Cutaneous Manifestations of Granulomatosis with Polyangiitis: A Case Series Study
Trinidad Montero-Vilchez, Antonio Martinez-Lopez, Luis Salvador-Rodriguez, Maria del Carmen Ramírez-Barberena, Jesus Tercedor-Sanchez, Alejandro Molina-Leyva, Salvador Arias-Santiago
The aim of this study was to determine the prevalence and type of cutaneous manifestations which occur in patients with granulomatosis with polyangiitis and to explore the potential association between cutaneous and systemic involvement in these patients. A retrospective case series study was designed, including all granulomatosis with polyangiitis cases diagnosed between 2010 and 2018 at the Hospital Universitario Virgen de las Nieves. Thirty-nine patients with granulomatosis with polyangiitis were identified, of which 53.85% presented cutaneous manifestations. In decreasing order of frequency, the types of cutaneous problems observed included: palpable purpura, mucocutaneous ulcers, subcutaneous nodules, pyoderma gangrenosum-like ulcers, digital necrosis, papulonecrotic lesions and livedo reticularis. Patients with palpable purpura presented a higher frequency of renal involvement (p = 0.008). Cutaneous manifestations of granulomatosis with polyangiitis may facilitate early disease diagnosis. Likewise, a manifestation such as palpable purpura may be a predictor of kidney damage.
A specific skin finding has not previously been linked to the presence of systemic involvement in granulomatosis with polyangiitis. We studied 39 patients diagnosed with granulomatosis with polyangiitis, 53.85% cases presented cutaneous manifestations. We observed several types of cutaneous problems: palpable purpura, mucocutaneous ulcers, subcutaneous nodules, pyoderma gangrenosum-like ulcers, digital necrosis, papulonecrotic lesions and livedo reticularis. Moreover, we found that patients with palpable purpura presented a higher frequency of renal involvement. In that way, cutaneous manifestations of granulomatosis with polyangiitis may facilitate an early diagnosis and a specific skin finding, the palpable purpura, could be a predictor of kidney damage.