Segmental ulcerative vasculitis: a cutaneous manifestation of Takayasu's arteritis.
A 16-year-old girl with pyoderma gangrenosum (PG)-like skin lesions on the extremities, trunk and face developed Takayasu's arteritis (TA; pulseless disease). After 3 years under maintenance cyclosporin A therapy, the patient developed an ischaemic cerebral accident. Severe obstruction of both subclavian and left carotid arteries was found by Doppler sonography, angiography and computerised axial tomography. Evolution of this disease showed some characteristic findings: (a) PG-like lesions as the first cutaneous manifestation of pulseless disease; (b) methotrexate and cyclosporin A giving good results for the cutaneous lesions, but apparently not exerting an influence on the evolution of TA and the fatal outcome. This morphologic pattern may reflect underlying TA or Wegener's arteritis, and should be termed segmental ulcerative vasculitis.
Dourmishev
Assen L
AL
Dermatology and Venereology, University of Medicine, 1 St G. Solfiiski Street, 1431 Sofia, Bulgaria. assen_dourmishev@yahoo.com
Serafimova
Dimitrina K
DK
Vassileva
Snejina G
SG
Dourmishev
Lyubomir A
LA
Schwartz
Robert A
RA
D000293:Adolescent; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D012883:Skin Ulcer / Q000209:etiology*; D020521:Stroke / Q000209:etiology; D013625:Takayasu Arteritis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy