Pigmente Purpurik Dermatoz Hastalarında Klinik-Epidemiyolojik Özellikler ve Venöz Yetmezlik Sıklığının İncelenmesi
Öz
Amaç: Pigmente purpurik dermatozların (PPD) klinik ve epidemiyolojik özelliklerini tanımlamak ve hastalığın venöz yetmezlik ile olası ilişkisini
araştırmaktır.
Gereç ve Yöntem: Ocak 2010 ile Eylül 2022 tarihleri arasında Sağlık Bilimleri Üniversitesi, İstanbul Eğitim ve Araştırma Hastanesi dermatoloji
polikliniklerine başvuran, histopatolojik olarak PPD tanısı konmuş tüm hastaların dosyaları retrospektif olarak taranarak; klinik, demografik ve
radyolojik özellikleri kaydedildi.
Bulgular: Çalışmaya 111’i kadın (%57) toplam 195 PPD hastası dahil edilmiş olup, hastaların ortalama yaşı 44,25±19,99 idi. Ortalama hastalık
süresi 15,4±24,1 aydı. En sık tespit edilen hastalık subtipi Schamberg hastalığı (%66) iken bunu sırası ile Majocchi hastalığı (%16), liken aureus
(%8), Gougerot-Blum’un likenoid pigmente purpurik dermatiti, (%7) ve Doucas ve Kapetanakis’in egzama benzeri purpurası (%2) izledi. Hastaların
neredeyse tamamında (%99) alt ekstremitede lezyon bulunurken, yalnızca 26 (%13) hastada bel üstü vücut bölgelerinde lezyon tespit edildi.
Lezyonların dağılımı 167 (%87) hastada bilateraldi. Alt ekstremite venöz Doppler ultrasonografi incelemesi 101 hastada yapılmış olup, bunların
24’ünde (%23,8) venöz yetmezlik tespit edildi. Venöz yetmezlik tespit edilen ve edilmeyen hastalar arasında yaş, cinsiyet, hastalık süresi açısından
istatistiksel olarak anlamlı fark bulunmadı. Venöz yetmezlik lateralitesi ile lezyon dağılımların lateralitesi arasında korelasyon bulunmadı.
Sonuç: Genel popülasyonda venöz yetmezlik prevalansının %7-30 arasında değişen sıklıkla bildirildiği göz önüne alındığında, bizim çalışmamızda
önceki çalışmalardan farklı olarak PPD hastalarında venöz yetmezlik görülme sıklığının topluma göre artmış olmadığı düşünülmüştür.
Anahtar Kelimeler: Venöz yetmezlik, pigmente purpurik dermatoz, doppler ultrasonografi, pigmentasyon bozuklukları
Anahtar Kelimeler
Venöz yetmezlik pigmente purpurik dermatoz doppler ultrasonografi pigmentasyon bozuklukları
Etik Beyan
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Destekleyen Kurum
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Proje Numarası
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Teşekkür
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Kaynakça
- 1. Kim DH, Seo SH, Ahn HH, et al. Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis. Ann Dermatol. 2015;27:404-410.
- 2. Martínez Pallás I, Conejero Del Mazo R, Lezcano Biosca V. Pigmented Purpuric Dermatosis: A Review of the Literature. Actas Dermosifiliogr (Engl Ed). 2020;111:196-204.
- 3. Coulombe J, Jean SE, Hatami A, et al. Pigmented purpuric dermatosis: clinicopathologic characterization in a pediatric series. Pediatr Dermatol. 2015;32:358-362.
- 4. Spigariolo CB, Giacalone S, Nazzaro G. Pigmented Purpuric Dermatoses: A Complete Narrative Review. J Clin Med. 2021;10:2283.
- 5. Sharma L, Gupta S. Clinicoepidemiological study of pigmented purpuric dermatoses. Indian Dermatol Online J. 2012;3:17-20.
- 6. Sardana K, Sarkar R, Sehgal VN. Pigmented purpuric dermatoses: an overview. Int J Dermatol. 2004;43:482-488.
- 7. Ratnam KV, Su WP, Peters MS. Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases. J Am Acad Dermatol. 1991;25:642-647.
- 8. Kaplan R, Meehan SA, Leger M. A case of isotretinoin-induced purpura annularis telangiectodes of Majocchi and review of substance-induced pigmented purpuric dermatosis. JAMA Dermatol. 2014;150:182-184.
- 9. Torchia D. Segmental manifestation: a clue to explain the nature of pigmented purpuric dermatoses. Australas J Dermatol. 2011;52:235.
- 10. Ghersetich I, Lotti T, Bacci S, et al. Cell infiltrate in progressive pigmented purpura (Schamberg’s disease): immunophenotype, adhesion receptors, and intercellular relationships. Int J Dermatol. 1995;34:846-850.
- 11. Burrows NP, Jones RR. Cell adhesion molecule expression in capillaritis. J Am Acad Dermatol. 1994;31:826.
- 12. Parsi K, Kim B, O’Connor AA, et al. Chronic venous disease, platelet and haemostatic abnormalities contribute to the pathogenesis of pigmented purpuric dermatoses. Phlebology. 2022;37:348-360.
- 13. Kim HJ, Lee GW, Son JW, et al. Venous Insufficiency is a Clear Provoker of Pigmented Purpuric Dermatosis. Ann Dermatol. 2022;34:34-39.
- 14. Gönül M, Külcü Çakmak S, Ozcan N, et al. Clinical and laboratory findings of pigmented purpuric dermatoses. Ann Dermatol. 2014;26:610-614.
- 15. Cho JH, Lee JD, Kang H, et al. The clinical manifestations and etiologic factors of patients with pigmented purpuric dermatoses. Korean Journal of Dermatology. 2005;43:45-52.
- 16. Gupta G, Mushtaq S, Dogra D, et al. A Cross-Sectional Study of Clinicoetiological Profile and Associated Comorbidities in Indian Patients of Pigmented Purpuric Dermatoses. Indian J Dermatol. 2020;65:187-192.
- 17. Kim KE, Moon HR, Ryu HJ. Dermoscopic Findings and the Clinicopathologic Correlation of Pigmented Purpuric Dermatosis: A Retrospective Review of 60 Cases. Ann Dermatol. 2021;33:214-221.
- 18. Burghaus J, Enk A, Toberer F. Purpura annularis telangiectodes : Case report and review of the literature. Hautarzt. 2021;72:65-70.
- 19. Evans CJ, Fowkes FG, Ruckley CV, et al. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53:149-153.
- 20. Ruckley CV, Evans CJ, Allan PL, et al. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg. 2002;36:520-525.
- 21. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130:333-346.
- 22. Cross-cultural adaptation, reliability and validity of the Turkish version of the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20). Springerplus. 2016;5:381.
Clinicoepidemiologic Characteristics and Prevalence of Venous Insufficiency in Patients with Pigmented Purpuric Dermatosis
Öz
Objectives: To describe clinic-epidemiological characteristics of pigmented purpuric dermatosis (PPD) and to assess the potential relationship between venous insufficiency and PPD.
Materials and Methods: We retrospectively reviewed the medical records of all patients diagnosed with PPD at University of Health Sciences Türkiye, İstanbul Training and Research Hospital dermatology clinics between January 2010 and September 2022. Clinical, demographic, and radiological characteristics were examined.
Results: The study included a total of 195 PPD patients, of whom 111 were female (57%). The mean age of the patients was 44.25±19.99 years, and the average disease duration was 15.4±24.1 months. The most common subtype of the disease was Schamberg’s disease (66%), followed by Majocchi’s disease (16%), lichen aureus (8%), pigmented purpuric lichenoid dermatitis of Gougerot-Blum (7%), and eczematid-like purpura of Doucas and Kapetanakis (2%). Almost all patients (99%) had lesions on their lower extremities, while only 26 (13%) had lesions on the upper body. Lesion distribution was bilateral in 167 (87%) of the cases. Venous Doppler ultrasonography was performed in 101 patients, with venous insufficiency detected in 24 (23.8%) of them. There were no statistically significant differences in terms of age, gender, and disease duration between patients with and without venous insufficiency. There was no correlation between the laterality of venous insufficiency and the laterality
of lesion distribution.
Conclusion: Considering venous insufficiency is reported to affect 7% to 30% of the general population, our study implies that its occurrence in PPD patients may not be higher than in the general population, contrary to prior research.
Key Words: Venous insufficiency, pigmented purpuric eruption, doppler ultrasonography, pigmentation disorders
Anahtar Kelimeler
Venous insufficiency pigmented purpuric eruption doppler ultrasonography pigmentation disorders
Etik Beyan
The study protocol was approved by the University of Health Sciences Türkiye, İstanbul Training and Research Hospital Institutional Review Board (IRB no: 2011-KAEK-50-369).
Destekleyen Kurum
-
Proje Numarası
-
Teşekkür
-
Kaynakça
- 1. Kim DH, Seo SH, Ahn HH, et al. Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis. Ann Dermatol. 2015;27:404-410.
- 2. Martínez Pallás I, Conejero Del Mazo R, Lezcano Biosca V. Pigmented Purpuric Dermatosis: A Review of the Literature. Actas Dermosifiliogr (Engl Ed). 2020;111:196-204.
- 3. Coulombe J, Jean SE, Hatami A, et al. Pigmented purpuric dermatosis: clinicopathologic characterization in a pediatric series. Pediatr Dermatol. 2015;32:358-362.
- 4. Spigariolo CB, Giacalone S, Nazzaro G. Pigmented Purpuric Dermatoses: A Complete Narrative Review. J Clin Med. 2021;10:2283.
- 5. Sharma L, Gupta S. Clinicoepidemiological study of pigmented purpuric dermatoses. Indian Dermatol Online J. 2012;3:17-20.
- 6. Sardana K, Sarkar R, Sehgal VN. Pigmented purpuric dermatoses: an overview. Int J Dermatol. 2004;43:482-488.
- 7. Ratnam KV, Su WP, Peters MS. Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases. J Am Acad Dermatol. 1991;25:642-647.
- 8. Kaplan R, Meehan SA, Leger M. A case of isotretinoin-induced purpura annularis telangiectodes of Majocchi and review of substance-induced pigmented purpuric dermatosis. JAMA Dermatol. 2014;150:182-184.
- 9. Torchia D. Segmental manifestation: a clue to explain the nature of pigmented purpuric dermatoses. Australas J Dermatol. 2011;52:235.
- 10. Ghersetich I, Lotti T, Bacci S, et al. Cell infiltrate in progressive pigmented purpura (Schamberg’s disease): immunophenotype, adhesion receptors, and intercellular relationships. Int J Dermatol. 1995;34:846-850.
- 11. Burrows NP, Jones RR. Cell adhesion molecule expression in capillaritis. J Am Acad Dermatol. 1994;31:826.
- 12. Parsi K, Kim B, O’Connor AA, et al. Chronic venous disease, platelet and haemostatic abnormalities contribute to the pathogenesis of pigmented purpuric dermatoses. Phlebology. 2022;37:348-360.
- 13. Kim HJ, Lee GW, Son JW, et al. Venous Insufficiency is a Clear Provoker of Pigmented Purpuric Dermatosis. Ann Dermatol. 2022;34:34-39.
- 14. Gönül M, Külcü Çakmak S, Ozcan N, et al. Clinical and laboratory findings of pigmented purpuric dermatoses. Ann Dermatol. 2014;26:610-614.
- 15. Cho JH, Lee JD, Kang H, et al. The clinical manifestations and etiologic factors of patients with pigmented purpuric dermatoses. Korean Journal of Dermatology. 2005;43:45-52.
- 16. Gupta G, Mushtaq S, Dogra D, et al. A Cross-Sectional Study of Clinicoetiological Profile and Associated Comorbidities in Indian Patients of Pigmented Purpuric Dermatoses. Indian J Dermatol. 2020;65:187-192.
- 17. Kim KE, Moon HR, Ryu HJ. Dermoscopic Findings and the Clinicopathologic Correlation of Pigmented Purpuric Dermatosis: A Retrospective Review of 60 Cases. Ann Dermatol. 2021;33:214-221.
- 18. Burghaus J, Enk A, Toberer F. Purpura annularis telangiectodes : Case report and review of the literature. Hautarzt. 2021;72:65-70.
- 19. Evans CJ, Fowkes FG, Ruckley CV, et al. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53:149-153.
- 20. Ruckley CV, Evans CJ, Allan PL, et al. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg. 2002;36:520-525.
- 21. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130:333-346.
- 22. Cross-cultural adaptation, reliability and validity of the Turkish version of the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20). Springerplus. 2016;5:381.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Dermatoloji |
| Bölüm | Makaleler |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 28 Mart 2024 |
| Gönderilme Tarihi | 2 Kasım 2023 |
| Kabul Tarihi | 28 Kasım 2023 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 77 Sayı: 1 |
