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High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
Published on: March 16, 2022
Lower extremity ulcers in connective tissue disease
Victoria K Shanmugam1, Virginia D Steen, Thomas R Cupps
1Division of Rheumatology, Immunology and Allergy, Georgetown University Hospital, Washington, DC 20007, USA. vickishanmugam@hotmail.com
The Israel Medical Association Journal : IMAJ
|August 30, 2008
Summary
Lower extremity ulcers in connective tissue diseases are complex. Antiphospholipid antibodies and prothrombotic states contribute to vasculopathy, causing ulcers and hindering healing.
Area of Science:
- Rheumatology
- Vascular Medicine
- Dermatology
Background:
- Lower extremity ulcers are a common complication in connective tissue diseases (CTDs).
- Historically attributed to vasculitis, inflammatory vessel injury underlies less than 20% of these ulcers.
- The pathogenesis is multifactorial, involving synergistic processes.
Purpose of the Study:
- To review the evidence linking antiphospholipid antibodies and prothrombotic states to vasculopathy in CTDs.
- To understand the contribution of these factors to ulcer development and impaired healing.
Main Methods:
- Literature review of studies on connective tissue diseases, lower extremity ulcers, antiphospholipid antibodies, and prothrombotic states.
- Analysis of evidence for synergistic mechanisms in ulcer pathogenesis.
Main Results:
- Antiphospholipid antibodies and prothrombotic states are significant contributors to vasculopathy in CTDs.
- These factors precipitate ulceration and impede wound healing.
- Inflammatory vessel injury is a less common cause than previously thought.
Conclusions:
- Vasculopathy driven by antiphospholipid antibodies and prothrombotic states is a key mechanism in CTD-related lower extremity ulcers.
- Understanding these complex pathogenic pathways is crucial for effective treatment and improved patient outcomes.
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