Updates in the Approach to the Patient with Purpura

Arakaki, Ryan; Fox, Lindy P.

doi:10.1007/s13671-017-0184-7

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…6 , 9 , 14 - 18 The differential diagnoses for an adult developing purpuric lesions and acro-ischemia include microvascular occlusion syndromes, arterial emboli, hypercoagulable disorders, and vasculitis. 19 Our case demonstrates that COVID-19 should also be considered and ruled out. The acro-ischemia was attributed to COVID-19 because of the temporal onset of the disease, the patient's elevated D-dimer, and arterial Doppler findings of right peroneal artery stenosis and mild diffuse infrapopliteal atherosclerosis.…”

Section: Discussionmentioning

confidence: 74%

Dermatologic Manifestation of Acro-Ischemia Associated With COVID-19

Gumbita

Prasad

Radwan

et al. 2022

TOJ

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Background: The common dermatologic manifestations seen in patients with coronavirus disease 2019 (COVID-19) include morbilliform, pernio-like, urticarial, macular erythematous, vesicular, and papulosquamous disorders, as well as retiform purpura. Although cases of acro-ischemia have been demonstrated, they are not well studied or reported. Case Report: A 73-year-old male was admitted for acute hypoxic respiratory failure secondary to COVID-19 infection. During the patient's hospital course, his oxygen requirement progressively increased, and he developed painful, violaceous purpura on his right lower extremity digits. The patient was treated with therapeutic doses of enoxaparin and nitroglycerin ointment in the hospital and apixaban on discharge. The patient was lost to follow-up. Conclusion: The multiorgan dysfunction associated with COVID-19 includes dermatologic manifestations. This case illustrates that acro-ischemia can resolve with guideline-based medical treatment.

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