Malignant atrophic papulosis with motor aphasia and intestinal perforation: A case report and review of published works

J Dermatol. 2018 Jun;45(6):723-726. doi: 10.1111/1346-8138.14280. Epub 2018 Mar 8.

Abstract

Malignant atrophic papulosis (MAP) is a rare type of obliterating vasculopathy that can present as pure cutaneous lesions or a systemic entity affecting multiple organs. Systemic disease, such as gastrointestinal or central nervous system involvement, may predispose the patients to poorer or even fatal outcomes. We present a 30-year-old female patient with systemic manifestation of MAP 10 days after delivery of a full-term pregnancy who subsequently developed motor aphasia and intestinal perforation. The patient was administrated empirical treatment with an antiplatelet, anticoagulant, methylprednisolone sodium succinate and alprostadil. Antibiotics were administrated due to intestinal perforation and secondary sepsis. Despite all treatment, the patient died a week later. We summarized all the previous reports of MAP based on thorough review of previous published work. Overall, this is the first patient with MAP combined with motor aphasia and intestinal perforation and may provide insights for future studies on the treatment of this disease.

Keywords: case report; intestinal perforation; malignant atrophic papulosis; motor aphasia; review of published work.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Alprostadil / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Aphasia, Broca / diagnostic imaging
  • Aphasia, Broca / drug therapy
  • Aphasia, Broca / etiology*
  • Fatal Outcome
  • Female
  • Humans
  • Intestinal Perforation / drug therapy
  • Intestinal Perforation / etiology*
  • Magnetic Resonance Angiography
  • Malignant Atrophic Papulosis / complications*
  • Malignant Atrophic Papulosis / drug therapy
  • Malignant Atrophic Papulosis / pathology
  • Neuroprotective Agents / therapeutic use
  • Platelet Aggregation Inhibitors / therapeutic use
  • Sepsis / drug therapy
  • Sepsis / etiology*
  • Skin / pathology

Substances

  • Anti-Bacterial Agents
  • Anticoagulants
  • Neuroprotective Agents
  • Platelet Aggregation Inhibitors
  • Alprostadil