Acral retiform purpura

Cutaneous microvascular occlusion syndrome as the first manifestation of catastrophic lupus-associated antiphospholipid antibody syndrome: a case report

BACKGROUND

Antiphospholipid syndrome (APS), defined by thrombotic events or obstetric complications in the presence of persistently high antiphospholipid antibodies, is characterized by a wide variety of clinical presentations and the effects of vascular occlusion can impact almost any organ system or tissue. Since adult-onset APS classification criteria are not well verified in pediatrics (where pregnancy-related problems are rare), estimating childhood prevalence is challenging. Stroke and pulmonary embolism are thromboembolic events occurring in children that can cause considerable long-term morbidity. Children with APS are more prone to recurrent thromboembolism than adults. Cutaneous symptoms are prominent and typically represent the first clue of APS. Although dermatologic findings are exceedingly heterogeneous, it is essential to consider which dermatological symptoms justify the investigation of antiphospholipid syndrome and the required further management.

CASE PRESENTATION

We describe a seven-year-old Iranian boy with retiform purpura and acral cutaneous ischemic lesions as the first clinical presentation of antiphospholipid syndrome in the setting of systemic lupus erythematous.

CONCLUSION

APS in pediatrics, is associated with a variety of neurologic, dermatologic, and hematologic symptoms. Therefore, it is essential for pediatricians to be aware of the rare appearance of Catastrophic APS as an initial indication of APS.

Systemic lupus erythematosus and antiphospholipid syndrome with retiform purpura as the initial skin lesion: A case study

Retiform purpura-like lesions are rarely seen clinically and can be induced by cutaneous vascular wall damage or a lumen-occlusive disease arising from a broad range of triggers, including infection, drugs, emboli, cryoglobulinemia, disseminated intravascular coagulation, and autoimmune disease. Here, we present the case of a patient suffering from both systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), with retiform purpura as the first lesion and lacking other typical symptoms of SLE, such as photosensitivity, malar rash, ulceration of the mouth and nose, alopecia, and joint pain.