D-dimer levels as a marker of cutaneous disease activity: case reports of cutaneous polyarteritis nodosa and atypical recurrent urticaria.
OBJECTIVE
Biochemical markers of disease allow clinicians to monitor disease severity, progression, and response to treatment. C-reactive protein and erythrocyte sedimentation rate are commonly used biochemical markers of inflammatory disease. We present 2 cases that indicate that D-dimer levels may be useful as a potential biochemical marker of disease activity in certain cutaneous inflammatory conditions.


METHODS
We report 2 cases in which clinical disease activity correlates with D-dimer levels. The first case is a woman in her 50s with a diagnosis of cutaneous polyarteritis nodosa. The second case is a man in his 20s with recurrent urticaria. In both patients, plasma D-dimer levels increased with clinical evidence of disease activity and decreased with treatment and resolution of the disease flare. Interestingly, serum C-reactive protein levels did not correlate with disease activity and were found to be normal during clinically active disease.


CONCLUSIONS
We show the potential value of D-dimer measurements as a marker of vasculocentric and/or vasculopathic inflammation and suggest that vascular endothelial damage may be ongoing in certain cutaneous inflammatory conditions.
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Mark G
MG
Kirchhof
Vancouver Coastal Health, Vancouver General Hospital, Vancouver, British Columbia, Canada3Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Agnes Y Y
AY
Lee
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada4Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
Jan P
JP
Dutz
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000097:blood*; D012008:Recurrence; D012720:Severity of Illness Index; D014581:Urticaria / Q000097:blood*
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D002097:C-Reactive Protein