Article Text

Download PDFPDF

Case Number 24: Scalp necrosis in giant cell arteritis
  1. F H Khattak
  1. Sandwell NHS Trust, Lyndon, West Bromwich, West Midlands B71 4HJ, UK

    Statistics from

    A 73 year old woman was referred with two weeks' history of temporal headaches, jaw claudication, and painful rash on both temples (fig 1). The jaw claudication was so intense that she could take fluids only and could not chew solid food. She had no visual symptoms. The erythrocyte sedimentation rate was 50 mm/1st h and C reactive protein 70 mg/l.

    Diagnosis of scalp necrosis in giant cell arteritis (GCA) was made on clinical grounds. Biopsy was not undertaken as she had already been receiving oral corticosteroids and because of the risk (perhaps theoretical) of worsening the scalp necrosis. Treatment with corticosteroids led to a resolution of symptoms and complete healing of the scalp.

    Scalp necrosis in GCA is a rare but recognised complication. It may represent a subset of severe disease. Of the 24 cases reported in English, 16 had visual loss, four gangrene of the tongue, and one nasal septal necrosis.1

    Figure 1

    Scalp necrosis in giant cell arteritis. Reproduced with consent of the patient.



    • Series editor: Gary D Wright

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.