Table 1 Review of cases of Takayasu arteritis with pyoderma gangrenosum in the literature
From: Takayasu arteritis with pyoderma gangrenosum: case reports and literature review
Authors, country, year | Sex | Racial or ethnic group | Location of PG | Age at onset of the first manifestations, years | Therapy | Systemic symptoms | First vascular manifestation | Vascular involvement | Other complications | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
Systemic | Cutaneous | Vascular | |||||||||
Okamura et al. [6] Japan, 2017 | M | Japanese | First in left buccal region and then spread to cheek, trunk and lower legs | 33 | 37 | 33 | Betamethasone 1 g/d and tacrolimus 3 mg/d for TA, prednisolone 50 mg/d for PG | Fever | Left cervical pain followed by dizziness |  |  |
Vettiyil et al. [7], India, 2017 | F | Indian | Dorsum of left foot | 8 | 10 | 8 | Prednisolone (1 mg/kg/d) and mycophenolate mofetil for TA and PG |  | Pain andclaudication pain over legs and back with breathlessness on exertion | Dilation of the ascending aorta, the left common carotid artery, left subclavian, right subclavian and axillary were narrowed at the origin and proximal portion | Chronic recurrent multifocal osteomyelitis |
Loetscher et al. [3], Switzerland, 2016 | F | Caucasian | Lower extremities | No record | 42 | 43 | Prednisone 50 mg/d, cyclosporine, methotrexate |  |  | Proximal occlusion of the left subclavian artery, wall thickening of the aortic arch and the subclavian artery | Erythema nodosum |
Barrera-Vargas et al. [2], Mexico, 2015 | F | Mexican | First in lower limbs and then to head, neck, upper and lower extremities | 20 | 20 | 26 | Prednisone 1.5 mg/kg/d and thalidomide 200 mg/d for PG, three methylprednisolone pulses (1 g/d) and prednisone 1 mg/kg/d and methotrexate 15 mg/week for TA | Fever | Sudden amaurosis in left eye | Both the carotid and vertebral system, all the supra-aortic branches, right pulmonary artery | CT revealed a cystic lesion with an air-fluid level in the lower right pulmonary lobe |
Barrera-Vargas et al. [2], Mexican, 2015 | M | Mexican | Neck, trunk, upper and lower extremities | 25 | 17 | 26 | Prednisone and cyclosporine, and later thalidomide 200 mg/d, dapsone 100 mg/d, azathioprine 100 mg/d for PG. Prednisone 1 mg/kg/d, thalidomide 200 mg/d, dapsone 100 mg/d, azathioprine 100 mg/d for TA | No | Light-headedness and syncope | Aortic dilatation, narrowing thickening of the wall of the left carotid artery, and celiac trunk stenosis, as well as thickening at the origin of the superior mesenteric artery and left renal artery | Pulmonary nodules,histopathologic analysis showing granulomatous chronic inflammation with giant cells |
Futaki et al. [8], Japan, 2009 | F | Japanese | Neck, face and forearm | 28 | 28 | 29 | Prednisolone 30 mg/d | Intermittent fever, sore throat and cough |  | Pulmonary artery | TA without typical symptoms |
Minagawa et al. [9], Japan, 2009 | F | Japanese | Left lower leg | 21 | 16 | 21 | Tacrolimus for PG, prednisolone 25 mg/d for TA and necrotizing vasculitis | Episodic general fatigue and low-grade fever | Dysaesthesia in arms | Stenosis and thickened walls in the subclavian, left carotid and right renal arteries | Necrotizing vasculitis with lobular panniculitis in the deep dermis |
Ghosn et al. [10], Lebanon, 2008 | F | Lebanese | Face, trunk and extremities | 7 | 7 | 7 | Solumedrol 0.5 mg/kg/d, followed by infliximab 100 mg at weeks 0, 2, and 6 |  | Acute-onset right wrist drop | Marked aneurysmal dilatation of the ascending aorta with occlusion of the left and right subclavian arteries, in addition to a large aneurysmal pouch in the right axillary area compressing the nerve plexus | Diagnosed as RP for 5 years |
Aoussar et al. [11], France, 2007 | F | Caucasian | Forearm | No record | 21 | 23 | Prednisone | Â | Â | Â | Â |
Kanaemistu et al. [12], Japan, 2005 | F | Japanese | Neck, chest and arm | No record | 34 | 34 | Prednisolone and cyclosporine A, surgery | Â | Â | Aneurysm from the ascending aorta to the aortic arch | Thoracic aortic aneurysm |
Ujiie et al. [13], Japan, 2004 | F | Japanese | First limited to lower legs and then extended to buttocks, lower trunk, upper limbs and scalp | 21 | 29 | 21 | Prednisolone 20 mg/d for TA, prednisone 50 mg/d, cyclosporine 6 mg/kg/d | Hypertension and dizziness | Diminished arterial pulse intensity and bruits | Stenosis in the right subclavian, right vertebral and right carotid arteries and occlusions in the left subclavian and left carotid arteries |  |
Fearfield et al. [14], U.K., 1999 | F | Caucasian | Perineum, forearms and upper arms | 27 | 27 | 33 | Prednisone 150 mg/d, intravenous immunoglobulin, minocycline 200 mg/d, later methotrexate 7.5 mg/week and cyclosporine 5 mg/kg/d | Mild influenza- like symptoms, including general muscle aches | Heaviness in arms | Bilateral proximal subclavian artery occlusions with slight narrowing of the right vertebral artery origin |  |
Dagan et al. [15], Israel, 1995 | M | Israeli | Face and extremities | 4 | 9 months | 4 | Prednisone 2 mg/kg/d and dapsone 5 mg/kg for PG, high-dose prednisone and surgery for TA | Restless, tired and febrile | Absence of both radial pulses | Severe aneurysmatic dilation of the ascending aorta, severe stenosis of the left subclavian artery | Sterile osteomyelitis |
Fullerton et al. [16], 1991 | F | Saudi Arabian | Abdomen, followed by rapid spread to legs | No record | 28 | No record | Prednisone, cyclosporine | Â | Â | Â | Â |
Frances et al. [4], France, 1990 | F | Portuguese | Left arm | 32 | 32 | 33 | Prednisolone 0.5 mg/kg/d | Fever, arthralgia | Absence of left radial pulse | Supra-aortic arteries, abdominal aorta |  |
Perniciaro et al. [17], USA, 1987 | M | Â | Left popliteal area | 17.5 | 19 | 19 | Systemic corticosteroids | Intermittent fever | Â | Â | Â |
Case 1 | F | Chinese | Bilateral thighs and buttocks, upper extremities | 24 | 24 | 28 | Prednisolone 40 mg/d, cyclosporine 0.1 g/d, triptolide 60 mg/d | Fever | Dizziness, pulseless in both upper limbs | The right innominate artery (subclavian artery, common carotid artery) was completely obliterated, and the left common carotid artery was entirely occluded. The initial segment of the left vertebral artery had stenosis, and the left vertebral artery was enlarged |  |
Case 2 | F | Chinese | Both lower and upper extremities, left buccal region, face | No record | 17 | 24 | Methylprednisolone | Â | Left arm weakness and dizziness | The left carotid artery, left subclavian artery and bilateral femoral arteries, the superficial femoral arteries and left popliteal artery, the ascending aorta,aortic arch and its branches, descending aorta, abdominal aorta. The celiac stem and mesenteric artery were occluded, with multiple collateral circulation formation. The main hepatic artery and splenic artery | Â |