ABSTRACT
A 43-year-old, non-smoking man presented with acute ischemic lesions of his left hand. He had been taking beta-blockers for his arterial hypertension. The day before the occurrence of these acute lesions, he self medicated with a drug containing ergotamine and caffeine because of a headache. About one hour after mild trauma to the hand, he noticed intense cyanosis accompanied by severe pain in the fingers that progressed to digital necrosis. Hematological tests, hand radiography, echo Doppler, and nailfold videocapillaroscopy were performed. Digital necrosis owing to an unusual combination of ischemic mechanisms is assumed.
Subject(s)
Drug Therapy, Combination/adverse effects , Fingers/pathology , Hand Injuries/complications , Ischemia/chemically induced , Adrenergic beta-1 Receptor Antagonists/adverse effects , Adrenergic beta-1 Receptor Antagonists/therapeutic use , Adult , Analgesics, Non-Narcotic/adverse effects , Analgesics, Non-Narcotic/therapeutic use , Bisoprolol/adverse effects , Bisoprolol/therapeutic use , Caffeine/adverse effects , Caffeine/therapeutic use , Central Nervous System Stimulants/adverse effects , Central Nervous System Stimulants/therapeutic use , Ergotamine/adverse effects , Ergotamine/therapeutic use , Headache/drug therapy , Humans , Hypertension/drug therapy , Ischemia/complications , Male , Necrosis/etiology , Self Medication , Wounds, Nonpenetrating/complicationsABSTRACT
El síndrome anticuerpo antifosfolipido (SAF) constituye una enfermedad autoinmune que se caracteriza por presentar trombosis vascular y abortos recurrentes, asociada a la elevación persistente de anticuerpos antifosfolípidos séricos. Los eventos trombóticos pueden ocurrir tanto en las arterias y venas como en la microcirculación. Las manifestaciones clínicas dermatológicas más frecuentes son livedo reticularis, vasculitis livedoide y úlceras, entre otras. En este trabajo se actualizan los conceptos de su etiología y los criterios diagnósticos corregidos desde el año 2004. Además se plantea un algoritmo diagnóstico y las pautas de tratamiento actuales.
