Currey J
Department of Rheumatology, Princess Alexandra Hospital NHS Trust, Harlow, Essex.
Br J Rheumatol. 1997 Jul;36(7):814-6. doi: 10.1093/rheumatology/36.7.814.
A patient with giant cell arteritis (GCA) who developed scalp necrosis (SN) is described and 23 other cases in the English language literature are reviewed. SN is rare and occurs in older patients of mean age 77 yr. Thirteen patients presented to dermatologists. Nineteen (79%) had other serious complications of GCA: visual loss in 16, gangrene of the tongue in four and nasal septum necrosis in one. The mean interval between the onset of symptoms of GCA and SN was 3.0 months in the 19 cases which antedated corticosteroid therapy. SN resulted from active arteritis and no case was definitely linked to temporal artery biopsy. Scalp healing was complete or progressing satisfactorily in 18 cases (75%). SN is a potentially reversible complication of GCA and adequate corticosteroid therapy is mandatory. In the current case. SN related to inadequate dosage of prednisolone.
本文描述了1例发生头皮坏死（SN）的巨细胞动脉炎（GCA）患者，并对英文文献中的其他23例病例进行了回顾。SN较为罕见，发生于平均年龄77岁的老年患者。13例患者就诊于皮肤科医生。19例（79%）有GCA的其他严重并发症：16例视力丧失，4例舌坏疽，1例鼻中隔坏死。在19例先于糖皮质激素治疗的病例中，GCA症状出现至SN的平均间隔时间为3.0个月。SN由活动性动脉炎引起，且无一例明确与颞动脉活检有关。18例（75%）头皮愈合完全或进展满意。SN是GCA潜在可逆的并发症，必须给予充分的糖皮质激素治疗。在本例中，SN与泼尼松龙剂量不足有关。
