TdC 328: Caso clínico de Necrose de extremidades

João Mendes e Amyr Chacar discutem um caso de necrose de extremidades apresentado pela Eduarda Guedes.Referências:1. McMahan ZH, Wigley FM. Raynaud's phenomenon and digital ischemia: a practical approach to risk stratification, diagnosis and management. Int J Clin Rheumtol. 2010;5(3):355-370. doi: 10.2217/ijr.10.17.2. Abdul Gafoor SM, Gelson Thomas A, Boissiere J, Roberts L, Bernal W, Creamer D. Purpura fulminans: a dermatological emergency revisited. Clin Exp Dermatol. 2026 Jan 27;51(2):212-219. doi: 10.1093/ced/llaf3733. Warkentin TE. Ischemic Limb Gangrene with Pulses. N Engl J Med. 2015 Aug 13;373(7):642-55. doi: 10.1056/NEJMra13162594. Bendapudi PK, Losman JA. How I diagnose and treat acute infection-associated purpura fulminans. Blood. 2025 Mar 27;145(13):1358-1368. doi: 10.1182/blood.2024025078. PMID: 39786416.5. Long B, Koyfman A, Gottlieb M. Complications in the adult asplenic patient: a review for the emergency clinician. Am J Emerg Med. 2021 Jun;44:452-457. doi: 10.1016/j.ajem.2020.03.049. Epub 2020 Mar 26.  6. Caroline I Reckart, Elizabeth A Aguilera, Audrey Wanger, Rafael Bravo-Santos, Rodrigo Hasbun, P-118. Does Antibiotic Therapy Affect Multiplex PCR Results in Community-Acquired Bacterial Meningitis?, Open Forum Infectious Diseases, Volume 13, Issue Supplement_1, January 2026, ofaf695.346, https://doi.org/10.1093/ofid/ofaf695.3467. Hirschmann JV, Raugi GJ. Blue (or purple) toe syndrome. J Am Acad Dermatol. 2009 Jan;60(1):1-20. doi: 10.1016/j.jaad.2008.09.0388. Holl-Ulrich K, Rose C. Kutane Vaskulitis und Vaskulopathie : Differenzialdiagnosen an der unteren Extremität [Cutaneous vasculitis and vasculopathy : Differential diagnosis in biopsies of the lower extremities]. Pathologe. 2020 Jul;41(4):355-363. German. doi: 10.1007/s00292-020-00786-99. Llamas-Velasco, Mar MD*; Alegría, Victoria MD†; Santos-Briz, Ángel MD‡; Cerroni, Lorenzo MD§; Kutzner, Heinz MD¶; Requena, Luis MD‖. Occlusive Nonvasculitic Vasculopathy. The American Journal of Dermatopathology 39(9):p 637-662, September 2017. | DOI: 10.1097/DAD.000000000000076610. Zeineddine L, Gomez-Manjarres D. Examining the differential of digital ischaemia and review of paraneoplastic ischaemia. BMJ Case Rep. 2023 Apr 13;16(4):e255165. doi: 10.1136/bcr-2023-25516511. Lavoie MA, Milot A. A 58-year-old man with subacute digital ischemia of all limbs. CMAJ. 2024 Sep 23;196(31):E1076-E1082. doi: 10.1503/cmaj.231733.12. Brown PJ, Zirwas MJ, English JC 3rd. The purple digit: an algorithmic approach to diagnosis. Am J Clin Dermatol. 2010;11(2):103-16. doi: 10.2165/11530180-000000000-0000013. Titan AL, Chang J, Megerle K, Murray P, Hammert W. State of the art review: The management of chronic vascular disorders in the hand and upper limb. J Hand Surg Eur Vol. 2023 Apr;48(4):295-302. doi: 10.1177/17531934221145498. 14. Tartari F, Di Altobrando A, Merli Y, Patrizi A, Mirelli M, Bianchi T. Blue Toe Syndrome: A Challenging Diagnosis. Indian J Dermatol. 2019 Nov-Dec;64(6):506-507. doi: 10.4103/ijd.IJD_580_18. 15. Zhou L, Li H, Luo G; CANF experts group representing the Chinese Burn Association; Editorial Board of the Chinese Journal of Burns and Wounds; Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare. Consensus on the Diagnosis and Treatment of Adult Necrotizing Fasciitis (2025 Edition). Burns Trauma. 2025 Jun 12;13:tkaf031. doi: 10.1093/burnst/tkaf031.