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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2013 ; 92
(6
): 331-343
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The spectrum of paraneoplastic cutaneous vasculitis in a defined population:
incidence and clinical features
#MMPMID24145696
Loricera J
; Calvo-Río V
; Ortiz-Sanjuán F
; González-López MA
; Fernández-Llaca H
; Rueda-Gotor J
; Gonzalez-Vela MC
; Alvarez L
; Mata C
; González-Lamuño D
; Martínez-Taboada VM
; González-Gay MA
; Blanco R
Medicine (Baltimore)
2013[Nov]; 92
(6
): 331-343
PMID24145696
show ga
Cutaneous vasculitis may be associated with malignancies, and may behave as a
paraneoplastic syndrome. This association has been reported in a variable
proportion of patients depending on population selection. We conducted the
current study to assess the frequency, clinical features, treatment, and outcome
of paraneoplastic vasculitis in a large unselected series of 766 patients with
cutaneous vasculitis diagnosed at a single university hospital. Sixteen patients
(10 men and 6 women; mean age ± standard deviation, 67.94 ± 14.20 yr; range,
40-85 yr) presenting with cutaneous vasculitis were ultimately diagnosed as
having an underlying malignancy. They constituted 3.80% of the 421 adult
patients. There were 9 hematologic and 7 solid underlying malignancies. Skin
lesions were the initial clinical presentation in all of them, and the median
interval from the onset of cutaneous vasculitis to the diagnosis of the
malignancy was 17 days (range, 8-50 d). The most frequent skin lesions were
palpable purpura (15 patients). Other clinical manifestations included
constitutional syndrome (10 patients) and arthralgia and/or arthritis (4 cases).
Hematologic cytopenias (11 cases) as well as immature peripheral blood cells (6
cases) were frequently observed in the full blood cell count, especially in those
with vasculitis associated with hematologic malignancies. Specific treatment for
vasculitis was prescribed in 10 patients; nonsteroidal antiinflammatory drugs (4
patients), corticosteroids (3 patients), chloroquine (1 patient), antihistamines
(1 patient), and cyclophosphamide (1 patient). Ten patients died due to the
malignancy and 6 patients recovered following malignancy therapy. Patients with
paraneoplastic vasculitis were older, more frequently had constitutional
syndrome, and less frequently had organ damage due to the vasculitis than the
remaining patients with cutaneous vasculitis. In summary, cutaneous
paraneoplastic vasculitis is an entity not uncommonly encountered by clinicians.
The most common underlying malignancy is generally hematologic. In these cases
the presence of cytopenias and immature cells may be red flags for the diagnosis
of cancer. In patients with paraneoplastic cutaneous vasculitis, the prognosis
depends on the underlying neoplasia.