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Karimi K, Odhav A, Kollipara R, Fike J, Stanford C, Hall JC. Acute Cutaneous Necrosis: A Guide to Early Diagnosis and Treatment. J Cutan Med Surg 2017; 21:425-437. [DOI: 10.1177/1203475417708164] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Acute cutaneous necrosis is characterised by a wide range of aetiologies and is associated with significant morbidity and mortality, warranting complex considerations in management. Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin. This review discusses major causes of cutaneous necrosis, examines the need for early assessment, and integrates techniques related to diagnosis and management. The literature, available via PubMed, on acute cutaneous necrotic syndromes was reviewed to summarise causes and synthesise appropriate treatment strategies to create a clinician’s guide in the early diagnosis and management of acute cutaneous necrosis. Highlighted in this article are key features associated with common causes of acute cutaneous necrosis: warfarin-induced skin necrosis, heparin-induced skin necrosis, calciphylaxis, pyoderma gangrenosum, embolic phenomena, purpura fulminans, brown recluse spider bite, necrotising fasciitis, ecthyma gangrenosum, antiphospholipid syndrome, hypergammaglobulinemia, and cryoglobulinemia. This review serves to increase recognition of these serious pathologies and complications, allowing for prompt diagnosis and swift limb- or life-saving management.
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Affiliation(s)
- Karen Karimi
- Texas Tech University Health Sciences Center, Department of Dermatology, Lubbock, TX, USA
| | - Ashika Odhav
- National Jewish Health, Department of Allergy and Immunology, Denver, CO, USA
| | - Ramya Kollipara
- Texas Tech University Health Sciences Center, Department of Dermatology, Lubbock, TX, USA
| | - Jesse Fike
- Texas Tech University Health Sciences Center- El Paso, Paul L. Foster School of Medicine, El Paso, TX, USA
| | - Carol Stanford
- University of Missouri Kansas City, Department of Internal Medicine, Kansas City, MO, USA
| | - John C. Hall
- University of Missouri Kansas City, Department of Internal Medicine, Kansas City, MO, USA
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