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Vasculitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Ivy M. Obonyo, Virginia A. Jones, Kayla A. Clark, Maria M. Tsoukas
Clinical presentation: Common skin manifestations include palpable purpura and nodules. Necrotic ulcers, vesicles, bullae, urticarial plaques, petechiae, and subcutaneous nodules may also be present (Figures 13.8 and 13.9). Ocular involvement is common, as are oral manifestations (e.g., petechial hemorrhages), myalgias and arthralgias, rhinorrhea, and saddle-nose deformity due to granulomatous involvement of the nasal septum. Pulmonary signs, such as cough and hemoptysis, and renal signs, including hematuria and proteinemia, are also common.
General Medical Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Causes of palpable purpura include: Vasculitis:polyarteritis nodosaleucocytoclastic (hypersensitivity), Henoch–Schönlein purpura.Emboli:meningococcaemiagonococcaemiaother infections: Staphylococcus, Rickettsia (Rocky Mountain spotted fever), enteroviruses.
Case 27: A Purpuric Rash
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
Large vessel vasculitis includes giant cell arteritis (GCA) and Takayasu's arteritis. GCA presents with headache, scalp tenderness and jaw claudication and is often associated with shoulder and pelvic girdle pain, typical of polymyalgia rheumatic. Takayasu's arteritis is a vasculitis predominantly affecting the carotid and vertebral arteries and the aorta. Symptoms include headache, fever and arthralgia. Typical examination findings are hypertension, carotid bruits and a significant difference in blood pressures between the left and right arms. Aside from palpable purpura, patients can develop areas of ulceration and necrosis.
Sinonasal and respiratory outcomes of eosinophilic granulomatosis with polyangiitis patients receiving 100 mg mepolizumab in real-life clinical practice: 1-year follow up study
Published in Journal of Asthma, 2023
Ozge Can Bostan, Emine Duran, Gulseren Tuncay, Melek Cihanbeylerden, Omer Karadag, Ebru Damadoglu, Gul Karakaya, Ali F. Kalyoncu
The determination of migrating pulmonary infiltrates or pleural effusion on computed tomography (CT) scan or chest x-ray was considered pulmonary involvement. Due to recent studies demonstrating the association of severe asthma and EGPA with bronchiectasis, the presence of bronchiectasis on CT was also noted and classified (19–24). Palpable purpura on the skin that could not be explained by other reasons or confirmed by skin biopsy was considered skin involvement. Chronic rhinosinusitis, nasal polyps, paranasal sinus involvement supported by imaging studies were evaluated as upper respiratory tract involvement, and mononeuritis multiplex or polyneuropathy supported by EMG as peripheral nerve involvement. Intestinal vasculitis, eosinophilic esophagitis or gastroenteritis were evaluated as gastrointestinal involvement. Myocarditis, pericardial effusion, myopericarditis, endomyocardial fibrosis, or ischemic heart disease due to vasculitis demonstrated on echocardiography were accepted as cardiac involvement. Proteinuria >500 mg/24 h, and hematuria (>5-10 red blood cells per high power field (hpf) in urine), supporting biopsy or renal failure due to renal vasculitis were evaluated as renal involvement. Arthralgia, arthritis, myalgia, or myositis were evaluated as musculoskeletal involvement (25).
Do practical laboratory indices predict the outcomes of children with Henoch-Schönlein purpura?
Published in Postgraduate Medicine, 2019
Rabia Miray Kisla Ekinci, Sibel Balci, Sinem Sari Gokay, Hayri Levent Yilmaz, Dilek Dogruel, Derya Ufuk Altintas, Mustafa Yilmaz
Mean age at diagnosis was 7.6 ± 3.1 years among 214 HSP patients, 43.5% (n = 93) female and 56.5% (n = 121) male. Median follow-up duration was 19.2 (range, 3–91.4) months. All patients had palpable purpura at the time of diagnosis with the following symptoms: abdominal pain in 66.8% (n = 163) and arthralgia in 57% (n = 122). Although renal involvement occurred in 56 (26.2%) patients, renal biopsy was performed in only 17 patients due to nephrotic range proteinuria and revealed nephritis in 16 (7.5%) patients. Severe GI involvement was present in 77 (36%) patients, 12 of whom had intussusception. Twentynine (13.5%) patients had suffered from at least one recurrence with GI and/or skin involvement during follow-up.
Clinical manifestations of granulomatosis with polyangiitis: key considerations and major features
Published in Postgraduate Medicine, 2018
Bogna Grygiel-Górniak, Nattakarn Limphaibool, Katarzyna Perkowska, Mariusz Puszczewicz
Dermatologic involvement has been reported in approximately 23% of patients with palpable purpura being the most common finding. Less commonly, skin ulcers, cutaneous vasculitis, urticarial, and erythematous nodules may be present [13,46,52]. Nervous system involvement is seen in about one-third of patients with peripheral neuropathies being the most common [4,52]. Other important neurological findings include cranial neuropathies, mononeuritis multiplex, and pituitary gland dysfunction resulting in secondary hypogonadism and diabetes insipidus [2,4,15,53]. Manifestations involving the gastrointestinal and cardiovascular system is less commonly present (Figure 4).