Yaqub Sabeen, Stepenaskie Shelly A, Farshami Fatemeh Jafari, Sibbitt Wilmer L, Fangtham Monthida, Emil N Suzanne, Bankhurst Arthur D
Drs. Yaqub, Farshami, Sibbitt, Fangtham, Emil, and Bankhurst are with the Department of Internal Medicine, Division of Rheumatology, and School of Medicine at the University of New Mexico Health Sciences Center in Albuquerque, New Mexico.
Dr. Stepenaskie is with the Departments of Dermatology and Pathology at the University of New Mexico Health Sciences Center in Albuquerque, New Mexico.
J Clin Aesthet Dermatol. 2019 Nov;12(11):23-26. Epub 2019 Nov 1.
Painful, palpable purpura usually indicate underlying vasculitis. We report a case of systemic vasculitis treated with immunosuppression that developed painful, vasculitis-like purpuric lesions that progressed rapidly to fulminant Kaposi sarcoma (KS). These purpuric, tumorous lesions resolved completely following the suspension of immunosuppression; however, without immunosuppression, the underlying autoimmunity recurred. This case highlights the potential for early KS to present as a vasculitis mimic or pseudovasculitis that clinicians should keep in mind when purpuric, vasculitis-like lesions develop in an immunosuppressed patient with vasculitis. It is important to recognize these pseudovasculitis lesions as KS rather than recurrent vasculitis so that immunosuppression can be withdrawn.
疼痛性、可触及的紫癜通常提示潜在的血管炎。我们报告一例接受免疫抑制治疗的系统性血管炎患者,该患者出现了疼痛性、血管炎样紫癜性病变,并迅速进展为暴发性卡波西肉瘤(KS)。停用免疫抑制后,这些紫癜性肿瘤性病变完全消退;然而,未进行免疫抑制时,潜在的自身免疫复发。该病例强调了早期KS可能表现为血管炎模仿症或假血管炎,临床医生在免疫抑制的血管炎患者出现紫癜性、血管炎样病变时应牢记这一点。将这些假血管炎病变识别为KS而非复发性血管炎很重要,这样才能停用免疫抑制。