Papulosis Atrophicans Maligna – Clinical Case with Review in the Literature

    M. Kadurina, V. Mateeva, A. Shishkova, Z. Tsvetanova, A. Jordanova
    Department of Dermatovenereology and Allergology – Military Medical Academy, Sofia

    Papulosis atrophicans maligna is an uncommon thrombo-occlusive vasculopathy that involve small calibre vessels predominantly of the skin, gastrointestinal tract and central nervous system.There are two clinical forms of the disease: with affecting only the skin – benign form and with affecting the skin and other internal organs and systems – malignant form.
    We present here a case of 47 year old woman with reddish papules with central depression and necrosis surrounding violaceous rim that were distributed over the chests, trunk and lower extremities. There is association with acute abdominal pain and persistent fever. Histology showed typical wedge-shaped necrosis; narrowed vessels in the pappilar dermis with endothelial proliferation and occlusion by thrombus. The diagnosis of papulosis atrophicans maligna was made based on the history of the patient,classsical skin lesions and typical histopathology picture. Our patient was put on anticoagulant and antiagregant therapy and show significant improvement of the dermatologic status. This is the third clinical case report published in the Bulgarian scientific literature.

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