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Dopamine-Associated Symmetric Peripheral Gangrene

Dopamine-Associated Symmetric Peripheral Gangrene Abstract Symmetric peripheral gangrene (SPG) presents acutely as symmetric acral necrosis without large vessel obstruction or vasculitis.1 While relatively rare, this syndrome has been well described in the critical care literature, mainly in the context of septic shock, disseminated intravascular coagulation (DIC), and as an uncommon presentation of purpura fulminans. Vasopressors have been implicated directly or as a contributory cause in many cases.1 Dermatologists often receive referrals from the intensive care unit, frequently for the evaluation of purpura or necrosis in the setting of septic shock and DIC.2 We present 2 cases of dopamine hydrochloride— associated SPG seen over the course of 9 months. Report of Cases. Case 1. A 65-year-old white man with recurrent metastatic transitional cell carcinoma of the bladder presented with vomiting, diarrhea, and a 7.6-kg weight loss. He had received chemotherapy consisting of cisplatin, sodium methotrexate, and vincristine sulfate prior to admission. References 1. Johansen K, Murphy T, Pavlin E, et al. Digital ischemia complicating pneumococcal sepsis: reversal with sympathetic blockade . Crit Care Med. 1991; 19:114-116.Crossref 2. Falanga V, Schachner LA, Rae V, et al. Dermatologic consultations in the hospital setting . Arch Dermatol. 1994;130:1022-1025.Crossref 3. Holzer J, Karliner JS, O'Rourke RA, Pitt W, Ross J Jr. Effectiveness of dopamine in patients with cardiogenic shock . Am J Cardiol. 1973;32:79-84.Crossref 4. Winkler MJ, Trunkey DD. Dopamine gangrene association with disseminated intravascular coagulation . Am J Surg. 1981;142:588-591.Crossref 5. Hayes LA, Yau EHS, Hinds CJ, Watson JD. Symmetrical peripheral gangrene: association with noradrenaline administration . Intensive Care Med. 1992;18: 433-436.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Dopamine-Associated Symmetric Peripheral Gangrene

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References (5)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1997.03890380121027
Publisher site
See Article on Publisher Site

Abstract

Abstract Symmetric peripheral gangrene (SPG) presents acutely as symmetric acral necrosis without large vessel obstruction or vasculitis.1 While relatively rare, this syndrome has been well described in the critical care literature, mainly in the context of septic shock, disseminated intravascular coagulation (DIC), and as an uncommon presentation of purpura fulminans. Vasopressors have been implicated directly or as a contributory cause in many cases.1 Dermatologists often receive referrals from the intensive care unit, frequently for the evaluation of purpura or necrosis in the setting of septic shock and DIC.2 We present 2 cases of dopamine hydrochloride— associated SPG seen over the course of 9 months. Report of Cases. Case 1. A 65-year-old white man with recurrent metastatic transitional cell carcinoma of the bladder presented with vomiting, diarrhea, and a 7.6-kg weight loss. He had received chemotherapy consisting of cisplatin, sodium methotrexate, and vincristine sulfate prior to admission. References 1. Johansen K, Murphy T, Pavlin E, et al. Digital ischemia complicating pneumococcal sepsis: reversal with sympathetic blockade . Crit Care Med. 1991; 19:114-116.Crossref 2. Falanga V, Schachner LA, Rae V, et al. Dermatologic consultations in the hospital setting . Arch Dermatol. 1994;130:1022-1025.Crossref 3. Holzer J, Karliner JS, O'Rourke RA, Pitt W, Ross J Jr. Effectiveness of dopamine in patients with cardiogenic shock . Am J Cardiol. 1973;32:79-84.Crossref 4. Winkler MJ, Trunkey DD. Dopamine gangrene association with disseminated intravascular coagulation . Am J Surg. 1981;142:588-591.Crossref 5. Hayes LA, Yau EHS, Hinds CJ, Watson JD. Symmetrical peripheral gangrene: association with noradrenaline administration . Intensive Care Med. 1992;18: 433-436.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Feb 1, 1997

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