A 66‐Year‐Old Woman With Hemoptysis

Patel, Falin B.; Couch, Kara; McNish, Sean; Miller, Jonathan; Siegel, Robert S.; Easley, Samantha; Shanmugam, Victoria K.

doi:10.1002/acr.22820

Cited by 2 publications

(2 citation statements)

References 46 publications

(51 reference statements)

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“…With the advent of B-cell depletion therapy for ANCA associated vasculitis, several authors have reported successful treatment of vasculitic leg ulcers with rituximab (Rituxan®, Genentech) (31, 32). …”

Section: Leg Ulcers Due To Anca-associated Vasculitismentioning

confidence: 99%

Vasculitic and autoimmune wounds

Shanmugam

Angra

Rahimi

et al. 2017

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Chronic wounds are a major cause of morbidity and mortality. Approximately 20–23% of non-healing wounds that are refractory to vascular intervention have other etiologies including vasculitis, pyoderma gangrenosum and other autoimmune diseases. The purpose of this article is to review the autoimmune and coagulopathic diseases that are commonly associated with leg ulceration. OBJECTIVES To review the literature across medical and surgical specialties with regards to refractory chronic wounds associated with vasculitis and autoimmune diseases and to delineate clinical outcomes of these wounds in response to vascular and other interventions. METHODS An electronic search encompassing MEDLINE®, PubMed®, Cochrane Library and Scopus ® was completed using the following search terms: rheumatoid arthritis; systemic sclerosis; systemic lupus erythematosus; ANCA associated vasculitis; mixed connective tissue disease; antiphospholipid syndrome; pyoderma gangrenosum; thromboangiitis obliterans; cryoglobulinemia; hydroxyurea; sickle-cell; atrophie blanche; livedoid vasculitis; cholesterol emboli; calciphylaxis; antiphospholipid antibodies; prothrombotic; combined with the terms: chronic wound and leg ulcer. Full text articles published in English up to March 1, 2016 that investigated the clinical outcomes of chronic wounds associated with autoimmune diseases were included. Review articles and evaluations of management of chronic wounds were also reviewed. Primary outcomes included in the review were amputation, ulcer healing, reduction in wound size, overall survival and freedom from reintervention. Owing to the heterogeneity of data reporting among articles, qualitative analysis is also reported. CONCLUSIONS Autoimmune and vasculitic etiologies should be considered in patients with chronic wounds who do not respond to appropriate vascular intervention and standard local wound care. A multidisciplinary approach with the involvement of rheumatology allows investigation for underlying systemic disease and improves clinical outcomes for many of these challenging patients.

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Section: Leg Ulcers Due To Anca-associated Vasculitismentioning

confidence: 99%

Vasculitic and autoimmune wounds

Shanmugam

Angra

Rahimi

et al. 2017

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…As with ulcers caused by other autoimmune etiologies, aggressive treatment of the underlying autoimmune disease often results in healing of the wound (27, 29). With the advent of B-cell depletion therapy for ANCA associated vasculitis, several authors have reported successful treatment of vasculitic leg ulcers with rituximab (Rituxan®, Genentech) (29, 30). …”

Section: Overview Of Vasculitic Woundsmentioning

confidence: 99%

Vasculitic Diseases and Prothrombotic States Contributing to Delayed Healing in Chronic Wounds

Shanmugam

2016

Curr Derm Rep

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PURPOSE Autoimmune diseases are a common cause of delayed wound healing and should be considered in patients with chronic wounds who do not respond to local wound care or who fail skin grafting in the absence of infection. RECENT FINDINGS Epidemiologic studies have shown that, of patients with chronic wounds evaluated in specialized wound healing clinics, 20–23% have autoimmune etiologies for their wounds including vasculitis, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, pyoderma gangrenosum and other autoimmune diseases. SUMMARY In this article autoimmune diseases known to be associated with chronic wounds and delayed wound healing are reviewed and the importance of a multidisciplinary approach for patients with chronic wounds, with involvement of rheumatology and dermatology is highlighted. This approach allows for investigation of underlying systemic disease and improves clinical outcomes for many of these challenging patients.

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A 66‐Year‐Old Woman With Hemoptysis

Cited by 2 publications

References 46 publications

Vasculitic and autoimmune wounds

Vasculitic and autoimmune wounds

Vasculitic Diseases and Prothrombotic States Contributing to Delayed Healing in Chronic Wounds

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