Granulomatosis with polyangiitis (GPA) is a systemic necrotizing small vessel vasculitis associated with circulating anti-neutrophil cytoplasmic antibodies (ANCAs). Skin manifestations, mostly represented by palpable purpura, papulonodular lesions and livedo reticularis, are present in up to 50% of the cases. Ulcerations with undermined, raised erythematous–violaceous border resembling pyoderma gangrenosum (PG) have rarely been reported as skin involvement in GPA. The presence of circulating ANCAs with a cytoplasmic labelling pattern, the involvement of internal organs, particularly of the lung, and the absence on histology of a mainly neutrophilic infiltrate in early phases of the cutaneous lesions may be regarded as clues to rule out true PG and confirm the diagnosis of GPA skin ulcerations simulating PG. Herein, we describe two paradigmatic cases of such a unique presentation of GPA and a literature review focusing on clinicopathological features of GPA presenting with PG-like ulcerations in the skin has been provided. Moreover, referring to the scenario observed in these two cases, an easy-to-use working approach for the differential diagnosis between the two conditions has also been proposed.
Pyoderma gangrenosum-like ulcerations in granulomatosis with polyangiitis : two cases and literature review / G. Genovese, S. Tavecchio, E. Berti, F. Rongioletti, A.V. Marzano. - In: RHEUMATOLOGY INTERNATIONAL. - ISSN 0172-8172. - 38:6(2018), pp. 1139-1151.
|Titolo:||Pyoderma gangrenosum-like ulcerations in granulomatosis with polyangiitis : two cases and literature review|
MARZANO, ANGELO VALERIO (Corresponding)
|Parole Chiave:||ANCA-associated vasculitis; Granulomatosis with polyangiitis; Pyoderma gangrenosum; Rheumatology; Immunology and Allergy; Immunology|
|Settore Scientifico Disciplinare:||Settore MED/34 - Medicina Fisica e Riabilitativa|
|Data di pubblicazione:||2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00296-018-4035-z|
|Appare nelle tipologie:||01 - Articolo su periodico|
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