D-Dimer Levels as a Marker of Cutaneous Disease Activity: Case Reports of Cutaneous Polyarteritis Nodosa and Atypical Recurrent Urticaria | Allergy and Clinical Immunology | JAMA Dermatology | JAMA Network
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Case Report/Case Series
August 2014

D-Dimer Levels as a Marker of Cutaneous Disease Activity: Case Reports of Cutaneous Polyarteritis Nodosa and Atypical Recurrent Urticaria

Author Affiliations
  • 1Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
  • 2Vancouver Coastal Health, Vancouver General Hospital, Vancouver, British Columbia, Canada
  • 3Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  • 4Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
JAMA Dermatol. 2014;150(8):880-884. doi:10.1001/jamadermatol.2013.9944
Abstract

Importance  Biochemical markers of disease allow clinicians to monitor disease severity, progression, and response to treatment. C-reactive protein and erythrocyte sedimentation rate are commonly used biochemical markers of inflammatory disease. We present 2 cases that indicate that D-dimer levels may be useful as a potential biochemical marker of disease activity in certain cutaneous inflammatory conditions.

Observations  We report 2 cases in which clinical disease activity correlates with D-dimer levels. The first case is a woman in her 50s with a diagnosis of cutaneous polyarteritis nodosa. The second case is a man in his 20s with recurrent urticaria. In both patients, plasma D-dimer levels increased with clinical evidence of disease activity and decreased with treatment and resolution of the disease flare. Interestingly, serum C-reactive protein levels did not correlate with disease activity and were found to be normal during clinically active disease.

Conclusions and Relevance  We show the potential value of D-dimer measurements as a marker of vasculocentric and/or vasculopathic inflammation and suggest that vascular endothelial damage may be ongoing in certain cutaneous inflammatory conditions.

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