Granulomatous Dermatitis With Pseudoxanthoma Elasticum–Like Changes

Tiger, Jeffrey B.; McKenzie, Jill; Tran, Don T.; Olerud, John E.; George, Evan

doi:10.1001/archdermatol.2009.238

Cited by 2 publications

(2 citation statements)

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“…PXE, ABCC6 gene mutation, is an autosomal recessive disorder with notable calcification of the elastic fibers of the skin, eyes and cardiovascular system, which leads to progressive blindness, grouped papular lesions on flexural skin, myocardial infraction and gastrointestinal bleeding from arterial ruptures . Nevertheless, rare case reports in the literature report PXE‐like changes in patients that do not have PXE . These PXE‐like changes were usually found in the deep dermis or subcutis of the lower extremities in patients with chronic inflammatory dermatoses or in septa of the subcutis of patients with chronic renal failure .…”

Section: Introductionmentioning

confidence: 99%

“…3 Nevertheless, rare case reports in the literature report PXE-like changes in patients that do not have PXE. 3,4 These PXE-like changes were usually found in the deep dermis or subcutis of the lower extremities in patients with chronic inflammatory dermatoses or in septa of the subcutis of patients with chronic renal failure. 3,4 This is a unique case that exemplifies both PXE-like changes and hydrophilic polymer emboli, which has led to vasculopathy and loss of the affected toe.…”

Section: Introductionmentioning

confidence: 99%

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Hydrophilic polymer vasculopathy with coinciding pseudoxanthoma elasticum‐like changes in an amputated toe

2017

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For the past decades, hydrophilic polymer gel coating have been widely used on endovascular devices to decrease friction and to aid with binding and delivering of medications in drug-eluting stents. In the recent years, hydrophilic polymer emboli disease has been recognized as an iatrogenic adverse effect which has led to considerable morbidity and mortality of patients. This under-recognized embolic phenomenon now has reproducible pathognomonic histologic findings. Small- to medium-sized blood vessels are occluded with basophilic, amorphous, non-refractile, non-polarizable and whirled aggregates of foreign body material. Depending on the affected organ, the patients have variable symptomatology, from livedo racemosa, gangrene of extremities to cardiac arrhythmias, hemiparesis, stroke and death. Here, we present a unique case of hydrophilic polymer vasculopathy 6 years post-endovascular procedure with coinciding pseudoxanthoma elasticum-like changes. As the literature has seen increased reporting of individual cases and case series documenting the patients' diverse symptomatology; hydrophilic polymer vasculopathy should be entertained sooner in the patient's differential diagnosis.

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Section: Introductionmentioning

confidence: 99%