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Antiphospholipid syndrome and the skin
G E Gibson1, W P Su, M R Pittelkow
1Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
Journal of the American Academy of Dermatology
|June 1, 1997
Summary
Antiphospholipid syndrome is a hypercoagulation disorder with serologic markers like lupus anticoagulant. Early cutaneous signs, including livedo reticularis and skin necrosis, may indicate this condition requiring anticoagulant therapy.
Area of Science:
- Rheumatology
- Hematology
- Dermatology
Background:
- Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by hypercoagulation.
- It can be primary or secondary to other systemic diseases.
- Key serologic markers include lupus anticoagulant and anticardiolipin antibodies.
Purpose of the Study:
- To review the clinical and histopathologic features of antiphospholipid syndrome.
- To highlight the significance of cutaneous manifestations as early indicators of APS.
- To discuss current prophylaxis and treatment strategies for thrombotic events in APS.
Main Methods:
- Literature review of antiphospholipid syndrome.
- Analysis of clinical presentations, serologic markers, and histopathologic findings.
- Summary of treatment modalities including anticoagulants and antiplatelet agents.
Main Results:
- Recurrent thrombotic events (arterial/venous), fetal loss, and thrombocytopenia are primary clinical features.
- Cutaneous manifestations are common and can be the initial sign, including livedo reticularis, vasculitis, ulceration, and necrosis.
- Noninflammatory vascular thrombosis is the predominant histopathologic finding.
Conclusions:
- Antiphospholipid syndrome presents with diverse clinical and cutaneous manifestations.
- Recognition of skin findings is crucial for early diagnosis and management.
- Anticoagulant and antiplatelet therapies are the mainstay for preventing thrombosis in APS.