Acute cutaneous necrosis: A guide to early diagnosis and treatment

Karen Karimi, Ashika Odhav, Ramya Kollipara, Jesse Fike, Carol Stanford, John C. Hall

Research output: Contribution to journalReview articlepeer-review

44 Scopus citations

Abstract

Acute cutaneous necrosis is characterised by a wide range of aetiologies and is associated with significant morbidity and mortality, warranting complex considerations in management. Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin. This review discusses major causes of cutaneous necrosis, examines the need for early assessment, and integrates techniques related to diagnosis and management. The literature, available via PubMed, on acute cutaneous necrotic syndromes was reviewed to summarise causes and synthesise appropriate treatment strategies to create a clinician's guide in the early diagnosis and management of acute cutaneous necrosis. Highlighted in this article are key features associated with common causes of acute cutaneous necrosis: warfarin-induced skin necrosis, heparin-induced skin necrosis, calciphylaxis, pyoderma gangrenosum, embolic phenomena, purpura fulminans, brown recluse spider bite, necrotising fasciitis, ecthyma gangrenosum, antiphospholipid syndrome, hypergammaglobulinemia, and cryoglobulinemia. This review serves to increase recognition of these serious pathologies and complications, allowing for prompt diagnosis and swift limb- or life-saving management.

Original languageEnglish (US)
Pages (from-to)425-437
Number of pages13
JournalJournal of Cutaneous Medicine and Surgery
Volume21
Issue number5
DOIs
StatePublished - Sep 2017
Externally publishedYes

Keywords

  • Acute cutaneous necrosis
  • Early
  • Management
  • Necrosis
  • Surgical debridement

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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