Scalp necrosis, one of the symptoms of giant cell arteritis

Authors

  • Thirasak Saeko Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok
  • Pawinee Rerknimitr Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok
  • Pravit Asawanonda Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok

Keywords:

scalp necrosis, giant cell arteritis, vasculitis

Abstract

Giant cell arteritis (GCA) is an inflammatory systemic vasculitis that affected both medium and large-sized arteries. The etiology is unknown and it occurs mostly in elderly patients. The common presentations include headaches over the temporal and the occipital regions and tenderness around the areas. Fever, malaise, jaw claudication, polymyalgia rheumatica and partial or complete loss of vision are occasionally observed. Another drastic complication is an abrupt development of scalp necrosis. We present a case of a 77- year-old male with severe headache and visual loss for 7 days and an abrupt appearance of necrotic patches on the scalp for 5 days

References

1. Palmer VE, Young-Zvandasara T, Vusirikala B. Forehead necrosis, one of the many facades of giant cell arteritis. BMJ Case Rep 2015; 172:65-6.

2. Bhatti MT, Tabandeh H. Giant cell arteritis: diagnosis and management. Curr Opin Ophthalmol 2001; 12:393-9.

3. Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of giant cell arteritis. Rheumatology (Oxford) 2010; 49:1594-7.

4. Nesher G, Berkun Y, Mates M, Baras M, Rubinow A, Sonnenblick M. Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis. Arthritis Rheum 2004; 50:1332-7.

5. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 1990; 33:1122-8.

6. Tsianakas A, Ehrchen JM, Presser D, et al. Scalp necrosis in giant cell arteritis: case report and review of the relevance of this cutaneous sign of largevessel vasculitis. J Am Acad Dermatol 2009; 61:701-6.

7. Currey J. Scalp necrosis in giant cell arteritis and review of the literature. Br J Rheumatol 1997; 36:814- 6.

8. Poller DN, van Wyk Q, Jeffrey MJ. The importance of skip lesions in temporal arteritis. J Clin Pathol 2000; 53:137-9.

9. Mukhtyar C, Guillevin L, Cid MC, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 2009; 68:318-23.

10. Vaith P, Warnatz K. [Clinical and serological findings of giant-cell arteritis]. Z Rheumatol 2009; 68:124-31. \

11. Proven A, Gabriel SE, Orces C, O'Fallon WM, Hunder GG. Glucocorticoid therapy in giant cell arteritis: duration and adverse outcomes. Arthritis Rheum 2003; 49:703-8.

12. Aui-Aree N, Tungsinmunkong K, Hirunpat S, Ratanasukon M, Wangsupadilok B. A variety of atypical manifestations in giant cell arteritis. J Med Assoc Thai 2010; 93:629-32.

Downloads

Published

2017-06-01

How to Cite

Saeko, T., Rerknimitr, P., & Asawanonda, P. (2017). Scalp necrosis, one of the symptoms of giant cell arteritis. Thai Journal of Dermatology, 33(2), 161–166. Retrieved from https://he02.tci-thaijo.org/index.php/TJD/article/view/159233

Issue

Section

Case Report