The Clinical Problem Solvers
Episode 345: Schema Episode – Retiform Purpura
Jul 24, 2024
Sharmin, Jack, Maddy, and Youssef share their approach to retiform purpura in a lively discussion led by Andrew Sanchez. They cover diagnostic criteria and manifestations of antiphospholipid syndrome, exploring the effectiveness of warfarin versus direct oral anticoagulants, and analyzing complex dermatologic cases in clinical practice. The team delves into challenging cases, unexpected findings, and diagnostic tools in an engaging and informative manner.
38:22
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Quick takeaways
- Consider immune status, lesion characteristics, and systemic involvement in retiform purpura cases.
- Focus on antiphospholipid syndrome diagnosis through antibody testing, vascular events, and lupus anticoagulant assessments.
Deep dives
Aliquot 1: Dermatologic Evaluation and Skin Necrosis
A 60-year-old man with atrial fibrillation presented with a painful, erythematous rash on his chest showing central necrosis. The distribution was dermatomal, leading to considerations of immune status, lesion characteristics, and systemic involvement. Factors like necrosis, rapid progression, and systemic symptoms were assessed to identify potential causes like VZV, necrotizing fasciitis, or an underlying bleeding syndrome.
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