Keywords :
Case report, Digital gangrene, Raynaud's phenomenon, Systemic lupus erythematosus, Vasculitis
Citation Information :
Negi R, Vashist S, Mehta KI, Chauhan PS, Sharma A, Sharma R, Thakur P, Kukreja A. Digital Gangrene in Early Systemic Lupus Erythematosus: An Uncommon Presentation. Curr Trends Diagn Treat 2023; 7 (2):55-57.
Systemic lupus erythematosus (SLE) is a multisystem disorder presenting with a myriad of presentations including skin manifestations. However, digital gangrene, despite being sporadically reported in various populations, is a rare presentation, especially in relatively early disease and in absence of antiphospholipid syndrome (APS). A case of digital gangrene in a woman leading up to a diagnosis of SLE with multiorgan involvement in the absence of antiphospholipid syndrome is reported here. She was later diagnosed with SLE, lupus nephritis, skin vasculitis with Libman-Sacks endocarditis, and responded well to conservative therapy.
Werth V, Vera-Kellet C, Dutz J. Skin. In: Lahita R, Tsokos G, Buyon J, (Eds). Systemic lupus erythematosus, 5th edition. Oxford: Elsevier; 2011. p. 747.
Kurnia E, Hardi F, Dewiasty E. Digital gangrene in systemic lupus erythematosus. Acta Med Indones 2012;44(4):335–336. PMID: 23314976.
Sonkar SK, Kumar S, Atam V, et al. Digital dry gangrene as a primary manifestation of systemic lupus erythematosus. BMJ Case Rep 2019;12(12):e230869. DOI: 10.1136/bcr-2019-230869.
Adelowo O, Olaosebikan H, Ajani W, et al. Digital gangrene as the initial presentation of systemic lupus erythematosus. BMJ Case Rep 2012;2012: bcr2012006259. DOI: 10.1136/bcr-2012-006259.
Sharma A, Dhooria A, Aggarwal A, et al. Connective tissue disorder-associated vasculitis. Curr Rheumatol Rep 2016;18(6):1–10. DOI: 10.1007/s11926-016-0584-x.
Rajasekhar L, Jayachandran NV, Prabu VNN, et al. Comment on: Prevalence, serological features, response to treatment and outcome of critical peripheral ischaemia in a cohort of lupus patients. Rheumatology 2009;48(4):451–452. DOI: 10.1093/rheumatology/ken451.
Liu A, Zhang W, Tian X, et al. Prevalence, risk factors and outcome of digital gangrene in 2684 lupus patients. Lupus 2009;18(12):1112–1118. DOI: 10.1177/0961203309106643.
Jeffery RC, Narshi CB, Isenberg DA. Prevalence, serological features, response to treatment and outcome of critical peripheral ischaemia in a cohort of lupus patients. Rheumatology 2008;47(9):1379–1383. DOI: https://doi.org/10.1093/rheumatology/ken210.
Yang SG, Kim KH, Park KCP, et al. A case of systemic lupus erythematosus showing acute gangrenous change of fingertips. Br J Dermatol 1996;134(1):185–187. DOI: 10.1111/j.1365-2133.1996.tb07870.x.
Jindal BK, Martin MFR, Gayner A. Gangrene developing after minor surgery in a patient with undiagnosed systemic lupus erythematosus and lupus anticoagulant. Ann Rheum Dis 1983;42(3):347–349. DOI: 10.1136/ard.42.3.347.
Giuggioli D, Manfredi A, Lumetti F, et al. Scleroderma skin ulcers definition, classification and treatment strategies our experience and review of the literature Autoimmun Rev. 2018;17(2):155–164. DOI: 10.1016/j.autrev.2017.11.020.
Bhatt SP, Handa R, Gulati GS, et al. Peripheral vascular disease in systemic lupus erythematosus. Lupus 2007;16(9):720–723. DOI: 10.1177/0961203307081123.
Molnár K, Kovács L, Kiss M, et al. Antineutrophil cytoplasmic antibodies in patients with systemic lupus erythematosus. Clin Exp Dermatol 2002;27(1):59–61. DOI: 10.1046/j.0307-6938.2001.00964.x.
Edgar JDM, McMillan SA, Bruce IN, et al. An audit of ANCA in routine clinical practice. Postgrad Med J 1995;71(840):605–612. DOI: 10.1136/pgmj.71.840.605.
Salvi S, Chopra A. Leprosy in a rheumatology setting: A challenging mimic to expose. Clin Rheumatol 2013;32(10):1557–1563. DOI: 10.1007/s10067-013-2276-5.
