Telangiectasias extensas adquiridas: comparación entre telangiectasia esencial generalizada y vasculopatía colágena cutánea

Cutaneous Collagenous Vasculopathy: A Short Case Series and Literature Review

ABSTRACT

Cutaneous collagenous vasculopathy (CCV) is a rare and idiopathic microangiopathy of superficial dermal blood vessels. There have been 75 cases described in the literature to date, not including the current report; however, given its clinical similarity to other primary telangiectasias, it is likely to be underreported and underdiagnosed. Here, we describe the clinical and histological features of 2 patients we newly diagnosed with CCV. Both generally fit the profile of prior cases and confirm previously described associations-they both are older White women, have rashes on their lower extremities, and have conditions and medications that are common among other reported cases. However, both are also somewhat atypical, as Patient 1 had symptomatic CCV and Patient 2 had a papular rash. As such, both cases broaden the spectrum of our current understanding of CCV. We also provide a comprehensive review of all published reports of CCV to date and uncover 2 previously unreported associations: one with visceral malignancy, and the other with hypothyroidism. Whether these association are coincidental is worth investigating in future studies.

Dermoscopic features of telangiectasia macularis multiplex acquisita

Telangiectasia macularis multiplex acquisita is a rarely described entity, characterized by multiple asymptomatic erythematous and/or brownish macules with telangiectasias, preferably on bilateral upper arms and trunk. We reported a 56-year-old Chinese man with telangiectasia macularis multiplex acquisita. Dermoscopic examination demonstrated an erythematous-brownish background with a striking angioid streak pattern (a central arteriole with superficial radiating small vessels attributed to spider-like eruptions) and linear-irregular branching vessels. We suggest dermoscopic features can be used to improve the accuracy of clinical diagnosis and avoid unnecessary skin biopsies.

Rare case of cutaneous collagenous vasculopathy in a patient with chronic HCV infection 1b subtype

The article is devoted to a rare disease of cutaneous collagenous vasculopathy (CCV), which is characterized by common leather telangiectasias and specific histological signs: extended capillaries in the surface layers of the dermis, the walls of which are thickened due to hyaline deposits containing type IV collagen. According to literature, there are no publications about CCV in Russian sources. In foreign literature, only 60 cases are described, the first of which is mentioned in 2000. The patient turned to the EXCLUSIVE medical clinic to resolve the issue of the tactics of treatment of chronic HCV-infection 1b subtype and complaints of common telangiectasia on the skin and mucous membrane of both sclera, without subjective sensations. The first rashes appeared in 2008 and gradually progressed. When performing histological examination, expanded capillaries were found in the surface layers of the dermis, the walls of which are thickened due to protein deposits containing type IV collagen. The described case of CCV is the first in Russian literature and shows the need for histological and immunohistologycal studies to establish a final diagnosis.

A Case of Cutaneous Collagenous Vasculopathy Associated with Multiple Myeloma and with Pathogenic Variant in the Glucocerebrosidase Gene

Cutaneous collagenous vasculopathy (CCV) is an extremely rare acquired microangiopathy of unknown etiology. The authors describe a case of a 68-year-old man, a carrier of a heterozygous pathogenic variant in the glucocerebrosidase (GBA) gene, who was diagnosed with CCV, revealing uncommon fibrinogen positivity in direct immunofluorescence. The patient was subsequently diagnosed with multiple myeloma. The treatment of myeloma with combined chemotherapy including bortezomib, followed by autologous stem cell transplantation, led to significant reduction of cutaneous lesions. To the best of the authors' knowledge, this is the first published case of CCV in a carrier of a pathogenic variant in the GBA gene, associated with multiple myeloma and with significant regression of CCV after the myeloma treatment. Direct immunofluorescence examination revealed uncommon fibrinogen positivity. Hypothetical causative role of bortezomib treatment was proposed regarding significant regression of CCV. This article is protected by copyright. All rights reserved.

Pathophysiology of telangiectasias of the lower legs and its therapeutic implication: A systematic review

Objective Telangiectasias of the lower legs are intradermal dilatations of the subpapillary venous plexus, but their pathophysiology and risk factors are still largely unknown. The purpose of this review is to summarize the current knowledge on the pathophysiology and risk factors for telangiectasias. Methods A systematic review of the literature indexed in Medline completed with textbooks and European phlebology journals from the French, Swiss, and German phlebology societies was performed. Results A multitude of risk factors and several pathophysiological hypotheses, such as reflux, arterio-venous micro-shunts, parietal, and connective tissue abnormalities, are described in the literature. The different hypotheses are discussed and put in a clinical perspective, in particular their therapeutic implications for phlebologists. Conclusion In conclusion, pathophysiology and risk factors of telangiectasias are still largely unknown, and a better understanding could improve treatment results and reduce recurrence.