作为药物诱发皮肤血管炎罕见表现的红细胞增多症:病例报告

IF 2.1 Q3 RHEUMATOLOGY BMC Rheumatology Pub Date : 2024-09-10 DOI:10.1186/s41927-024-00413-7
Ezwan Rafizi Zakaria, Wan Syamimee Wan Ghazali, Hafsah Sazali, Nor Shuhaila Shahril, Salzihan Md Salleh, Siti Nurbaya Mohd Nawi
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引用次数: 0

摘要

肢端青紫症的特征是肢端出现持续性的青色变色,这是由于外周血流减少导致氧气汲取增加所致。病因可分为原发性和继发性两种。原发性青紫病一般无痛,病程良性,而继发性病因则可能导致并发症。本病例报告了继发于皮肤血管炎的青紫病,该病发展为数字坏疽,而数字坏疽是皮肤血管炎的罕见并发症。一名 68 岁的男子因双脚脚趾发蓝变色伴疼痛 4 天后出现坏疽。肢体严重缺血检查未发现严重动脉狭窄的证据。进一步的病史显示,患者在发病前几天曾因肾绞痛肌肉注射非甾体抗炎药双氯芬酸。彻底的皮肤检查显示,他的大腿、臀部和腹部出现多发性紫癜性皮疹。皮肤活检确诊为皮肤(淋巴细胞)血管炎,很可能是药物引起的。红斑痤疮最初对甲基强的松龙有反应,但不幸的是,病情进一步发展为数字坏疽,需要进行双侧经跖骨截肢。了解继发性渐冻人症的临床特征、病因和检查方法对于早期识别和治疗潜在病因以预防不可逆转的并发症至关重要。
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Acrocyanosis as a rare presentation of drug-induced cutaneous vasculitis: a case report
Acrocyanosis is characterised by persistent bluish discolouration of the extremities, resulting from reduced peripheral blood flow leading to increased oxygen extraction. The aetiology can be divided into primary and secondary causes. While primary acrocyanosis is generally painless and has a benign course, secondary causes may lead to complications. This case reported acrocyanosis secondary to cutaneous vasculitis which progressed to digital gangrene, which is a rare complication of cutaneous vasculitis. A 68-year-old man presented with a four-day history of bluish discolouration involving bilateral toes associated with pain and started to become gangrenous. Investigations for critical limb ischemia did not show evidence of critical arterial stenosis. Further history revealed history of recent administration of intramuscular injections with diclofenac, a non-steroidal anti-inflammatory agent for renal colic pain a few days prior to the onset of the. Thorough skin search showed multiple purpuric rash of his thighs, buttocks and abdomen. Skin biopsy confirmed the diagnosis of cutaneous (lymphocytic) vasculitis, which was likely to be drug-induced. The acrocyanosis initially responded to methylprednisolone, however unfortunately it progressed further to digital gangrene which required bilateral transmetatarsal amputations. Knowledge on clinical features, aetiology and investigations of secondary acrocyanosis is crucial for early recognition and treatment of the underlying cause to prevent irreversible complications.
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来源期刊
BMC Rheumatology
BMC Rheumatology Medicine-Rheumatology
CiteScore
3.80
自引率
0.00%
发文量
73
审稿时长
15 weeks
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