Lesson of the month
Autologous skin transplantation for widespread cutaneous necrosis in secondary antiphospholipid syndrome
C Fiehna, A Breitbarta, G Germannba Department of
Internal Medicine V, University of Heidelberg, Germany, b Department of Plastic
Surgery, University of Heidelberg, BG-Unfallklinik, Ludwigshafen,
Germany
Correspondence to: Dr C Fiehn, Rheumaambulanz der Medizinischen Klinik und Poliklinik V, Universität Heidelberg, Hospitalstr 3, 69115 Heidelberg, Germany christoph_fiehn@med.uni-heidelberg.de
Accepted for publication 23 April
2001
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Cutaneous involvement in primary and secondary antiphospholipid syndrome often is a therapeutical dilemma. Here we describe a case of widespread cutaneous necrosis due to thrombosis of the microvasculature, and cutaneous vasculitis in secondary antiphospholipid syndrome in a patient with systemic lupus erythematosus. Autologous skin transplantation was able to cover the skin defects but was only successful in the presence of immunosuppressive treatment with glucocorticoids and cyclosporin A.
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Case report |
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A 34 year old women was admitted to hospital because of widespread
necrosis of the skin and muscle of both legs. She had a two year
history of seronegative non-erosive polyarthritis of the knees,
proximal interphalangeal and metacarpophalangeal joints, which was
successfully treated with methotrexate 10 mg by mouth once a week. She
complained about Raynaud's symptoms and dryness of the mouth but
previously had no skin rash, fever, photosensitivity, ulceration of the
oral or genital mucosa, or signs of pleuritis, pericarditis, or
neurological abnormalities.
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