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October 1981

Temporal Arteritis With Scalp Necrosis

Author Affiliations

Oviedo, Spain

Arch Dermatol. 1981;117(10):604-605. doi:10.1001/archderm.1981.01650100004006

To the Editor.—  In the July 1980 Archives (116:749), Quintanilla and colleagues reported an unusual case of temporal arteritis with gangrene of the scalp.1 We want to elaborate on the histologic aspects of the skin lesions that are not frequently described.2

Report of a Case.—  Recently, we treated a patient with chronic, asymptomatic, lymphocytic leukemia in whom severe headaches and tender, indurated, and pulseless temporal arteries, followed by violet skin changes in both parietal regions, with cutaneous necrosis and crust formation (Fig 1), developed. The biopsy specimen of the temporal artery confirmed a typical pattern of temporal arteritis. Clinically, this patient's scalp lesions were similar to those previously reported in temporal arteritis.1 We performed a biopsy on one of these as well. Microscopically, thereFig 1.—Ulcerations with eschar formation on parietal region of scalp.Fig 2.—Arteriolar vasculitis in reticular dermis showing fibrinoid necrosis and inflammatory changes with

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