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Ischemic colitis and malignant atrophic papulosis

M A Rodriguez

    The American Journal of Gastroenterology
    |February 1, 1977
    PubMed
    Summary

    Malignant atrophic papulosis (Degos' disease) can cause ischemic colitis, even without typical skin lesions. This case highlights vascular intimal lesions leading to splenic flexure stricture.

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    Area of Science:

    • Gastroenterology
    • Vascular Pathology
    • Dermatology

    Background:

    • Idiopathic nephrotic syndrome, hypertension, and transient ischemic attacks are significant comorbidities.
    • Ischemic colitis with splenic flexure stricture developed in a 37-year-old male.
    • The patient had no history or evidence of skin lesions.

    Observation:

    • Vascular lesions were identified in the middle colic artery and smaller vessels.
    • These lesions were localized to the intimal layer.
    • A proliferation of spindle-shaped cells, characteristic of malignant atrophic papulosis, was noted.

    Findings:

    • The vascular and gastrointestinal lesions were histologically identical to those seen in malignant atrophic papulosis (Degos' disease).
    • Ischemic colitis was attributed to these specific vascular changes.
    • The absence of skin lesions complicated the diagnosis.

    Implications:

    • This case expands the known clinical spectrum of malignant atrophic papulosis.
    • It underscores the importance of considering Degos' disease in unexplained ischemic colitis, even without cutaneous manifestations.
    • Early recognition and management of vascular complications are crucial.

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