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Published on: March 16, 2022
[Thrombotic skin gangrene: A rare extra-intestinal manifestation of ulcerative colitis]
A Aounallah1, N Ghariani Fetoui1, N Ghariani1
1Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
Background:
Thrombotic cutaneous gangrene is a rare extra-intestinal manifestation of ulcerative colitis with a severe prognosis.
Case Report:
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.
Conclusion:
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.
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