Presentation
We hereby describe a case of 45 year old female presenting with pitting pedal edema, multiple ulcers over bilateral lower limbs with irregular margins with erythema and hyperpigmentation of the surrounding skin. [ncbi.nlm.nih.gov]
Entire Body System
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Lymphadenopathy
There was no palpable thrill or bruit, no clinical evidence of varicose veins and no significant lymphadenopathy. All the peripheral pulsations were well felt. Systemic examination was within normal limits. [ncbi.nlm.nih.gov]
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Swelling
CASE REPORT A Forty five-year-old previously healthy female presented with complaints of swelling and pain in bilateral feet for eight years and history of recurrent episodes of multiple nodules over bilateral legs and feet, which burst to form ulcers [ncbi.nlm.nih.gov]
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Gangrene
There were some small ulcers on the left leg laterally and chronic inflammation in the left first interdigital cleft but no evidence of critical ischaemia or gangrene. [ejves.com]
Cardiovascular
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Vascular Disease
(Vascular Diseases: Various forms of Vasculitis) Visit: Dermpath- India ; Image Link1 ; Image Link2 [histopathology-india.net]
Skin
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Purpura
Stasis dermatitis - (unlike stasis dermatitis, acroangiodermatitis is usually associated with minimal epidermal changes and eosinophils in the inflammatory infiltrate in the dermis ) ; Pigmented purpura ; vasculitis. [histopathology-india.net]
The purpura do not generally present fibrosis and eosinophiles. In vasculitis, the differential histological diagnosis is simplified by the presence of vascular fibrinoid necrosis. [scielo.br]
[…] malformation of the lower leg with multiple AV shunts), Mali type (an exaggerated stasis dermatitis seen in elderly patients, which is usually bilateral associated with chronic venous insufficiency), Acroangiodermatitis in first pregnancy presenting as gravity purpura [ncbi.nlm.nih.gov]
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Papule
Patients present with itchy, painful, confluent, violaceous or brown-black macules, papules or plaques usually at the distal lower limbs. There may be ulceration and bleeding. [en.wikipedia.org]
Clinical presentation: The lesion presents as circumscribed violaceous, brown or dusky macules, papules, plaques and nodules. [histopathology-india.net]
[…] and plaques on the edematous skin.[7] It presents clinically as acroangiodermatitis characterized by multiple papules, nodules and plaques, sharply defined reddish-brown, sometimes in bizarre configurations, generally localized on the dorsal aspect of [ncbi.nlm.nih.gov]
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Hyperpigmentation
Multiple irregular ulcers with surrounding hyperpigmentation and multiple scars present over lateral aspect of left foot and lower leg Single superficial ulcer over medial malleolus of right foot in healing stage with surrounding hyperpigmentation Proliferation [ncbi.nlm.nih.gov]
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Foot Ulcer
View Large Image Figure Viewer Download Hi-res image Download (PPT) Conclusion Acroangiodermatitis is a rare, benign condition associated with chronic venous insufficiency and may progress to foot ulcers. [ejves.com]
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Hyperkeratosis
Other features : Hyperkeratosis of overlying epidermis ; extravasated red blood cells, hemosiderin and variable infiltrate of lymphocytes around vascular proliferation. [histopathology-india.net]
Workup
Colonoscopy
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Multiple Ulcerations
We hereby describe a case of 45 year old female presenting with pitting pedal edema, multiple ulcers over bilateral lower limbs with irregular margins with erythema and hyperpigmentation of the surrounding skin. [ncbi.nlm.nih.gov]
Other Pathologies
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Lymphocytic Infiltrate
Moderate amount of hemosiderin deposits were seen around these vessels with perivascular lymphocytic infiltrate and mucin [Figure 2]. [ncbi.nlm.nih.gov]
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Fibrinoid Necrosis
In vasculitis, the differential histological diagnosis is simplified by the presence of vascular fibrinoid necrosis. [scielo.br]
Treatment
It resembles Kaposi's sarcoma histologically but appears to respond to a combination of surgical treatment of the venous hypertension and medical treatment with erythromycin. [ejves.com]
This case report underlines that any vascular malformation may take an uncertain turn and needs an attentive follow-up with adequate treatment. Read this article (multiple options) Trending Papers [read.qxmd.com]
The ulcers showed a good response within 2 months of treatment. Keywords: Acroangiodermatitis of Mali, chronic venous insufficiency, pseudo-Kaposi′s sarcoma How to cite this article: Mehta AA, Pereira RR, Nayak CS, Dhurat RS. [ijdvl.com]
[…] of this condition has not been discussed in detail in the previous literature available, mainstay of treatment being the correction of the underlying pathology. [ncbi.nlm.nih.gov]
Prognosis
Rüdlinger8 performed a meticulous study on the subject, demonstrating the similarities of the syndromes of Mali and of Stewart-Bluefarb with Kaposi's sarcoma, however they concluded that they were different above all in relation to the prognosis and proposed [scielo.br]
Prevention
Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive [jamanetwork.com]
The lesions were associated pain and edema and they prevented him from standing for a long time. Dermatologic examination revealed hypertrophic, violaceous plaques around the left ankle spreading to the proximal part of the knee. [escholarship.org]