Hautveränderungen bei Vaskulitiden

Sunderkötter, Cord; Michl, Christiane

doi:10.1007/s00108-019-0642-3

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…Similar to a hypercoagulable state seen in LV, we found coagulopathy in the majority (87.5%) of our patients, suggesting a major role for anticoagulant therapy in CA as well. While immunosuppressives are the mainstay of therapy, long‐term management of our patients necessitated the introduction of anticoagulative treatment, with good therapeutic response 3,4 . Although cutaneous biopsy provides essential morphological insights, it is also important to consider the clinical experience and therapeutic responses, hence, we believe the vasculopathic aspects of CA play a major role, in addition to vasculitis.…”

Section: Discussionmentioning

confidence: 99%

“…2 While these two diseases are currently considered different, the pathomechanisms leading to thrombotic versus inflammatory processes in these entities are not well understood. 3,4 In clinical practice, segregating vasculitis and vasculopathy is a constant challenge, often leaving one cogitating whether thrombosis was secondary to the inflammation or vice versa. The aim of our article is to propose the hypothesis that, owing to the underlying dynamic pathomechanisms, both vasculitis and vasculopathy can complementarily appear together, and that diagnostic stratification based on histopathology alone may not grasp the full scope of the condition at hand.…”

Section: Introductionmentioning

confidence: 99%

“…While these two diseases are currently considered different, the pathomechanisms leading to thrombotic versus inflammatory processes in these entities are not well understood 3,4 …”

Section: Introductionmentioning

confidence: 99%

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Focal vascular occlusion: A link between livedoid vasculopathy and cutaneous arteritis?

Nagy

Veres

Belső

et al. 2023

JEADV Clinical Practice

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BackgroundLivedoid vasculopathy (LV) and cutaneous arteritis (CA) are rare cutaneous diseases. A consideration of these two conditions as different entities is debatable, because thrombosis and inflammation are closely related in their pathogenesis mechanisms. Varying reports on the effectiveness of anticoagulant and immunosuppressant therapies in LV and CA also point to diagnostic challenge and overlap in these conditions.ObjectiveWe sought to assess the therapeutic effect of anticoagulation therapy in adult patients with CA, who were recalcitrant to immunosuppressive modalities.MethodsA monocentric retrospective analysis of adult patients who were diagnosed with CA between 2010 and 2018, was carried out.ResultsWe describe 8 cases of long‐term recalcitrant CA, in whom anticoagulation therapy significantly reduced the pain and cutaneous symptoms. All patients had cutaneous symptoms compatible with CA along with clinical features also characteristic of LV, including underlying procoagulative disorders in the majority (87.5%), as confirmed by screening for thrombophilia. We also review current concepts regarding LV and CA, and suggest vascular occlusion is a common link between these two entities.ConclusionAlthough current knowledge advocates segregating vasculopathy from vasculitis by means of histopathological examination in LV and CA, clinical experience suggests some overlap and common complex underlying pathomechanisms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Focal vascular occlusion: A link between livedoid vasculopathy and cutaneous arteritis?

Nagy

Veres

Belső

et al. 2023

JEADV Clinical Practice

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“…Similar to a hypercoagulable state seen in LV, we found coagulopathies in the majority (87.5%) of our patients, giving a considerable role for anticoagulant therapy in CPAN as well. While immunosuppressives are the mainstay, long-term management of our patients necessitated the introduction of anticoagulative treatment, with good therapeutic response (31,32). Although cutaneous biopsy provides essential morphological insights, it is also important to consider the clinical experience and therapeutic responses, hence, we believe a considerable role should be given to the vasculopathic aspects of CPAN, in addition to vasculitis, which may serve as a common ground for widening our scope of the vasculopathy vs. vasculitis question.…”

Section: Discussionmentioning

confidence: 99%

“…To date, however, the conceptualization of thrombotic vs. inflammatory processes in LV and CPAN still continues to be perplexing (31,32).…”

Section: Cutaneous Vasculitis and Vasculopathymentioning

confidence: 99%

Vasculitides primarily involving the skin

Nagy

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Background IgA vasculitis (IgAV) is a small-vessel leucocytoclastic cutaneous vasculitis, often associated with kidney and gastrointestinal (GI) manifestations. Although predictive factors for systemic involvement have been extensively studied in children, there is paucity in the literature regarding adult patients. Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker, used to assess systemic inflammation in various diseases.Objective We sought to evaluate whether NLR can be used for predicting renal and GI involvement in adult IgA vasculitis patients.Methods This was a retrospective review of adult patients who were diagnosed with IgAV at our institution between 2004 and 2016.Results A total of 40 patients met our inclusion criteria. Half of the enrolled patients had clinical symptoms suggestive of systemic involvement, of which 6 (15%) had only renal, 3 (7.5%) had only GI and 11 (27.5%) had both renal and GI involvement. Pretreatment NLR was significantly associated with renal and/or GI manifestations of the disease (P < 0.001). The optimal cut-off value of NLR, for predicting systemic involvement was 3.34, with a specificity of 95% and a sensitivity of 85%. In addition, pretreatment NLR was also found to be significantly correlated with the severity of the systemic manifestations of IgAV (P = 0.022). ConclusionThis study suggests that NLR is a potential indicator for prognosticating systemic involvement in adult IgAV.

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Takayasu-Arteriitis bei Kindern und Jugendlichen

Rolfes

2022

Pädiatrische Rheumatologie

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Hautveränderungen bei Vaskulitiden

Cited by 9 publications

References 24 publications

Focal vascular occlusion: A link between livedoid vasculopathy and cutaneous arteritis?

Focal vascular occlusion: A link between livedoid vasculopathy and cutaneous arteritis?

Vasculitides primarily involving the skin

Takayasu-Arteriitis bei Kindern und Jugendlichen

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