EDITORIAL What Have We Learned in the Past 20 Years? FIRST became interested in the subject of vascu- present study, there is not the same selection bias that litis in 1973 while caring for a previously healthy may be present in the Martinez-Taboada et al study. In 17-year-old boy who suddenly developed gen- the present study, a number of patients had systemic in- eralized palpable purpura and large areas of re- volvement and a small number even died presumably from I ticulated necrosis of his skin. Gastrointestinal their vasculitis. Therefore, patients with small-vessel cu- tract symptoms and signs predated the onset of his erup- taneous vasculitis should be considered to have a sys- tion, and several drugs had been administered simulta- temic disease with prominent cutaneous involvement, neously with the onset of the eruption. Examination of whether or not there is clinical evidence of involvement the gastrointestinal tract disclosed purpuric lesions simi- of internal organs. In all patients, a thorough evaluation lar to those observed on the skin. Hematuria and pro- should be performed to exclude the possibility of inter- teinuria were also present. A biopsy specimen of the skin nal involvement that might adversely affect prognosis. failed to
JAMA Dermatology – American Medical Association
Published: Mar 1, 1998
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