Pyoderma Gangrenosum as a Presenting Feature of Takayasu Arteritis
Wajeeha Batool1, Sulhera Khan1, Bareerah Khan2
1Department of Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Cureus
|May 1, 2023
Summary
Takayasu arteritis (TA), a large vessel vasculitis, can manifest with skin lesions and pulseless limbs. This case highlights the diagnostic challenges and need for comprehensive evaluation in TA.
Area of Science:
- Rheumatology
- Dermatology
- Vascular Medicine
Background:
- Takayasu arteritis (TA) is a rare large vessel vasculitis affecting the aorta and its branches.
- TA predominantly affects young females and presents with diverse symptoms, including characteristic skin manifestations.
Observation:
- A 50-year-old female presented with ulcerative skin lesions and pulseless upper limbs.
- Diagnostic workup revealed positive antinuclear antibodies (ANA), elevated inflammatory markers, and CT angiography findings consistent with aortic arch involvement.
- Skin biopsy showed inflammation and ulceration, supporting a dermatological component.
Findings:
- The patient met ACR-1990 classification criteria for TA.
- The diagnosis was established as Takayasu arteritis associated with pyoderma gangrenosum.
- Histopathological examination of skin lesions confirmed ulceration and inflammation.
Implications:
- This case underscores the varied clinical presentations of Takayasu arteritis, emphasizing the importance of integrating clinical, laboratory, and imaging data for accurate diagnosis.
- Early recognition and multidisciplinary management are crucial for addressing the complex nature and potential complications of TA.
- Long-term monitoring is essential due to the chronic, relapsing-remitting course of Takayasu arteritis.
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