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High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

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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.

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High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

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Published on: February 10, 2023

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.