Cutaneous manifestations of ANCA-associated vasculitis and immunosuppressive therapy: cause-effect relationships (a case report)

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Abstract

Granulomatosis with polyangiitis, formerly known as Wegener’s granulomatosis, is an autoimmune ANCA-associated systemic vasculitis characterized by extensive damage to multiple organs and systems. Besides a typical clinical triad of ENT, lungs, and kidneys injury, various types of skin lesions can be found in 10–50% of cases. A severe course of the disease and low survival of patients often requires using aggressive treatment in a form of combined immunosuppressive therapy. On the one hand, it generally improves the prognosis, and on the other is itself associated with numerous complications. One of them is a secondary infection. Skin is the second most common localization of infection after the respiratory system. Preceding skin lesions caused by vasculitis may increase the risk of infection. Thus, patients with ANCA-associated vasculitis should be carefully observed for cutaneous manifestation, both before and during the immunosuppressive therapy.

About the authors

Madina A. Kitova

Municipal Out-Patient Department No 93

Email: madina8141@mail.ru

rheumatologist, Municipal out-patient department №93

Russian Federation, Saint Petersburg

Maksim V. Maksimov

Pavlov University

Email: bolec@sampo.ru

PhD (Medicine), associate professor, Hospital Therapy Department

 

Russian Federation, Saint Petersburg

Valeriy N. Marchenko

Pavlov University

Email: marchvn@mail.ru
ORCID iD: 0000-0002-2440-7222
SPIN-code: 1711-4150
Scopus Author ID: 57206419660

PhD (Medicine), Professor, Hospital Therapy Department

Russian Federation, Saint Petersburg

Elena A. Bruchkus

Pavlov University

Email: bruklen@listl.ru

Head of the Second Cardiology Department, Scientific Research Institute of Rheumatology and Allergology of the Scientific and Clinical Research Center

Russian Federation, Saint Petersburg

Denis A. Davydov

Pavlov University

Author for correspondence.
Email: davydov.rheum@gmail.com
ORCID iD: 0000-0002-5524-1616
SPIN-code: 1132-5294
Scopus Author ID: 57217159189

resident, Hospital Therapy Department

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Crusted ulcerative defects of the left shin

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3. Fig. 2. Weeping ulcer in the left inframammary fold

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4. Fig. 3. Fibrin-covered ulcer in the sacral region

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5. Fig. 4. Ulcer with detritus behind the left ear

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Copyright (c) 2020 Kitova M.A., Maksimov M.V., Marchenko V.N., Bruchkus E.A., Davydov D.A.

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