Stasis dermatitis of the hand associated with an iatrogenic arteriovenous fistula

Bilen,; Apaydin,; Harova,; Anadolu,; Dogan,; Paksoy,

doi:10.1046/j.1365-2230.1998.00372.x

Cited by 12 publications

(6 citation statements)

References 5 publications

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“…Bilen et al 20 described a case of stasis dermatitis of the hand associated with an arteriovenous fistula in a 27-year-old woman with chronic renal failure on hemodialysis. She had a violaceous, slightly scaly patchy lesion with ill-defined borders that was 4–5 cm in diameter.…”

Section: Discussionmentioning

confidence: 99%

Post-reconstruction dermatitis of the breast

Rosen

Goh²,

Lacouture

et al. 2017

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Background Approximately one-third of women diagnosed with breast cancer undergo mastectomy with subsequent implant-based or autogenous tissue-based reconstruction. Potential complications include infection, capsular contracture, and leak or rupture of implants with necessity for explantation. Skin rashes are infrequently described complications of patients who undergo mastectomy with or without reconstruction. Methods A retrospective analysis of breast cancer patients referred to the Dermatology Service for diagnosis and management of a rash post-mastectomy and expander or implant placement or transverse rectus abdominis myocutaneous (TRAM) flap reconstruction was performed. Parameters studied included reconstruction types, time to onset, clinical presentation, associated symptoms, results of microbiologic studies, management, and outcome. Results We describe 21 patients who developed a rash on the skin overlying a breast reconstruction. Average time to onset was 25.7 months after expander placement or TRAM flap reconstruction. Clinical presentations included macules and papules or scaly, erythematous patches and plaques. Five patients had cultures of the rash, which were all negative. Skin biopsy was relatively contraindicated in areas of skin tension, and was reserved for non-responding eruptions. Treatments included topical corticosteroids and topical antibiotics, which resulted in complete or partial responses in all patients with documented follow-ups. Conclusion Our findings suggest that tension and post-surgical factors play a causal role in this hitherto undescribed entity: “post-reconstruction dermatitis of the breast.” This is a manageable condition that develops weeks to years following breast reconstruction. Topical corticosteroids and antibiotics result in restoration of skin barrier integrity and decreased secondary infection.

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Section: Discussionmentioning

confidence: 99%

Post-reconstruction dermatitis of the breast

Rosen

Goh²,

Lacouture

et al. 2017

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Gangrene (1) Wood et al 13 1 AVF used for HD Ulceration of the hand (1) Robert et al 12 1 AVF used for HD Ulceration of the forearm (1) Golblum et al 11 1 AVF used for HD Scaly, crusted, violaceous patches on the hand (0) Bogaert et al 10 3 AVF used for HD (unknown) Landthaler et al 9 1 AVF used for HD Brownish to deep purple irregular plaque on hand (0) Kim et al 8 2 AVF used for HD Crusted vesicles and purplish patches located on hand (0) Bilen et al 7 1 AVF used for HD Violaceous, slightly scaling patch on hand (0) Sebastian et al 6 1 AVF used for HD malformation (type C) of the hand Ulceration of the hand (1)…”

Section: Discussionmentioning

confidence: 99%

“…Stasis dermatitis of the upper limbs is rare, with only 30 reported cases, because frequent anastomoses of the blood vessels in the arms reduce the chance of serious venous insufficiency 2 . Severe stasis dermatitis of the upper limbs associated with ulcers most commonly develops after the creation of artificial arteriovenous (AV) fistulas for hemodialysis 3–15 . We report on a patient with severe stasis dermatitis and ulceration of the forearm.…”

Section: Introductionmentioning

confidence: 99%

“…2 Severe stasis dermatitis of the upper limbs associated with ulcers most commonly develops after the creation of artificial arteriovenous (AV) fistulas for hemodialysis. [3][4][5][6][7][8][9][10][11][12][13][14][15] We report on a patient with severe stasis dermatitis and ulceration of the forearm. The skin symptoms were dramatically improved after additional vascular surgery.…”

Section: Introductionmentioning

confidence: 99%

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Ulcerating stasis dermatitis of the forearm due to arteriovenous fistula: A case report and review of the published work

Deguchi

Imafuku

Nakayama

2010

The Journal of Dermatology

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Stasis ulcers of the upper limbs are rare, and only 30 cases have been reported, all of which were due to rheological abnormalities. A 59-year-old woman sustained an injury to her right upper limb, resulting in incomplete transections of the brachial artery and the brachial vein. Emergent reconstruction of the brachial artery was performed. Raynaud's phenomenon was observed postoperatively, followed by extreme edema, eczematization and the development of ulcers on the forearm. She was referred to our hospital for treatment. 3-D computed tomography (CT) revealed end-to-end anastomosis of the brachial artery and the brachial vein. An additional brachial-radial artery bypass and closure of the anastomosis dramatically improved her skin symptoms. Vascular anomalies including surgery should be suspected when patients present with stasis dermatitis of the upper limbs.

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“…However, various complications of an AV fistula such as cardiac failure, carpal tunnel syndrome, stasis dermatitis, a n d h y p o t e n s i o n h a v e b e e n reported. [1][2][3][4] One significant complication in patients with chronic renal failure is recurrent thrombosis of the AV fistula. AV fistula thrombosis accounts for at least $1 billion in annual expenses and 25% of hospitalizations of chronic hemodialysis patients in the United States.…”

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confidence: 99%