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Temporal arteritis presenting with scalp ulceration.

C Monteiro1, B Fernandes, I Reis

  • 1Department of Dermatology, University Hospital, Praceta Prof Mota Pinto, 3000-075 Coimbra, Portugal. c.monteiro@netc.pt

Journal of the European Academy of Dermatology and Venereology : JEADV
|December 17, 2002
PubMed
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Temporal arteritis can cause scalp ulcerations and blindness. Prompt steroid treatment is crucial for temporal arteritis to prevent irreversible vision loss, though scalp necrosis indicates a poor prognosis.

Area of Science:

  • Vascular Medicine
  • Dermatology
  • Ophthalmology

Background:

  • Giant cell arteritis (GCA), also known as temporal arteritis, is a systemic vasculitis primarily affecting medium and large arteries.
  • Ocular complications, including vision loss, are a major concern in GCA, necessitating early diagnosis and treatment.

Observation:

  • A 75-year-old woman presented with bilateral scalp ulcerations, blindness, severe headache, and scalp tenderness.
  • Biopsy from the ulceration border confirmed giant cell arteritis.
  • The patient had no systemic involvement of GCA.

Findings:

  • Treatment with oral prednisone (60 mg/day) led to healing of scalp ulcerations within weeks.
  • Despite treatment, the patient's vision loss was irreversible.
  • Scalp necrosis and ulcerations were identified as skin signs associated with a poor prognosis in this case.

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Implications:

  • This case underscores the critical importance of timely diagnosis and prompt systemic steroid therapy for temporal arteritis to prevent severe complications like permanent blindness.
  • It highlights that cutaneous manifestations such as scalp necrosis can indicate a grave prognosis in GCA.
  • Early recognition of GCA symptoms, including headache and scalp tenderness, is vital for preserving vision.