title: [Thrombotic skin gangrene: A rare extra-intestinal manifestation of ulcerative colitis].
abstract: BACKGROUND
  Thrombotic cutaneous gangrene is a rare extra-intestinal manifestation of ulcerative colitis with a severe prognosis.
  
  
  METHODS
  A 35-year-old woman with a 7-year history of ulcerative colitis presented with extensive ecchymotic lesions that began a few hours earlier. On examination, she was febrile with multiple necrotic lesions. Skin biopsy showed multiple microthrombi in the dermal vessels. A diagnosis of thrombotic cutaneous gangrene was established. The patient was treated with heparin and systemic corticosteroids. The majority of cutaneous lesions showed improvement after 1 month. Thrombophlebitis of the left lower limb occurred subsequently.
  
  
  CONCLUSIONS
  Thrombotic cutaneous gangrene is attributed to microvascular thrombosis, which arises from the hypercoagulability observed in ulcerative colitis. Complete blood and coagulation tests must be performed and early anticoagulation with heparin must be considered in order to prevent the progression of cutaneous infarction.
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie. Electronic address: amina_aounallah@yahoo.fr.
authors: A
authors: A
authors: Aounallah
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: N
authors: N
authors: Ghariani Fetoui
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: N
authors: N
authors: Ghariani
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: M
authors: M
authors: Korbi
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: S
authors: S
authors: Mokni
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: L
authors: L
authors: Boussofara
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: W
authors: W
authors: Saidi
authors: Service de gastro-entérologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: M
authors: M
authors: Ksiaa
authors: Service de médecine interne et gastroentérologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: I
authors: I
authors: Ben Jazia
authors: Laboratoire d'anatomie et de cytologie pathologiques, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: M
authors: M
authors: Guerfala
authors: Laboratoire d'anatomie et de cytologie pathologiques, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: B
authors: B
authors: Sriha
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: C
authors: C
authors: Belajouza
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: M
authors: M
authors: Denguezli
authors: Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
authors: R
authors: R
authors: Nouira
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D004359:Drug Therapy, Combination; D005260:Female; D005734:Gangrene / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D009336:Necrosis; D012867:Skin / Q000098:blood supply / Q000187:drug effects / Q000473:pathology*; D013927:Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000305:Adrenal Cortex Hormones; D006493:Heparin
keywords: Gangrene; Gangrène; Hypercoagulability; Hypercoagulabilité; Microvascular thrombosis; Nécrose cutanée; Rectocolite hémorragique; Skin necrosis; Thrombose microvasculaire; Ulcerative colitis