Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder in which autoantibodies are produced against a variety of phospholipids and phospholipid-binding proteins. The purpose of this article is to review cutaneous findings in patients with APS diagnosis. An overview regarding prevalence, description, pathogenesis and histopathology, are described for cutaneous manifestations of APS.
Baker WF, Jr. and Bick RL. The clinical spectrum of antiphospholipid syndrome. Hematol Oncol Clin North Am 2008; 22: 33–52, v–vi.
2.
Pinto-AlmeidaTCaetanoMSanchesMSeloresM.Cutaneous manifestations of antiphospholipid syndrome: a review of the clinical features, diagnosis and management. Acta Reumatol Port2013;
38: 10–18.
3.
CanaudGBienaiméFTabarinF, et al.
Inhibition of the mTORC pathway in the antiphospholipid syndrome. N Engl J Med2014;
371: 303–312.
4.
GibsonGESuWPDPittelkowMR.Antiphospholipid syndrome and the skin. J Am Acad Dermatol1997;
36: 970–982.
5.
TektonidouMGAndreoliLLimperM, et al.
EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis2019;
78: 1296–1304.
6.
ArachchillageDRJLaffanM.Pathogenesis and management of antiphospholipid syndrome. Br J Haematol2017;
178: 181–195.
7.
BickRL.Antiphospholipid thrombosis syndromes. Hematol Oncol Clin North Am2003;
17: 115–147.
8.
BlumeJEMillerCC.Antiphospholipid syndrome: a review and update for the dermatologist. Cutis2006;
78: 409–415.
9.
RaiRSekarCSKumaresanM.Antiphospholipid syndrome in dermatology: an update. Indian J Dermatol Venereol Leprol2010;
76: 116–124.
10.
MiyakisSLockshinMDAtsumiT, et al.
International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome. J Thromb Haemost2006;
4: 295–306.
11.
Gómez-PuertaJACerveraR.Diagnosis and classification of the antiphospholipid syndrome. J Autoimmun2014;
48–49: 20–25.
12.
BranchDWPietteJBreyR, et al.
International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum1999;
42: 1309–1311.
13.
CerveraRTektonidouMGEspinosaG, et al.
Task force on catastrophic antiphospholipid syndrome (APS) and non-criteria APS manifestations (II): thrombocytopenia and skin manifestations. Lupus2011;
20: 174–181.
14.
LallyLSammaritanoLR.Vasculitis in antiphospholipid syndrome. Rheum Dis Clin North Am2015;
41: 109–123.
15.
CuadradoMJHughesGR.Hughes (antiphospholipid).Rheum Dis Clin North Am2001;
27: 507–524.
16.
WeinsteinSPietteW.Cutaneous manifestations of antiphospholipid antibody syndrome. Hematol Oncol Clin North Am2008;
22: 67–77.
17.
AbreuMMDanowskiAWahlDG, et al.
The relevance of “non-criteria” clinical manifestations of antiphospholipid syndrome : 14th international congress on antiphospholipid antibodies technical task force report on antiphospholipid syndrome clinical features. Autoimmun Rev2015;
14: 401–414.
18.
ToubiEShoenfeldY.Livedo reticularis as a criterion for antiphospholipid syndrome. Clin Rev Allerg Immunol2007;
32: 138–144.
19.
UthmanIWKhamashtaMA.Livedo racemosa: a striking dermatological sign for the antiphospholipid syndrome. J Rheumatol2006;
33: 2379–2382.
20.
FrancèsCNiangSLaffitteELe PelletierFCostedoatNPietteJC.Dermatologic manifestations of the antiphospholipid syndrome: Two hundred consecutive cases. Arthritis Rheum2005;
52: 1785–1793.
21.
GrobJJMarcoMSAlllaudMFAndracLGabrielBMercierC.Unfading acral microlivedo. J Am Acad Dermatol1991; 24: 53–58.
22.
GibbsMBIiiJCEZirwasMJ.Livedo reticularis: an update. J Am Acad Dermatol2005;
52: 1009–1019.
23.
SangleSRD’CruzDP.Livedo reticularis: an enigma. Isr Med Assoc J2015;
17: 104–107.
24.
AclandKMDarvayAWakelinSHRussell-JonesR.Livedoid vasculitis: a manifestation of the antiphospholipid syndrome?Br J Dermatol1999;
140: 131–135.
25.
RestrepoJP.Vasculopatía livedoide debida a síndrome antifosfolípido livedoid vasculopathy due to antiphospholipid syndrome. Rev Colomb Reumatol2011;
18: 311–316.
26.
SoBJParkJBYooMGKimISonSW.Successful treatment of livedoid vasculitis with primary antiphospholipid syndrome by using aspirin and low dose warfarin combination therapy. Ann Dermatol2015;
27: 614–615.
27.
CerveraRPietteJ-CFontJ, Euro-Phospholipid Project Groupet al.
Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum2002;
46: 1019–1027.
28.
FrancesC.Dermatological manifestations of Hughes antiphospholipid antibody syndrome. Lupus2010;
19: 1071–1077.
29.
WangKRossNASaediN.Anetoderma treated with combined 595-nm pulsed-dye laser and 1550-nm non-ablative fractionated laser. J Cosmet Laser Ther2016;
18: 38–40.
30.
HodakEFeuermanHMoladYMonseliseYDavidM.Primary anetoderma: a cutaneous sign of antiphospholipid antibodies. Lupus2003;
12: 564–568.
31.
ChoSJungJYLeeJH.Treatment of anetoderma occurring after resolution of Stevens-Johnson syndrome using an ablative 10,600-nm carbon dioxide fractional laser. Dermatol Surg2012;
38: 677–679.
32.
Fernández-PérezERGrabscheidEScheinfeldNS.A case of systemic malignant atrophic papulosis (Köhlmeier-Degos’ disease). J Natl Med Assoc2005;
97: 421–425.
33.
GonzalezMEKahnPPriceHNKaminoHSchafferJV.Retiform purpura and digital gangrene secondary to antiphospholipid syndrome successfully treated with sildenafil. Arch Dermatol2011;
147: 164–167.
34.
CromeCRRajagopalanSKuhanGFluckN.Antiphospholipid syndrome presenting with acute digital ischaemia, avascular necrosis of the femoral head and superior mesenteric artery thrombus. BMJ Case Rep2012;
2012: bcr2012006731.
35.
HaiAAslamMAshrafTH.Symmetrical peripheral gangrene : a rare presentation of antiphospholipid syndrome. Intern Emerg Med2012;
7: 71–73.
36.
Vargas-HitosJASabioJMNavarrete-NavarreteNZamora-PasadasMJiménez-AlonsoJ.Severe digital necrosis as the clinical onset of antiphospholipid syndrome. Intern Emerg Med2016;
11: 761–762.
37.
KawakamiTSomaYMizoguchiM.Initial cutaneous manifestations associated with histopathological leukocytoclastic vasculitis in two patients with antiphospholipid antibody syndrome. J Dermatol2005;
32: 1032–1037.
38.
CreamerDHuntBJBlackMM.Widespread cutaneous necrosis occurring in association with the antiphospholipid syndrome: a report of two cases. Br J Dermatol2000;
142: 1199–1203.
39.
FrancèsCPietteJCSaadaV, et al.
Multiple subungual splinter hemorrhages in the antiphospholipid syndrome: a report of five cases and review of the literature. Lupus1994;
3: 123–128.
40.
WangJZBeroukhimKChenYCTartarDFungMBrassardA.Tumid lupus erythematosus–like pseudovasculitic lesions in catastrophic antiphospholipid syndrome. JAAD Case Rep2019;
5: 198–200.
41.
ErkanDLockshinMD.Non-criteria manifestations of antiphospholipid syndrome. Lupus2010;
19: 424–427.
42.
DoriaA.The antiphospholipid antibody syndrome: diagnosis, skin manifestations and current therapy. Clin Exp Rheumatol2006;
24: S46–S51.
43.
NayerAOrtegaLM.Catastrophic antiphospholipid syndrome: a clinical review journal of nephropathology. J Nephropathol2014;
3: 9–17.
