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.
AI Snips
Chapters
Transcript
Episode notes
Ischemia Spectrum
- Retiform purpura, a sign of complete blood vessel occlusion in the skin, is on a spectrum of ischemia.
- Livedo reticularis and livedo racemosa represent lesser degrees of ischemia.
Purpura Evaluation
- When evaluating purpura, consider both bleeding and ischemia as potential causes.
- For bleeding, assess vessel wall integrity, platelet function, clotting factors, and von Willebrand factor.
Warfarin's Advantage
- Warfarin seems more effective than DOACs like apixaban in treating APLS, though the reason is unclear.
- This observation adds to the diagnostic picture, favoring APLS in this case.