Vol 6, No 3 (2020)
Review paper
Published online: 2020-09-30
Get Citation

Takayasu arteritis — clinical presentation, diagnosis and treatment

Magdalena Żychowska1
·
Forum Dermatologicum 2020;6(3):82-86.
Affiliations
  1. Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University

paid access

Vol 6, No 3 (2020)
REVIEW ARTICLES
Published online: 2020-09-30

Abstract

Systemic vasculitis is a heterogeneous group of diseases of a not fully understood etiology. The common feature is the development of immune-mediated inflammation in the vessel walls, which can lead to the weakening of the wall and formation of aneurysms or occlusion of the lumen, resulting in tissue ischemia. Skin lesions may be present in many conditions of this group. In small and medium vessel vasculitis, the skin may be directly affected by the pathological process. On the other hand, in large vessel vasculitis dermatological symptoms develop secondarily to the involvement of larger vessels. Clinical manifestations, diagnosis and treatment of Takayasu arteritis (TA), classified according to the International Chapel Hill Consensus Conference from 2012 in the group of large vessel vasculitis, are discussed in this article. The aim of the paper is to draw attention to the cutaneous lesions that may raise suspicion of systemic vasculitis. In patients with TA, Raynaud’s phenomenon (especially unilateral), finger necrosis, digital clubbing, erythema nodosum-like lesions or pyoderma gangrenosum-like lesions, erythema induratum, purpuric or necrotic eruptions, livedo reticularis and superficial phlebitis may be observed.

Abstract

Systemic vasculitis is a heterogeneous group of diseases of a not fully understood etiology. The common feature is the development of immune-mediated inflammation in the vessel walls, which can lead to the weakening of the wall and formation of aneurysms or occlusion of the lumen, resulting in tissue ischemia. Skin lesions may be present in many conditions of this group. In small and medium vessel vasculitis, the skin may be directly affected by the pathological process. On the other hand, in large vessel vasculitis dermatological symptoms develop secondarily to the involvement of larger vessels. Clinical manifestations, diagnosis and treatment of Takayasu arteritis (TA), classified according to the International Chapel Hill Consensus Conference from 2012 in the group of large vessel vasculitis, are discussed in this article. The aim of the paper is to draw attention to the cutaneous lesions that may raise suspicion of systemic vasculitis. In patients with TA, Raynaud’s phenomenon (especially unilateral), finger necrosis, digital clubbing, erythema nodosum-like lesions or pyoderma gangrenosum-like lesions, erythema induratum, purpuric or necrotic eruptions, livedo reticularis and superficial phlebitis may be observed.

Get Citation

Keywords

systemic vasculitis; Takayasu arteritis; Raynaud phenomenon

About this article
Title

Takayasu arteritis — clinical presentation, diagnosis and treatment

Journal

Forum Dermatologicum

Issue

Vol 6, No 3 (2020)

Article type

Review paper

Pages

82-86

Published online

2020-09-30

Page views

550

Article views/downloads

27

DOI

10.5603/FD.2020.0014

Bibliographic record

Forum Dermatologicum 2020;6(3):82-86.

Keywords

systemic vasculitis
Takayasu arteritis
Raynaud phenomenon

Authors

Magdalena Żychowska

References (21)
  1. Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2012; 65(1): 1–11.
  2. Carlson JA, Ng BT, Chen KR. Cutaneous vasculitis update: diagnostic criteria, classification, epidemiology, etiology, pathogenesis, evaluation and prognosis. Am J Dermatopathol. 2005; 27(6): 504–528.
  3. Chen KR, Carlson JA. Clinical approach to cutaneous vasculitis. Am J Clin Dermatol. 2008; 9(2): 71–92.
  4. Russo RAG, Katsicas MM. Takayasu arteritis. Front Pediatr. 2018; 6: 265.
  5. Zaldivar Villon MLF, de la Rocha JA, Espinoza LR. Takayasu arteritis: recent developments. Curr Rheumatol Rep. 2019; 21(9): 45.
  6. Terao C. Revisited HLA and non-HLA genetics of Takayasu arteritis — where are we? J Hum Genet. 2016; 61(1): 27–32.
  7. Yoshida M, Kimura A, Katsuragi K, et al. DNA typing of HLA-B gene in Takayasu's arteritis. Tissue Antigens. 1993; 42(2): 87–90.
  8. Pedreira AL, Santiago MB. Association between Takayasu arteritis and latent or active Mycobacterium tuberculosis infection: a systematic review. Clin Rheumatol. 2020; 39(4): 1019–1026.
  9. Inder S, Bobryshev Y, Cherian S, et al. Accumulation of lymphocytes, dendritic cells, and granulocytes in the aortic wall affected by Takayasu's disease. Angiology. 2016; 51(7): 565–579.
  10. Hata A, Noda M, Moriwaki R, et al. Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol. 1996; 54 Suppl: S155–S163.
  11. Vaideeswar P, Deshpande JR. Pathology of Takayasu arteritis: A brief review. Ann Pediatr Cardiol. 2013; 6(1): 52–58.
  12. Misra DP, Chaurasia S, Misra R. Increased circulating th17 cells, serum IL-17A, and IL-23 in Takayasu arteritis. Autoimmune Dis. 2016; 2016: 7841718.
  13. Soto ME, Espinola N, Flores-Suarez LF, et al. Takayasu arteritis: clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis. Clin Exp Rheumatol. 2008; 26(3 Suppl 49): S9–15.
  14. Mason JC. Takayasu arteritis — advances in diagnosis and management. Nat Rev Rheumatol. 2010; 6(7): 406–415.
  15. Kwon OhC, Lee SW, Park YB, et al. Extravascular manifestations of Takayasu arteritis: focusing on the features shared with spondyloarthritis. Arthritis Res Ther. 2018; 20(1): 142.
  16. Chasset F, Francès C. Cutaneous manifestations of medium- and large-vessel vasculitis. Clin Rev Allergy Immunol. 2017; 53(3): 452–468.
  17. Dourmishev AL, Serafimova DK, Vassileva SG, et al. Segmental ulcerative vasculitis: a cutaneous manifestation of Takayasu's arteritis. Int Wound J. 2005; 2(4): 340–345.
  18. Aeschlimann FA, Grosse-Wortmann L, Benseler S, et al. Arterial disseaction in childhood Takayasu Arteritis: not as rare as though. Pediatr Rheumatol Online J. 2016; 14: 56.
  19. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990; 33(8): 1129–1134.
  20. Dejaco C, Ramiro S, Duftner C, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018; 77(5): 636–643.
  21. Mukhtyar C, Guillevin L, Cid MC, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2009; 68(3): 318–323.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
phone: +48 58 320 94 94, fax: +48 58 320 94 60, e-mail: viamedica@viamedica.pl