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Current Dermatology Reports

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01-12-2019 | Vasculitis | Hospital-Based Dermatology (L Guggina and A Zhou, Section Editors)

An Approach to Retiform Purpura for the Inpatient Dermatologist

Authors: Abeer Alsarheed, Gabriela A. Cobos, Christine M. Cornejo, Ruth Ann Vleugels, Joseph F. Merola

Published in: Current Dermatology Reports | Issue 4/2019

Abstract

Purpose of Review

Retiform purpura is a potentially ominous cutaneous sign that develops secondary to vascular compromise by either vasculitis or a vasculopathic disorder. The wide array of associated complications mandate a thorough investigation in a timely fashion. This review provides an overview of the frequent causes of retiform purpura in hospitalized adult patients and proposes a diagnostic approach for the inpatient dermatologist.

Recent Findings

Early recognition of the primary cutaneous morphology in retiform purpura is especially important as this can help generate a focused differential and workup plan. A high-yield skin biopsy result warrants a proper site selection and an adequate depth. Further workup and treatment depend on the underlying pathogenic process. For patients with underlying systemic vasculitis, rituximab is emerging as an effective treatment. Rivaroxaban was found to have excess risk (increased thromboembolic and bleeding events) and no benefit when compared to warfarin in a trial of high-risk anti-phospholipid syndrome patients.

Summary

The differential diagnosis of retiform purpura is broad and a systematic approach is required to identify and treat the underlying cause.

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Title: An Approach to Retiform Purpura for the Inpatient Dermatologist
Authors: Abeer Alsarheed
Gabriela A. Cobos
Christine M. Cornejo
Ruth Ann Vleugels
Joseph F. Merola
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Vasculitis
Vasculitis
Granulomatosis with Polyangiitis
Churg-Strauss Syndrome
Churg-Strauss Syndrome
Granulomatosis with Polyangiitis
Warfarin
Published in: Current Dermatology Reports / Issue 4/2019
Electronic ISSN: 2162-4933
DOI: https://doi.org/10.1007/s13671-019-00281-2

At a glance: The STEP trials

Springer Medicine

An Approach to Retiform Purpura for the Inpatient Dermatologist

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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