Journal of the American Academy of Dermatology · 2007
Presentation and outcome of purpura fulminans associated with peripheral gangrene in 12 patients at Mayo Clinic.
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Davis Mark D P, Dy Katrina M, Nelson Steven
Аннотация
BACKGROUND: Dermatologists may be called to assist in the diagnosis and management of purpura fulminans.
METHODS: This retrospective case series details the clinical presentation and outcomes of patients presenting with purpura fulminans associated with peripheral gangrene between 1989 and 2004.
RESULTS: All 12 patients presented with sudden onset of purpuric patches and evolving gangrene of the extremities in association with a shock syndrome (hypotension, oliguria). Eleven patients had disseminated intravascular coagulation. The cause of purpura fulminans was infectious in 9 patients, surgical in two, and cancer in one. Three patients died (25%) within a week of onset of purpura fulminans. Of the 9 surviving patients, 8 required amputation of at least one limb. Four patients required amputation of all 4 limbs.
LIMITATIONS: Retrospective study design, varying clinical descriptions, and potential referral bias are limitations.
CONCLUSION: Purpura fulminans in association with symmetric peripheral gangrene is an ominous clinical presentation.
METHODS: This retrospective case series details the clinical presentation and outcomes of patients presenting with purpura fulminans associated with peripheral gangrene between 1989 and 2004.
RESULTS: All 12 patients presented with sudden onset of purpuric patches and evolving gangrene of the extremities in association with a shock syndrome (hypotension, oliguria). Eleven patients had disseminated intravascular coagulation. The cause of purpura fulminans was infectious in 9 patients, surgical in two, and cancer in one. Three patients died (25%) within a week of onset of purpura fulminans. Of the 9 surviving patients, 8 required amputation of at least one limb. Four patients required amputation of all 4 limbs.
LIMITATIONS: Retrospective study design, varying clinical descriptions, and potential referral bias are limitations.
CONCLUSION: Purpura fulminans in association with symmetric peripheral gangrene is an ominous clinical presentation.