A Case of Sjögren's Syndrome That Presented with Alcohol-induced Purpura

Cheong, S.K.; Han, Youjin; Choi, You-Won; Myung, Ki Bum; Lee, Ji-Soo; Choi, Hojin

doi:10.5021/ad.2010.22.1.99

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…Among them, three were related to HSP [8–10], one was associated with Sjögren’s syndrome [11], another one appeared simultaneously with an aspirin-induced platelet dysfunction [12], and a further one was suggested to result from thrombotic thrombocytopenic purpura due to alcohol binge drinking [13]. …”

Section: Introductionmentioning

confidence: 99%

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

2016

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BackgroundIt is unusual for purpura to emerge as a result of drinking alcohol. Such a peculiarity was observed in a 55-year-old man with a 30-year history of heavy alcohol use.Case presentationThe Caucasian patient was studied for 11 years during several detoxification treatments. During the last 2 years of that period, purpuric rashes were newly observed. The asymptomatic purpura was limited to both lower limbs, self-limiting with abstinence, and reoccurring swiftly with alcohol relapse. This sequence was observed six times, suggesting a causative role of alcohol or its metabolites. A skin biopsy revealed histological features of purpura pigmentosa progressiva (termed Schamberg’s disease). Additionally, alcoholic fatty liver disease markedly elevated serum immunoglobulins (immunoglobulin A and immunoglobulin E), activated T-lymphocytes, and increased C-reactive protein. In addition, moderate combined (cellular and humoral) immunodeficiency was found. Unlike the patient’s immunoglobulin A level, his serum immunoglobulin E level fell in the first days of abstinence, which corresponded to the time of purpura decline. Systemic vasculitis and clotting disorders were excluded. The benign character of the purpura was supported by missing circulating immune complexes or complement activation. An alcohol provocation test with vinegar was followed by the development of fresh “cayenne pepper” spots characteristic of Schamberg’s disease.ConclusionsThis case report demonstrates that Schamberg’s disease can be strongly related to alcohol intake, in our patient most likely as a late complication of severe alcoholism with alcoholic liver disease. Immunologic disturbances thereby acquired could have constituted a basis for a hypersensitivity-like reaction after ingestion of alcohol. Schamberg’s disease induction by vinegar may point to an involvement of acetate, a metabolite of ethanol.

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Section: Introductionmentioning

confidence: 99%

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

2016

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“…A case of Sjögren's syndrome associated with alcohol-induced purpura, and a case of purpura considered as a result of aspirin-induced platelet dysfunction aggravated by drinking alcohol have been reported; however in these cases skin biopsies were not performed. 2,4 …”

Section: To the Editormentioning

confidence: 99%

Alcohol-induced vasculitis: Case report and commentary

Abuabara

Samimi

Chu

et al. 2014

Journal of the American Academy of Dermatology

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“…There are few reports of alcohol-induced non-thrombopenic purpura [1][2][3][4][5][6]. Herein, we report a case of cutaneous IgA-vasculitis exacerbations associated with red wine intake.…”

mentioning

confidence: 92%

“…To our knowledge, only seven cases (including our own) of non-thrombopenic alcohol-associated purpura have been reported to date (Table 1) [1][2][3][4][5][6]. These cases (4 women and 3 men; mean age 44.2) are, however, heterogeneous and were explored in different ways.…”

mentioning

confidence: 99%

Cutaneous IgA-vasculitis flare-ups associated with intake of red and white wine

Kluger

2021

Annales de Dermatologie et de Vénéréologie

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A Case of Sjögren's Syndrome That Presented with Alcohol-induced Purpura

Cited by 6 publications

References 9 publications

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

Alcohol-induced vasculitis: Case report and commentary

Cutaneous IgA-vasculitis flare-ups associated with intake of red and white wine

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