Presentation and outcome of purpura fulminans associated with peripheral gangrene in 12 patients at Mayo Clinic - 19/08/11
, Katrina M. Dy, MD, Steven Nelson, BS
Reprint requests: Mark D. P. Davis, MD, Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.Abstract |
Background |
Dermatologists may be called to assist in the diagnosis and management of purpura fulminans.
Methods |
This retrospective case series details the clinical presentation and outcomes of patients presenting with purpura fulminans associated with peripheral gangrene between 1989 and 2004.
Results |
All 12 patients presented with sudden onset of purpuric patches and evolving gangrene of the extremities in association with a shock syndrome (hypotension, oliguria). Eleven patients had disseminated intravascular coagulation. The cause of purpura fulminans was infectious in 9 patients, surgical in two, and cancer in one. Three patients died (25%) within a week of onset of purpura fulminans. Of the 9 surviving patients, 8 required amputation of at least one limb. Four patients required amputation of all 4 limbs.
Limitations |
Retrospective study design, varying clinical descriptions, and potential referral bias are limitations.
Conclusion |
Purpura fulminans in association with symmetric peripheral gangrene is an ominous clinical presentation.
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| Mr Nelson is a visiting medical student from the University of Arizona, Phoenix. |
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| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 57 - N° 6
P. 944-956 - décembre 2007 Retour au numéro
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