Document Detail

Presentation and outcome of purpura fulminans associated with peripheral gangrene in 12 patients at Mayo Clinic.
MedLine Citation:
PMID:  17719676     Owner:  NLM     Status:  MEDLINE    
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.
Mark D P Davis; Katrina M Dy; Steven Nelson
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Publication Detail:
Type:  Case Reports; In Vitro; Journal Article; Review     Date:  2007-08-24
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  57     ISSN:  1097-6787     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-20     Completed Date:  2007-12-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  944-56     Citation Subset:  IM    
Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Aged, 80 and over
Child, Preschool
Disseminated Intravascular Coagulation / etiology
Fatal Outcome
Gangrene / etiology*
Middle Aged
Purpura, Schoenlein-Henoch / complications*,  diagnosis,  therapy
Retrospective Studies

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