Atherosclerosis-Induced Diffuse Dermal Angiomatosis With Fatal Outcome

Kirkland, Clem Ryan; Hawayek, Lana H.; Mutasim, Diya F.

doi:10.1001/archdermatol.2010.111

Cited by 11 publications

(11 citation statements)

References 5 publications

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“…In several case reports of DDA secondary to atherosclerotic disease, revascularization resulted in the resolution of skin lesions . Unfortunately, our patient was unsuitable for stenting or bypass due to the extensive nature of her disease.…”

Section: Diagnosismentioning

confidence: 75%

Severe atherosclerosis and a bewildering reticulated rash

et al. 2015

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A 60-year-old Chinese woman presented with a 3-week history of painful rash over her lower abdomen and thighs. Her medical history included ischemic heart disease, severe atherosclerosis with chronic occlusion of the infrarenal aorta, diabetes mellitus, hypertension, and hyperlipidemia. Physical examination revealed erythematous to dusky-brown, non-blanchable patches on the hips and thighs, and reticulated macular streaks on the lower abdomen (Fig. 1). Some of the dusky patches subsequently developed necrosis and ulceration.

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Section: Diagnosismentioning

confidence: 75%

Severe atherosclerosis and a bewildering reticulated rash

et al. 2015

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“…Since the first 2 cases of DDA reported in 1994, 26 additional cases of DDA have been described, presenting as erythematous, violaceous or livedoid, poorly demarcated plaques, which may evolve to ulceration and necrosis. Histopathological findings demonstrate a diffuse endothelial cell proliferation between collagen bundles in the papillary and reticular dermis . DDA differs from CRAE, in which intraluminal endothelial cell proliferation is predominant, and from intravascular histiocytosis, where the intraluminal proliferation is composed of CD68+ histiocytes.…”

Section: Reportmentioning

confidence: 87%

“…We searched PubMed with the term ‘DDA’, and found 28 cases in the English‐language literature, of which 7 were associated with PAD . Characteristics of the patients are shown in Table .…”

Section: Reportmentioning

confidence: 99%

“…We searched PubMed with the term 'DDA', and found 28 cases in the English-language literature, of which 7 were associated with PAD. [2][3][4][5][6][7] Characteristics of the patients are shown in Table 1. All patients Since the first 2 cases of DDA reported in 1994, 2 26 additional cases of DDA have been described, presenting as erythematous, violaceous or livedoid, poorly demarcated plaques, which may evolve to ulceration and necrosis.…”

Section: Reportmentioning

confidence: 99%

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Diffuse dermal angiomatosis associated with severe atherosclerosis: two cases and review of the literature

et al. 2015

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Diffuse dermal angiomatosis (DDA) is a rare condition characterized by endothelial proliferation in the reticular dermis. Several diseases have been associated with DDA, including peripheral arterial disease (PAD). We report two cases of DDA associated with PAD. Patient 1 was a 71-year-old woman, who presented with painful necrotic ulcerations on her trunk and a medical history of PAD. Skin biopsy revealed a dermal proliferation of endothelial cells, and despite medical treatment, she died 1 month later. Patient 2 was an 81-year-old man, who presented with an erythematous, bluish plaque of the shoulder. He was a heavy smoker, with severe PAD. Biopsy showed dermal capillary hyperplasia, with a few fibrin thrombi, and follow-up only was recommended. In both cases, laboratory tests and Doppler ultrasonography ruled out other thrombotic conditions and vascularitis. DDA is a rare complication of PAD, and the optimum medical treatment remains to be clarified, especially when revascularization has failed or is not possible, as in our cases.

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“…[6,7] Clinically DDA is manifested by multiple, persistent skin ulcers, developing on retiform erythematous–violaceous plaques, often arising in nonacral areas (trunk, abdomen, proximal aspects of the extremities). The lesions may be asymptomatic or painful and they tend to be persistent or enlarge progressively.…”

Section: Discussionmentioning

confidence: 99%

Persistent cutaneous abdominal ulcerations secondary to diffuse dermal angiomatosis

et al. 2016

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Background:Diffuse dermal angiomatosis (DDA) is a rare, acquired, reactive vascular proliferation, clinically characterized by livedoid erythematous–violaceous plaques, which frequently evolve to ulceration and necrosis. Histopathologically, it is manifested by a diffuse proliferation of endothelial cells within the full thickness of the dermis. DDA has been mainly associated with severe peripheral atherosclerosis.Methods:We report a 63-year-old woman who presented with multiple erythematous–violaceous plaques with central deep skin ulcers on thighs, lower abdomen, and perianal area, associated with intermittent claudication, low-grade fever, and weight loss. Initially, the clinical picture along with positive cultures for Klebsiella pneumoniae suggested a multifocal ecthyma gangrenosum; nevertheless, a skin biopsy showed a diffuse dermal proliferation of endothelial cells interstitially arranged between collagen bundles. A computed tomography scan revealed severe aortic atheromatosis with complete luminal occlusion of the infrarenal aorta and common iliac arteries.Results:The diagnosis of DDA secondary to severe atherosclerosis was established. The patient underwent a left axillofemoral bypass surgery with a rapidly healing of the ulcers in the next weeks.Conclusions:DDA should be considered in the differential diagnosis of livedoid ischemic lesions. Recognition of DDA as a cutaneous sign of severe peripheral vascular disease is important for both dermatologists and internists. Recognition of risk factors and their management with an early intervention to correct tissue ischemia can be curative.

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Atherosclerosis-Induced Diffuse Dermal Angiomatosis With Fatal Outcome

Cited by 11 publications

References 5 publications

Severe atherosclerosis and a bewildering reticulated rash

Severe atherosclerosis and a bewildering reticulated rash

Diffuse dermal angiomatosis associated with severe atherosclerosis: two cases and review of the literature

Persistent cutaneous abdominal ulcerations secondary to diffuse dermal angiomatosis

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