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Skin vasculitis

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https://www.readbyqxmd.com/read/29770208/case-report-polyarteritis-nodosa-or-complicated-henoch-schonlein-purpura-a-rare-case
#1
Sajad Hasanzadeh, Seyedeh Maryam Alavi, Elahe Masnavi, Maryam Rohani, Saeid Jokar
Background: Polyarteritis nodosa (PAN) is a vasculitis that affects medium sized arteries. PAN is a rare disease and requires a high vilgilance for diagnosis. For instance, PAN and Henoch-Schonlein purpura (HSP) have narrowing differential diagnosis. Here, we report a case of PAN. Case presentation : Our patient was a 65 year old woman that came to hospital due to abdominal pain and skin lesion on the right upper and right lower extremities. All rheumatologic tests were negative. A biopsy of the skin lesion was reported as mild hyperkeratosis, slight spongiosis with intact basal layer...
2018: F1000Research
https://www.readbyqxmd.com/read/29768374/treatment-of-multiple-refractory-ankle-ulcerations-in-thromboangiitis-obliterans-a-case-report
#2
Zheng-Hao Huang, San-Yuan Kuo, Yu-Hsiang Chiu, Hsiang-Cheng Chen, Chun-Chi Lu
RATIONALE: Thromboangiitis obliterans (TAOs, or Buerger's disease) present as a non-atherosclerotic segmental occlusive vasculitis within medium- and small-sized blood vessels. TAO frequently occurs in young adults and is associated with cigarette smoking. At present, there are no accurately defined treatments for TAO. PATIENT CONCERNS: A 34-year-old Asian woman with a 20-year history of heavy cigarette smoking and recurrent, small, and self-limited lower limb ulcerations since adolescence, presented with persisting unhealed ulcerations on both ankles for 6 months...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29761532/dermatological-aspects-of-tularaemia-a-study-of-168-cases
#3
M Polat, T Karapınar, F Sırmatel
BACKGROUND: Tularaemia is a zoonotic infectious disease caused by Francisella tularensis, an aerobic, uncapsulated, gram-negative coccobacillus. Several case reports have appeared on the dermatological manifestations of tularaemia, but relatively few longer-term studies are available. AIM: To identify skin features of tularaemia that aid in its diagnosis. METHODS: In total, 168 patients (68 male, 100 female) diagnosed with tularaemia were retrospectively examined...
May 14, 2018: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/29751784/henoch-sch%C3%A3-nlein-purpura-with-acute-pancreatitis-analysis-of-13-cases
#4
Qin Zhang, Qi Guo, Ming Gui, Zhenhua Ren, Bo Hu, Ling Lu, Fang Deng
BACKGROUND: Henoch-Schönlein purpura is a common small vessel vasculitis in children. Acute pancreatitis rarely presents as a complication of Henoch-Schönlein purpura and has not been well characterized. METHODS: We retrospectively reviewed 13 cases of Henoch-Schönlein purpura with acute pancreatitis among 3212 patients who attended our hospital between January 2003 and June 2016 and analyzed their clinical characteristics, laboratory findings, imaging findings, treatment and overall prognosis...
May 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29749594/-non-aneurysmal-subarachnoid-haemorrhage-secondary-to-panarteritis-nodosa-at-paediatric-age-a-case-report
#5
L Salgado-Lopez, C de Quintana-Schmidt, I Catala-Antunez, J Aibar-Duran, L San Roman-Manzanera, J Molet-Teixido
INTRODUCTION: Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors' knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease...
May 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29742184/complex-regional-pain-syndrome-what-the-dermatologist-should-know
#6
Azam A Qureshi, Adam J Friedman
Reflex sympathetic dystrophy is a subtype of complex regional pain syndrome, a condition characterized by persistent post-injury extremity pain. Temperature and sweating changes, edema, mobility changes, and a variety of hair, nail, and skin sequelae have been described. Only 23 articles published since 1990 describe dermatologic changes in CRPS. Given this paucity of literature, we present a case to further elucidate cutaneous manifestations of CRPS. Our patient is a 52-year-old Caucasian woman with a 19-year history of reflex sympathetic dystrophy who has presented with several dermatologic complaints...
May 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29741122/long-term-risk-and-outcome-of-infection-related-hospitalization-in-granulomatosis-with-polyangiitis-a-nationwide-population-based-cohort-study
#7
M Faurschou, N Obel, B Baslund
OBJECTIVE: To assess the long-term risk and outcome of infection-related hospitalization (IH) among patients with granulomatosis with polyangiitis (GPA). METHOD: We used administrative databases to establish a GPA cohort (n = 398), construct a comparison cohort of population controls (n = 3980), and collect clinical data. Cox regression analyses were used to determine hazard ratios (HRs) as a measure of relative risk. Follow-up began at date of GPA diagnosis and continued for up to 10 years...
May 9, 2018: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/29734473/treatment-for-hepatitis-c-virus-associated-mixed-cryoglobulinaemia
#8
REVIEW
Nuria Montero, Alexandre Favà, Eva Rodriguez, Clara Barrios, Josep M Cruzado, Julio Pascual, Maria Jose Soler
BACKGROUND: Hepatitis C virus (HCV)-associated mixed cryoglobulinaemia is the manifestation of an inflammation of small and medium-sized vessels produced by a pathogenic IgM with rheumatoid factor activity generated by an expansion of B-cells. The immune complexes formed precipitate mainly in the skin, joints, kidneys or peripheral nerve fibres. Current therapeutic approaches are aimed at elimination of HCV infection, removal of cryoglobulins and also of the B-cell clonal expansions. The optimal treatment for it has not been established...
May 7, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29722877/rituximab-for-induction-and-maintenance-therapy-of-granulomatosis-with-polyangiitis-a-single-centre-cohort-study-on-114-patients
#9
Xavier Puéchal, Michele Iudici, Ana Luisa Calich, Alexandre Vivot, Benjamin Terrier, Alexis Régent, Pascal Cohen, Claire Le Jeunne, Luc Mouthon, Philippe Ravaud, Loïc Guillevin
Objectives: To assess efficacy and safety of rituximab (RTX) induction and maintenance therapy for granulomatosis with polyangiitis (GPA) in a single-centre cohort study. Methods: All patients with active GPA, not enrolled in trials, who received ⩾1 RTX infusion(s) for induction were included. At remission, protocolized maintenance RTX infusions were given every 6 months for 18 months. Kaplan-Meier curves were used to estimate survival rates. Univariable analyses identified factors associated with remission failure and relapse, and Cox models retained independent predictors of relapse...
May 2, 2018: Rheumatology
https://www.readbyqxmd.com/read/29721696/pyoderma-gangrenosum-like-ulcerations-in-granulomatosis-with-polyangiitis-two-cases-and-literature-review
#10
REVIEW
Giovanni Genovese, Simona Tavecchio, Emilio Berti, Franco Rongioletti, Angelo Valerio Marzano
Granulomatosis with polyangiitis (GPA) is a systemic necrotizing small vessel vasculitis associated with circulating anti-neutrophil cytoplasmic antibodies (ANCAs). Skin manifestations, mostly represented by palpable purpura, papulonodular lesions and livedo reticularis, are present in up to 50% of the cases. Ulcerations with undermined, raised erythematous-violaceous border resembling pyoderma gangrenosum (PG) have rarely been reported as skin involvement in GPA. The presence of circulating ANCAs with a cytoplasmic labelling pattern, the involvement of internal organs, particularly of the lung, and the absence on histology of a mainly neutrophilic infiltrate in early phases of the cutaneous lesions may be regarded as clues to rule out true PG and confirm the diagnosis of GPA skin ulcerations simulating PG...
May 2, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29713318/complement-activation-in-inflammatory-skin-diseases
#11
REVIEW
Jenny Giang, Marc A J Seelen, Martijn B A van Doorn, Robert Rissmann, Errol P Prens, Jeffrey Damman
The complement system is a fundamental part of the innate immune system, playing a crucial role in host defense against various pathogens, such as bacteria, viruses, and fungi. Activation of complement results in production of several molecules mediating chemotaxis, opsonization, and mast cell degranulation, which can contribute to the elimination of pathogenic organisms and inflammation. Furthermore, the complement system also has regulating properties in inflammatory and immune responses. Complement activity in diseases is rather complex and may involve both aberrant expression of complement and genetic deficiencies of complement components or regulators...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29709950/an-autopsy-case-of-myeloperoxidase-anti-neutrophil-cytoplasmic-antibody-mpo-anca-associated-vasculitis-accompanied-by-cryoglobulinemic-vasculitis-affecting-the-kidneys-skin-and-gastrointestinal-tract
#12
Jumpei Hasegawa, Sachiko Wakai, Momoko Kono, Yusuke Imaizumi, Sakiko Masuda, Akihiro Ishizu, Kazuho Honda
Anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitis (AAV) and cryoglobulinemic vasculitis (CV) rarely coexist. An 83-year-old woman was admitted with rapidly progressive renal failure, gastrointestinal hemorrhage and purpura with myeloperoxidase (MPO) -ANCA positivity and cryoglobulinemia. Despite intensive immunosuppressive treatment, she died of aspergillus pneumonia. Autopsy revealed necrotizing crescentic glomerulitis in the majority of the glomeruli, accompanied by partially membranoproliferative-like glomerular changes...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29697421/a-case-report-and-literature-review-of-scrub-typhus-with-acute-abdomen-and-septic-shock-in-a-child-the-role-of-leukocytoclastic-vasculitis-and-granulysin
#13
Po-Hsiung Chang, Yu-Pin Cheng, Po-Sheng Chang, Chiao-Wei Lo, Lung-Huang Lin, Chin-Fang Lu, Wen-Hung Chung
Scrub typhus is becoming a clinically important cause of acute undifferentiated febrile illness in Taiwan. The incubation period is between 6 and 21 days after exposure. It is transmitted by chiggers (larva of trombiculid mite) in long grasses and in dirt-floor homes, with infection characterized by a flu-like illness of fever, headache, and myalgia lasting approximately 1 week. It has various systemic manifestations, including GI symptoms. In some, the illness progresses to multiorgan dysfunction syndrome and death...
April 24, 2018: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29683286/safety-profile-of-chronic-leg-ulcer-biopsy-a-monocentric-retrospective-series-on-866-patients
#14
Carlotta Baraldi, Lidia Sacchelli, Emi Dika, Martina Lambertini, Cosimo Misciali, Tommaso Bianchi, Pier A Fanti
BACKGROUND: Skin biopsy is an important tool for various skin conditions. However, in the case of leg ulcers, some Authors still consider it highly risky and mandatory only in selected cases. METHODS: To evaluate the rate of adverse events after leg ulcers biopsy in 866 consecutive patients referring to our Wound Care Unit in Bologna from January 2008 to December 2016. Two biopsies were performed (from the border and the centre) by the same dermatologist following a standardized structured protocol...
April 19, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29676708/-urticaria-multiforme-difficult-to-distinguish-from-other-skin-conditions
#15
L Zijp, P M J H Kemperman, G W den Tusscher
BACKGROUND: Urticaria multiforme is a rare clinical variant of urticaria that occurs specifically in children. CASE DESCRIPTION: A boy aged 11 months was presented at the Emergency Department with acute onset of itching urticarial skin weals and acral oedema. This picture is consistent with the diagnosis of urticaria multiforme. CONCLUSION: The diagnosis of urticaria multiforme can be made on the basis of the clinical picture. Treatment is symptomatic and in most cases this condition resolves spontaneously within two weeks...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29673750/-extra-facial-lever-granuloma-on-a-herpes-zoster-scar-wolf-s-isotopic-response
#16
E Melgar, J Henry, A Valois, M-B Dubois-Lacour, F Truchetet, B Cribier, J-F Cuny
BACKGROUND: Granuloma faciale (GF), or facial granuloma of Lever, is an uncommon dermatosis occurring classically on the face. We report a case of a GF on zoster scars located on the trunk, which is a highly particular isotopic response. PATIENTS AND METHODS: A 60-year-old man with a sole history of left lumbar zoster presented with a skin lesion present for two months. Clinical examination revealed a 2.5-cm papular erythematous lesion that was both infiltrated and pruritic...
April 16, 2018: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29672364/role-of-direct-immunofluorescence-in-cutaneous-small-vessel-vasculitis-experience-from-a-tertiary-center
#17
Khushboo Lath, Debajyoti Chatterjee, Uma Nahar Saikia, Biman Saikia, Ranjana Minz, Dipankar De, Sanjeev Handa, Bishan Radotra
Skin is commonly affected by vasculitic process and often subjected to biopsy. Cutaneous vasculitis can be either primary or part of a systemic vasculitic process. This study was conducted to evaluate the diagnostic utility of direct immunofluorescence (DIF) in determination of etiology of cutaneous vasculitis. All histologically proven cases of cutaneous vasculitis over the past two and half years were retrospectively analyzed along with their clinical and DIF findings (IgG, IgA, IgM, and C3). Within this study period, a total of 198 cases of small-vessel vasculitis were diagnosed based on skin biopsy and DIF findings...
April 17, 2018: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29668637/successful-mesenchymal-stem-cell-treatment-of-leg-ulcers-complicated-by-behcet-disease-a-case-report-and-literature-review
#18
Yanhong Li, Zhongming Wang, Yi Zhao, Yubin Luo, Wangdong Xu, Tony N Marion, Yi Liu
RATIONALE: Behçet disease (BD) is a recurrent vasculitis characterized by oral and genital mucous membrane ulcers, uveitis, and skin lesions but only rarely leg ulcers. To our knowledge, no efficacious therapy has been described for BD patients with complicating, destructive leg ulcers. PATIENT CONCERNS: Here, We report the case of a 55-year-old woman with generalized erythema nodosum-like, papulopustular lesions, recurrent oral and genital ulcers accompanied with recurrent leg ulcers and trouble walking...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29664511/bullous-henoch-sch%C3%A3-nlein-purpura-case-report
#19
Trinidad Hasbún, Ximena Chaparro, Viera Kaplan, Felipe Cavagnaro, Alex Castro
Henoch-Schönlein purpura (HSP) or IgA Vasculitis is the most common childhood vasculitis. The classic tetrad of signs and symptoms include palpable purpura, arthralgia, abdominal pain and renal disease. The occurrence of hemorrhagic bullae in children with HSP is rarely encountered. Objec tive: To report an unusual cutaneous manifestation of HSP in children. CASE REPORT: A 14-year-old girl complained about a 2-week painful bullous rash in both lower extremities and multiple arthral gias...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29607753/histopathology-of-cutaneous-inflammatory-disorders-in-children
#20
Andy C Hsi, Ilana S Rosman
Inflammatory dermatoses encompass a variety of histologic patterns that affect different portions of the skin. In spongiotic, psoriasiform, lichenoid, pityriasiform, and blistering disorders, there are predominately epidermal and junctional activities with variable superficial dermal inflammation. Hypersensitivity reactions can show either epidermal or mostly dermal changes depending on whether the exposure of the exogenous allergen occurs through an external or internal route, respectively. Exceptions include erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis, where the etiology is often due to infection or ingested medications, but the histologic features are almost exclusively confined to the epidermis and dermoepidermal junction...
March 2018: Pediatric and Developmental Pathology
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