Malignant atrophic papulosis: Two case reports

Area of Science:

• Vascular Medicine
• Gastroenterology
• Dermatology

Background:

• Malignant atrophic papulosis is a rare, potentially fatal thrombo-occlusive microvasculopathy.
• Characterized by distinctive cutaneous papules and gastrointestinal perforation.
• The exact pathogenesis remains poorly understood.

Observation:

• Two male patients presented with cutaneous lesions and abdominal symptoms.
• One patient had aubergine papules and gastrointestinal perforations requiring surgery.
• The second patient developed esophageal perforation and died from hemorrhage.

Findings:

• Histological findings included small bowel vasculitis, fibrinoid necrosis, and thrombosis.
• Cutaneous lesions varied from erythematous papules to porcelain-white atrophic depressions.
• The diverse multi-organ involvement supports the hypothesis that it may not be a specific disease entity.

Implications:

• This case series adds evidence to the debate on the specificity of malignant atrophic papulosis.
• Understanding the varied presentations is crucial for timely diagnosis and management.
• Further research into the pathogenesis is warranted to improve patient outcomes.