Arora Rajnish, Tayal Mohit, Rao Neeraj, Singh Monica, Walia Rohit
Department of Neurosurgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India.
Department of Radiology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India.
J Family Med Prim Care. 2022 May;11(5):2220-2222. doi: 10.4103/jfmpc.jfmpc_1634_21. Epub 2022 May 14.
A twelve-year-old girl with classical features of Takayasu arteritis presented with scalp ulceration and osteomyelitis. Her computed tomography (CT) of the head revealed an extensive ulcerated lesion over the left high parietal region with lytic destruction of the outer and inner tables of the skull. Because of full-thickness calvarial bone involvement, chronic osteomyelitis, and ulcerated scalp lesion, she underwent debridement of involved bone along with the margin of normal skin. During surgery, underlying dura was found to be not involved, and a transposition flap was done for reconstruction. Histopathology did not reveal any evidence of bacterial infection or granulomas. Sterile osteomyelitis of the skull associated with alopecia and scalp necrosis has not been reported with typical Takayasu disease. Family physicians should be vigilant to keep this as a differential diagnosis in nonhealing osteomyelitis, not responding to antibiotics, or showing any evidence of infection.
一名患有典型高安动脉炎特征的12岁女孩出现头皮溃疡和骨髓炎。她的头部计算机断层扫描（CT）显示左顶叶上部区域有广泛的溃疡病变，颅骨内外板有溶骨性破坏。由于颅骨全层受累、慢性骨髓炎和头皮溃疡病变，她接受了受累骨连同正常皮肤边缘的清创术。手术中发现硬脑膜未受累，并进行了转移皮瓣重建。组织病理学未发现细菌感染或肉芽肿的任何证据。典型的高安病尚未报告与脱发和头皮坏死相关的无菌性颅骨骨髓炎。家庭医生应保持警惕，将其作为抗生素治疗无效或有任何感染迹象的不愈合骨髓炎的鉴别诊断。
