title: Rumpel-Leede phenomenon in a patient with adult-onset Still's disease.
abstract: Rumpel-Leede phenomenon (RLP), also known as acute capillary rupture syndrome (ACRS), is a rare occurrence where distal dermal capillaries rupture in response to a proximal compressive force, such as a blood pressure cuff or tourniquet. This phenomenon has been reported to occur in states of vascular fragility such as long-term steroid use, hypertension or diabetes mellitus. Here, we provide a report of RLP occurring secondary to tourniquet application in a 26-year-old woman with adult-onset Still's disease (AOSD) and a recent drug rash. In this case, the cause of the phenomenon is most likely multifactorial. Likely contributing factors include long-term steroid use for the treatment of AOSD, and increased vascular permeability secondary to the drug rash. Patients and clinicians should be aware that the treatment of AOSD may induce a state of capillary fragility and they should work together to minimise the risk of complications.
authors.affiliation: George Washington University School of Medicine and Health Sciences, Arlington, Virginia, USA.
authors.forename: Jacob Trygve
authors.initials: JT
authors.lastname: Lambdin
authors.affiliation: George Washington University School of Medicine and Health Sciences, Stouffville, Ontario, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mackenzie
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D002196:Capillaries; D003875:Drug Eruptions / Q000150:complications* / Q000209:etiology; D005260:Female; D006801:Humans; D012307:Risk Factors; D012421:Rupture / Q000150:complications*; D012867:Skin / Q000098:blood supply*; D016706:Still's Disease, Adult-Onset / Q000150:complications* / Q000188:drug therapy; D014111:Tourniquets; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination