Clinical and laboratory prognosticators of atrophic papulosis (Degos disease): a systematic review

Orphanet Journal of Rare Diseases

Rebecca Levy¹  Lee Shapiro²  David Croitoru³  Muskaan Sachdeva⁴  Orli M. Silverberg⁴  Justin D. Lu⁵ 

[1] Department of Dermatology, The Hospital for Sick Children, Toronto, ON, Canada;Department of Pediatrics, University of Toronto, Toronto, ON, Canada;Department of Medicine, Division of Rheumatology, Albany Medical College, Albany, NY, USA;Division of Dermatology, Department of Medicine, Women’s College Hospital, 76 Grenville St, 3rd Floor, M5S 1B2, Toronto, ON, Canada;Faculty of Medicine, University of Toronto, Toronto, ON, Canada;Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada;

关键词: Degos disease;    Malignant atrophic papulosis;    Benign atrophic papulosis;    Inflammatory cytokines;   

DOI  :  10.1186/s13023-021-01819-z

来源: Springer

【 摘 要 】

BackgroundDegos disease is a rare vascular disorder with a cutaneous-limited form, benign atrophic papulosis (BAP), and a systemic variant, malignant atrophic papulosis (MAP). Despite the poor prognosis of MAP, no study has established features associated with systemic disease.ObjectivesThe aims of this systematic review were to: (1) summarize clinical features and treatments implemented for patients with MAP and BAP (2) identify clinical and laboratory factors associated with the development of MAP, compared to BAP.MethodsWe systematically searched MEDLINE and Embase from inception to April 2020. Demographic and clinical features of Degos patients were presented descriptively; multivariable logistic regression was performed to identify associations with MAP.ResultsWe identified 99 case studies, comprising 105 patients. MAP (64%) had a 2.15 year median survival time from cutaneous onset, most often with gastrointestinal or central nervous system involvement. We found that elevations in either of erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) were associated with systemic involvement (OR 2.27, p = 0.023). Degos secondary to an autoimmune connective tissue disease was found to be inversely associated with MAP (OR 0.08, p = 0.048).ConclusionsElevated ESR or CRP is associated with MAP and may be a predictor of systemic involvement for patients with Degos disease. In addition, secondary Degos disease is associated with a favourable prognosis. Clinicians should be aware of the differences between primary and secondary Degos and the utility of ESR or CRP in identifying disease evolution to systemic involvement. The utility of ESR and CRP to identify systemic involvement should be further explored.

【 授权许可】

CC BY