Widespread cutaneous necrosis as the first clinical manifestation of secondary antiphospholipid syndrome.
نویسندگان
چکیده
Antiphospholipid syndrome (APS) is an acquired prothrombotic state characterized by recurrent thromboses, pregnancy loss, thrombocytopenia, and the presence of antiphospholipid antibodies, anticardiolipin antibodies, lupus anticoagulant and/or anti2-glycoprotein antibody. The original clinical and laboratory criteria for APS, called the Sapporo criteria, were first published in 1999. These were replaced by the Sydney criteria in 2006, when patients were required to have at least 1 clinical criterion and 1 laboratory criterion for a diagnosis of APS to be made. A wide variety of dermatologic manifestations have been described in patients with APS, including livedo reticularis, livedoid vasculitis, digital gangrene, erythematous macules, skin ulcerations, and, on rare occasions, extensive cutaneous necrosis. We report the case of a patient with widespread cutaneous necrosis as the initial manifestation of APS. A 48-year-old woman presented at the emergency room with a 2-week history of fever, arthralgia, malaise, and chest pain. On examination she was noted to have 3 bullous erythematous violaceous plaques on her right leg (Fig. 1). Her medical history was remarkable for hypothyroidism, systemic lupus erythematosus (SLE), and obsessive-compulsive disorder. Medications included thyroxine, olanzapine, risperidone, and sertraline. Laboratory tests revealed thrombocytopenia (platelet count 25,000) and normal prothrombin and partial thromboplastin times. Lupus anticoagulant was present and the antinuclear antibody titer was 1:320. C3 and C4 levels were normal.
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ورودعنوان ژورنال:
- Actas dermo-sifiliograficas
دوره 103 9 شماره
صفحات -
تاریخ انتشار 2012