijdvl.IJDVL_828_17