Pressure-induced necrosis can mimic retiform purpura

Melrose, Ellen; Laageide, Leah; Mutgi, Krishna; Stone, Mary Seabury; Wanat, Karolyn A.

doi:10.1016/j.jdcr.2017.10.002

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Alterations within the sweat glands can exhibit a spectrum of variability, extending from subtle inflammatory infiltration with or without metaplasia to overt necrotic features. These changes are attributable to several causative factors, which encompass inflammatory diseases, infections, cutaneous lymphoproliferative disorders, trauma, prolonged pressure, leukocytoclastic vasculitis, disseminated intravascular coagulation, microwave radiation therapy, and drugs 34–36 . In these cases, eccrine gland necrosis could be explained by pathologic changes in the dermal blood vessel.…”

Section: Discussionmentioning

confidence: 99%

“…These changes are attributable to several causative factors, which encompass inflammatory diseases, infections, cutaneous lymphoproliferative disorders, trauma, prolonged pressure, leukocytoclastic vasculitis, disseminated intravascular coagulation, microwave radiation therapy, and drugs. [34][35][36] In these cases, eccrine gland necrosis could be explained by pathologic changes in the dermal blood vessel. Eccrine necrosis, particularly the secretory portion, is vulnerable to hypoxic damage when vascular compromise occurs, which can result from various factors such as inflammation, thrombosis, or obstruction.…”

Section: Discussionmentioning

confidence: 99%

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Skin necrosis after intradermal injection of lyophilized exosome: A case report and a review of the literature

Tawanwongsri,

Vachiramon

2024

J of Cosmetic Dermatology

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BackgroundExosomes have gained attention for their potential in skin rejuvenation. Currently, most exosome products are available for topical administration, and the use of subdermal injection as a route of administration has not been approved.AimsThe purpose of this case report is to describe a case of skin necrosis that occurred following an intradermal injection of lyophilized exosomes.Materials and MethodsWe hereby report a case of a middle‐aged man who experienced adverse effects after receiving an intradermal injection of lyophilized exosomes. Multiple injections of an exosome product were administered to treat enlarged facial pores. Shortly after the injection, the patient felt pain and noticed several dark red bumps. Three days after injection, the lesions transformed into palpable, painful, non‐blanchable purplish papules and nodules, accompanied by central, tiny crusted erosions. The residual product was injected into the upper arm using an intradermal method. Similar lesions also appeared, and a skin biopsy showed necrotic keratinocytes, leukocytoclastic vasculitis, and eccrine necrosis.ResultsThere are few reports available regarding complications, especially those related to intradermal exosomes. These complications include multiple foreign‐body granulomatous reactions at the injection sites. In our case, oral prednisolone was administered for a duration of 7 days. After the treatment, the lesions exhibited notable improvement, eventually leaving post‐inflammatory hyperpigmentation.ConclusionUtilizing exosomes through unapproved methods should be avoided due to the possibility of adverse reactions that could cause aesthetic issues.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Skin necrosis after intradermal injection of lyophilized exosome: A case report and a review of the literature

Tawanwongsri,

Vachiramon

2024

J of Cosmetic Dermatology

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“…Differential diagnosis may include autoimmune bullous diseases (e.g., pemphigoids, epidermolysis bullosa), bullosis diabeticorum, bullous drug eruptions, retiform purpura, friction and postburn blisters [23,41]. Moreover, coma blisters differ from pressure ulcers in several points and cannot be classified using the typical staging system graded from I to IV based on determining sequential layers of dermis and subcutaneous injury [42].…”

Section: Diagnosismentioning

confidence: 99%

Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Dinis-Oliveira

2019

CDRR

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Background: Coma blisters or coma bullae are bullous lesions that have been associated with cases of drug overdose-induced coma. Previous history of suicide attempt by administering benzodiazepines, barbiturates, ethanol, antipsychotics, antidepressants or opioids have been particularly implicated. Patients may present also painful deep skin and soft tissue involvement, edema and functional impairment. The pathophysiology remains unknown and lesions are usually self-limited and typically resolve without scarring. Objective: This work aims to fully review the state of the art regarding the causes pathophysiology, diagnosis and treatment of drug overdose-induced coma blisters. Conclusion: Coma blisters are a benign, self-limiting condition that should be suspected in patients who develop pressure blisters several hours after an altered state of consciousness.

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Aspirin/clopidogrel/warfarin

2018

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Pressure-induced necrosis can mimic retiform purpura

Cited by 5 publications

References 8 publications

Skin necrosis after intradermal injection of lyophilized exosome: A case report and a review of the literature

Skin necrosis after intradermal injection of lyophilized exosome: A case report and a review of the literature

Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Aspirin/clopidogrel/warfarin

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