Cutaneous cholesterol embolization

Lane, Joshua E.; Lane, Tanda N.; Shams, Marissa; Lane, Carl E.

doi:10.1016/j.jaad.2008.09.013

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Embolization of cholesterol crystals from atherosclerotic plaques to small arterioles (100-200 mm) occurs mostly in male patients, older than 60 years, with multiple risk factors for atherosclerosis, and often after invasive cardiovascular procedures or the onset of anticoagulant or fibrinolytic therapies [1][2][3]. However, spontaneous embolization may occur without any precipitating factor, as in our case.…”

Section: Commentairesmentioning

confidence: 57%

“…Ophthalmologic examination finds asymptomatic retinal crystals in less than 25% of the cases. Cholesterol clefts in small arteries or arterioles of the biopsy from an affected organ (skin, kidney, muscle) confirm the diagnosis [1][2][3]. Sudden onset of livedo reticularis and/or blue toes with or without a precipitating factor indicates the need for a deep skin biopsy including the deep dermis and hypodermis, to search for cholesterol crystals.…”

Section: Commentairesmentioning

confidence: 94%

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Spontaneous cutaneous cholesterol embolism

et al. 2010

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Section: Commentairesmentioning

confidence: 57%

Section: Commentairesmentioning

confidence: 94%

Spontaneous cutaneous cholesterol embolism

et al. 2010

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“…1 Cholesterol embolism may occur after the start of anticoagulant or thrombolytic therapy or after endovascular procedures or may occur spontaneously. [2][3][4][5] Atherosclerotic plaques are lined along the great and intermediate great vessels. 6 The effect of the embolism depends on the position of the plaque in the aorta.…”

Section: Introductionmentioning

confidence: 99%

Fatal Course of Cutaneous Cholesterol Embolization Syndrome: A Case Report

Beukel

Poot

Beuk

2021

The International Journal of Lower Extremity Wounds

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Cholesterol embolization syndrome is an increasing but underestimated problem after endovascular intervention or after the start of thrombolytic therapies. Embolies from the aortic wall involves abdominal organs and the skin of the lower extremities or buttocks. In our case a progressive ulceration and necroses occurs spontaneously. Endovascular treatment of the lower extremities was successful for a short period. Due to the progression of necrosis, both legs were amputated. Biopsies were taken from the skin were initially no directions to the diagnosis of Cholesterol embolization syndrome. After a second elliptical excision biopsy the diagnosis of cholesterol embolization syndrome was confirmed. Because the rapid progression of skin necroses despite the treatment of prednisone, patient died due to sepsis and renal failure. This case shows when arterial revascularization is performed and progression in skin necrosis occurs despite optimal arterial vascular status the diagnosis CES should be considered and treated in an early state of disease.

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“…Recommended treatment ranges from supportive care and avoidance of endovascular procedures for mild CES to cessation of anticoagulant therapy (thought to potentiate atherosclerotic plaque instability) for severe presentations. 4 We postulate that milder forms of CES, especially skin-limited presentations, may be …”

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confidence: 99%