scholarly journals Giant Cell Arteritis Presenting as Scalp Necrosis

2011 ◽  
Vol 11 ◽  
pp. 1313-1315 ◽  
Author(s):  
Daniel E. Maidana ◽  
Silvia Muñoz ◽  
Xènia Acebes ◽  
Roger Llatjós ◽  
Anna Jucglà ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Older Patients ◽  
Vision Loss ◽  
Mortality Rates ◽  
Elevated Risk ◽  
Irritant Contact Dermatitis ◽  
Scalp Necrosis ◽  
Microbial Infections ◽  
High Level

The differential of scalp ulceration in older patients should include several causes, such as herpes zoster, irritant contact dermatitis, ulcerated skin tumors, postirradiation ulcers, microbial infections, pyoderma gangrenosum, and giant cell arteritis. Scalp necrosis associated with giant cell arteritis was first described in the 1940s. The presence of this dermatological sign within giant cell arteritis represents a severity marker of this disease, with a higher mean age at diagnosis, an elevated risk of vision loss and tongue gangrene, as well as overall higher mortality rates, in comparison to patients not presenting this manifestation. Even though scalp necrosis due to giant cell arteritis is exceptional, a high level of suspicion must be held for this clinical finding, in order to initiate prompt and proper treatment and avoid blindness.

Drug-Associated Giant Cell Arteritis with Scalp Necrosis After Treatment with Pembrolizumab: a Case Report

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Bassel Bou Dargham ◽  
Julianna Kang ◽  
Joshua Gavin ◽  
Abhishek Nandan
Keyword(s):  
Case Report ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Scalp Necrosis

scholarly journals Vision Loss in Patients with Giant Cell Arteritis Treated with Tocilizumab

2020 ◽  
Author(s):  
Jennifer Amsler ◽  
Iveta Kysela ◽  
Christoph Tappeiner ◽  
Luca Seitz ◽  
Lisa Christ ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Structural Changes ◽  
Vision Loss ◽  
Treated Patient ◽  
Laboratory Data ◽  
Reactive Protein ◽  
American College Of Rheumatology ◽  
Low Incidence ◽  
Initiation Of Therapy

Abstract Objectives: Giant cell arteritis (GCA) may lead to vision loss. To what extent tocilizumab (TCZ) is able to prevent vision loss is unknown. The aim was to analyze the occurrence of vision loss in a large GCA cohort treated with TCZ.Methods: In this observational monocentric study, GCA patients treated with TCZ between the years 2010 and 2018 were studied. Demographic, clinical and laboratory data were analyzed. Results: A total of 186 patients were included (62% female); 109 (59%) fulfilled the American College of Rheumatology (ACR) criteria, in 123 (66%) patients, large vessel vasculitis was diagnosed in magnetic resonance-angiography (MRA). Cumulative duration of TCZ treatment was 224 years, median treatment duration was 11.1 (IQR 5.6-17.9) months. Glucocorticoids (GC) were tapered over a median of 5.8 (IQR 3.0-8.5) months. At baseline, visual symptoms were present in 70 (38%) and vision loss in 21 (11%) patients. Patients with vision loss at baseline were older (p=0.032), had a lower C-reactive protein (p=0.002), more often cranial symptoms (p<0.001) or jaw claudication (p=0.031) and showed a negative association with MRA of the aorta (p=0.006). Two patients (1.1%) developed vision loss, both at initiation of TCZ treatment.Conclusion: Our data show a very low incidence of vision loss in TCZ-treated patient. The two cases of AION occurred at initiation of therapy, they support the hypothesis that advanced, and established structural changes of arteries are key factors for this accident. Whether shorter duration of concomitant GC treatment is risky regarding vision loss needs to be studied.

Vision Loss From Giant Cell Arteritis in Patients With Other Ocular Diagnoses

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Prem Nichani ◽  
Valérie Biousse ◽  
Nancy J. Newman ◽  
Jonathan A. Micieli
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss

Scalp Necrosis Associated with Giant-Cell Arteritis

2016 ◽  
Vol 374 (6) ◽  
pp. e6 ◽  
Author(s):  
Qasim Akram ◽  
Hector Chinoy
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Scalp Necrosis

An unusual presentation of giant cell arteritis

VASA ◽  
2005 ◽  
Vol 34 (2) ◽  
pp. 128-130 ◽  
Author(s):  
Simon ◽  
Fritz ◽  
Amann-Vesti ◽  
Schenk Romer ◽  
Fischer ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Nasal Septum ◽  
Rare Complication ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Elderly Persons ◽  
First Case ◽  
Scalp Necrosis ◽  
Vessel Involvement

A 77-year-old-man with giant cell arteritis who developed bitemporal scalp ulcerations is described. Since 1946 when Cooke et al. reported the first case of scalp necrosis there were approximately 55 cases published. Scalp ulceration is a rare complication of giant cell arteritis and occurs mainly in elderly persons, particularly women. About half of all patients were presented to dermatologists. Most of the patients (70%) had other serious complications of giant cell arteritis: blindness, gangrene of the tongue and nasal septum necrosis. Seventy percent of the cases were confirmed by a temporal artery biopsy. The necrosis were of varying extent and uni- or bilateral. Although, in most cases necrosis has been located bilaterally as in the presented case. Scalp healing was complete nearly in all patients by conservative treatment within a year. Scalp ulceration is a potentially reversible complication of giant cell arteritis which indicates extensive vessel involvement and adequate coricosteroid therapy is required and essential.

Nivolumab-Associated Giant Cell Arteritis With Scalp Necrosis

2019 ◽  
Vol 155 (9) ◽  
pp. 1086 ◽  
Author(s):  
Alexander Kreuter ◽  
Bijan Koushk-Jalali ◽  
Antonino Cusenza ◽  
Frank Oellig ◽  
Christian Tigges
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Scalp Necrosis

Scalp necrosis in giant cell arteritis: Case report and review of the relevance of this cutaneous sign of large-vessel vasculitis

2009 ◽  
Vol 61 (4) ◽  
pp. 701-706 ◽  
Author(s):  
Athanasios Tsianakas ◽  
Jan M. Ehrchen ◽  
Dagmar Presser ◽  
Tobias Fischer ◽  
Birgit Kruse-Loesler ◽  
...  
Keyword(s):  
Case Report ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Scalp Necrosis

scholarly journals Evaluating the Incidence of Arteritic Ischemic Optic Neuropathy and Other Causes of Vision Loss from Giant Cell Arteritis

Ophthalmology ◽  
2016 ◽  
Vol 123 (9) ◽  
pp. 1999-2003 ◽  
Author(s):  
John J. Chen ◽  
Jacqueline A. Leavitt ◽  
Chengbo Fang ◽  
Cynthia S. Crowson ◽  
Eric L. Matteson ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
Ischemic Optic Neuropathy

scholarly journals Giant Cell Arteritis Presenting as Choroidal Infarction

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Nikolaos Kopsachilis ◽  
Maria Pefkianaki ◽  
Anca Marinescu ◽  
Sobha Sivaprasad
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss ◽  
Retinal Vessel ◽  
Interesting Case ◽  
Vessel Occlusion ◽  
Systemic Complications ◽  
Ocular Manifestations ◽  
Granulomatous Vasculitis ◽  
Choroidal Infarction

Background. Giant cell arteritis (GCA) is a systemic granulomatous vasculitis that affects large- and medium-sized arteries of the head and neck. Ocular manifestations of GCA usually are anterior ischaemic optic neuropathy (AION) or retinal vessel occlusion.Case Report. We report an interesting case of a 70-year-old man who presented with sudden vision loss and choroidal infarction in his left eye. Thorough clinical and paraclinical evaluation revealed an underlying GCA, the treatment of which prevented further vision loss and systemic complications.Conclusion. This is an unusual presentation of choroidal infarction associated with CGA and emphasizes the need of thorough systemic evaluation in patients with choroidal infarction.

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