Stasis pigmentation and chronic alcoholism

González-Reimers, C.E.; Santolaria-Fernández, F.; Batista-López, Norberto; Machado-Machado, Patricia

doi:10.1016/0376-8716(90)90140-a

Cited by 3 publications

(3 citation statements)

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“…The results agree with those of González-Reimers et al, and Rodriguez Rodriguez et al, who believe that chronic pigmented purpura is the earliest cutaneous indicator of alcoholism. 28,29 …”

Section: Discussionmentioning

confidence: 99%

Study on dermatoses and their prevalence in groups of confirmed alcoholic individuals in comparison to a non-alcoholic group of individuals

Bruno

Vilela

Oliveira³

2013

An. Bras. Dermatol.

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BACKGROUND The direct relationship between alcoholism and dermatoses has been evaluated in recent researches. However, there are few objective surveys that demonstrate and prove a direct relationship between alcohol and a specific dermatosis. OBJECTIVES to verify the prevalence of dermatoses in alcoholics, analize the dermatological changes found in these patients and their evolution during alcoholic abstinence. Also, to compare the results obtained with a non-alcoholic control group and with the data found in medical literature. METHODS: the dermatologic conditions of 278 alcoholic patients (250 men, 28 women) were studied over a period of 4 years, and compared to those of a control group of 271 non-alcoholic individuals (249 men, 22 women), members of the Military Police Force. The individuals in both groups were between 20 and 60 years old. RESULTS Pellagra, nummular eczema, purpura pigmentosa chronica (also known as pigmented purpuric dermatosis) and psoriasis were more frequent in the group of alcoholics and, apparently, occurred in parallel with alcoholism that seems to play a role in the evolution of these dermatoses. The dermatopathies were more frequent before the age of forty, regardless of factors such as profession, race or gender. CONCLUSION the association of dermatoses and alcoholism was extremely significant according to the statistical data. Alcoholism can be considered a risk factor for pellagra, psoriasis, nummular eczema and purpura pigmentosa chronica dermatoses, which can, as well, be considered alcoholism indicators.

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Section: Discussionmentioning

confidence: 99%

Study on dermatoses and their prevalence in groups of confirmed alcoholic individuals in comparison to a non-alcoholic group of individuals

Bruno

Vilela

Oliveira³

2013

An. Bras. Dermatol.

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“…Administration of 1 ml of 5 % acetic acid, however, was not followed by purpura [8], suggesting that technically negligible amounts of ethanol in vinegar may be “purpurogenic” or that this small amount of pure acetic acid was simply insufficient to “kindle” purpura. Over our patient’s years of heavy drinking, acute effects of alcohol or its metabolites on capillaries (possibly sustainably affected by IgA) involving IgE [8, 39, 46] or not involving IgE [22, 23, 47, 48] might have sensitized and eventually boosted the manifestation of purpura. We favor an IgE-mediated increase in the permeability of cutaneous capillaries [46, 48] facilitating the penetration of erythrocytes into the skin, thereby forming fresh purpura.…”

Section: Discussionmentioning

confidence: 99%

“…SD’s etiology is obscure, but antigen and other cellular immune mechanisms appear to be involved [19–21]. In addition, an abnormal, spasmlike motility of the capillaries, probably via dysautonomia [22] and stasis pigmentation [23], have been described as being associated with SD.…”

Section: Introductionmentioning

confidence: 99%

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

2016

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BackgroundIt is unusual for purpura to emerge as a result of drinking alcohol. Such a peculiarity was observed in a 55-year-old man with a 30-year history of heavy alcohol use.Case presentationThe Caucasian patient was studied for 11 years during several detoxification treatments. During the last 2 years of that period, purpuric rashes were newly observed. The asymptomatic purpura was limited to both lower limbs, self-limiting with abstinence, and reoccurring swiftly with alcohol relapse. This sequence was observed six times, suggesting a causative role of alcohol or its metabolites. A skin biopsy revealed histological features of purpura pigmentosa progressiva (termed Schamberg’s disease). Additionally, alcoholic fatty liver disease markedly elevated serum immunoglobulins (immunoglobulin A and immunoglobulin E), activated T-lymphocytes, and increased C-reactive protein. In addition, moderate combined (cellular and humoral) immunodeficiency was found. Unlike the patient’s immunoglobulin A level, his serum immunoglobulin E level fell in the first days of abstinence, which corresponded to the time of purpura decline. Systemic vasculitis and clotting disorders were excluded. The benign character of the purpura was supported by missing circulating immune complexes or complement activation. An alcohol provocation test with vinegar was followed by the development of fresh “cayenne pepper” spots characteristic of Schamberg’s disease.ConclusionsThis case report demonstrates that Schamberg’s disease can be strongly related to alcohol intake, in our patient most likely as a late complication of severe alcoholism with alcoholic liver disease. Immunologic disturbances thereby acquired could have constituted a basis for a hypersensitivity-like reaction after ingestion of alcohol. Schamberg’s disease induction by vinegar may point to an involvement of acetate, a metabolite of ethanol.

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